State of Slim – by Dr. James Hill & Dr. Holly Wyatt
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The premise of this book is “people in Colorado are on average the slimmest in the US”, and sets about establishing why, and then doing what Coloradans are doing. As per the subtitle (drop 20 pounds in 8 weeks), this is a weight loss book and does assume that you want to lose weight—specifically, to lose fat. So if that’s not your goal, you can skip this one already.
The authors explain, as many diet and not-diet-but-diet-adjacent book authors do, that this is not a diet—and then do refer to it as the Colorado Diet throughout. So… Is it a diet?
The answer is a clear “yes, but”—and the caveat is “yes, but also some associated lifestyle practices”.
The diet component is basically a very low-carb diet to start with (with the day’s ration of carbs being a small amount of oats and whatever you can get from some non-starchy vegetables such as greens, tomatoes, etc), and then reintroducing more carbohydrate centric foods one by one, stopping after whole grains. If you are vegan or vegetarian, you can also skip this one already, because this advises eating six animal protein centric meals per day.
The non-diet components are very general healthy-living advices mixed in with popular “diet culture” advices, such as practice mindful eating, don’t eat after 8pm, exercise more, use small plates, enjoy yourself, pre-portion your snacks, don’t drink your calories, get 8 hours sleep, weigh all your food, etc.
Bottom line: this is a very mixed bag, even to the point of being a little chaotic. It gives sometimes contradictory advice, and/but this results in a very “something for everyone” cafeteria approach to dieting. The best recommendation we can give for this book is “it has very many ideas for you to try and see if they work for you”.
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Black Cohosh vs The Menopause
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Black Cohosh, By Any Other Name…
Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.
Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
Does it work?
In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:
❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.
However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:
❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.
Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.
As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.
With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞
~ Dr. Castelo-Branco et al., 2020
(iCR = isopropanolic Cimicifuga racemosa)
So, is this estrogenic or not?
This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:
❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞
Source: Is Black Cohosh Estrogenic?
(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)
The short answer: no, black cohosh is not estrogenic
Is it safe?
As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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The Evidence-Based Skincare That Beats Product-Specific Hype
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A million videos on YouTube will try to sell you a 17-step skincare routine, or a 1-ingredient magical fix that’s messy and inconvenient enough you’ll do it once and then discard it. This one takes a simple, scientific approach instead.
The Basics That Count
Ali Abdaal, known for his productivity hacks channel, enlisted the help of his friend, dermatologist Dr. Usama Syed, who recommends the following 3–4 things:
- Moisturize twice per day. Skin acts as a barrier, locking in moisture and protecting against irritants. Moisturizers replenish fats and proteins, maintaining this barrier and preventing dry, inflamed, and itchy skin. He uses CeraVe, but if you have one you know works well with your skin, stick with that, because skin comes in many varieties and yours might not be like his.
- Use sunscreen every day. Your phone’s weather app should comment on your local UV index. If it’s “moderate” or above, then sunscreen is a must—even if you aren’t someone who burns easily at all, the critical thing here is avoiding UV radiation causing DNA mutations in skin cells, leading to wrinkles, dark spots, and potentially skin cancer. Use a broad-spectrum sunscreen, ideally SPF 50.
- Use a retinoid. Retinoids are vitamin A-based and offer anti-aging benefits by promoting collagen growth, reducing pigmentation, and accelerating skin cell regeneration. Retinols are weaker, over-the-counter options, while stronger retinoids may require a prescription. Start gently with low dosage, whatever you choose, as initially they can cause dryness or sensitivity, before making everything better. He recommends adapalene as a starter retinoid (such as Differen gel, to give an example brand name).
- Optional: use a cleanser. Cleansers remove oils and dirt that water alone can’t. He recommends using a hydrating cleanser, to avoid stripping natural healthy oils as well as unwanted ones. That said, a cleanser is probably only beneficial if your skin tends towards the oily end of the dry-to-oily spectrum.
For more on all of these, plus an example routine, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
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Which gut drugs might end up in a lawsuit? Are there really links with cancer and kidney disease? Should I stop taking them?
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Common medicines used to treat conditions including heartburn, reflux, indigestion and stomach ulcers may be the subject of a class action lawsuit in Australia.
Lawyers are exploring whether long-term use of these over-the-counter and prescription drugs are linked to stomach cancer or kidney disease.
The potential class action follows the settlement of a related multi-million dollar lawsuit in the United States. Last year, international pharmaceutical company AstraZeneca settled for US$425 million (A$637 million) after patients made the case that two of its drugs caused significant and potentially life-threatening side effects.
Specifically, patients claimed the company’s drugs Nexium (esomeprazole) and Prilosec (omeprazole) increased the risk of kidney damage.
Doucefleur/Shutterstock Which drugs are involved in Australia?
The class of drugs we’re talking about are “proton pump inhibitors” (sometimes called PPIs). In the case of the Australian potential class action, lawyers are investigating:
- Nexium (esomeprazole)
- Losec, Asimax (omeprazole)
- Somac (pantoprazole)
- Pariet (rabeprazole)
- Zoton (lansoprazole).
Depending on their strength and quantity, these medicines are available over-the-counter in pharmacies or by prescription.
They have been available in Australia for more than 20 years and are in the top ten medicines dispensed through the Pharmaceutical Benefits Scheme.
They are used to treat conditions exacerbated by stomach acid. These include heartburn, gastric reflux and indigestion. They work by blocking the protein responsible for pumping acid into the stomach.
These drugs are also prescribed with antibiotics to treat the bacterium Helicobacter pylori, which causes stomach ulcers and stomach cancer.
This class of drugs is also used with antibiotics to treat Helicobacter pylori infections. nobeastsofierce/Shutterstock What do we know about the risks?
Appropriate use of proton pump inhibitors plays an important role in treating several serious digestive problems. Like all medicines, there are risks associated with their use depending on how much and how long they are used.
When proton pump inhibitors are used appropriately for the short-term treatment of stomach problems, they are generally well tolerated, safe and effective.
Their risks are mostly associated with long-term use (using them for more than a year) due to the negative effects from having reduced levels of stomach acid. In elderly people, these include an increased risk of gut and respiratory tract infections, nutrient deficiencies and fractures. Long-term use of these drugs in elderly people has also been associated with an increased risk of dementia.
In children, there is an increased risk of serious infection associated with using these drugs, regardless of how long they are used.
How about the cancer and kidney risk?
Currently, the Australian consumer medicine information sheets that come with the medicines, like this one for esomeprazole, do not list stomach cancer or kidney injury as a risk associated with using proton pump inhibitors.
So what does the evidence say about the risk?
Over the past few years, there have been large studies based on observing people in the general population who have used proton pump inhibitors. These studies have found people who take them are almost two times more likely to develop stomach cancer and 1.7 times more likely to develop chronic kidney disease when compared with people who are not taking them.
In particular, these studies report that users of the drugs lansoprazole and pantoprazole have about a three to four times higher risk than non-users of developing chronic kidney disease.
While these observational studies show a link between using the drugs and these outcomes, we cannot say from this evidence that one causes the other.
Researchers have not yet shown these drugs cause kidney disease. crystal light/Shutterstock What can I do if I’m worried?
Several digestive conditions, especially reflux and heartburn, may benefit from simple dietary and lifestyle changes. But the overall evidence for these is not strong and how well they work varies between individuals.
But it may help to avoid large meals within two to three hours before bed, and reduce your intake of fatty food, alcohol and coffee. Eating slowly and getting your weight down if you are overweight may also help your symptoms.
There are also medications other than proton pump inhibitors that can be used for heartburn, reflux and stomach ulcers.
These include over-the-counter antacids (such as Gaviscon and Mylanta), which work by neutralising the acidic environment of the stomach.
Alternatives for prescription drugs include nizatidine and famotidine. These work by blocking histamine receptors in the stomach, which decreases stomach acid production.
If you are concerned about your use of proton pump inhibitors it is important to speak with your doctor or pharmacist before you stop using them. That’s because when you have been using them for a while, stopping them may result in increased or “rebound” acid production.
Nial Wheate, Professor and Director – Academic Excellence, Macquarie University; Joanna Harnett, Senior Lecturer – Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, and Wai-Jo Jocelin Chan, Pharmacist and Associate Lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Lyme Disease At-A-Glance
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Good info as always…was wondering if you have any recommendations for fighting Lyme disease naturally along wDr advice? Dr’s aren’t real keen on alternatives so always interested. Thanks❞
That depends on whether we’re looking at prevention or cure!
Prevention:
- Try not to get bitten by Lyme-disease-carrying ticks. Boots and long socks are your friends. As are long-gauntletted gloves for gardening.
- If you are in a high-risk area and/or engage in high-risk activities, check your body daily.
- This is because it usually takes 36–48 hours of being attached for a tick to cause an infection
- Obviously best if you can get a partner or close friend to help you with this, unless you have mastered some advanced pretzel positions of yoga.
- Contrary to many folk remedies, the safest way to remove a tick is with tweezers (carefully!).
- If you find and remove a tick, or otherwise suspect you have developed symptoms, go to your doctor immediately (not next week; today; time really counts for this).
Cure:
- No. Sorry. Regretfully, antibiotics are the only known effective treatment.
However! As with almost any kind of recovery, getting good rest, including good quality sleep, will hasten things. Also sensible is reducing stress if possible, and anything that could worsen inflammation.
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Almonds vs Cashews – Which is Healthier?
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Our Verdict
When comparing almonds to cashews, we picked the almonds.
Why?
Both are great! But here’s why we picked the almonds:
In terms of macros, almonds have a little more protein and more than 4x the fiber. Given how critical fiber is to good health, and how most people in industrialized countries in general (and N. America in particular) aren’t getting enough, we consider this a major win for almonds.
Things are closer to even for vitamins, but almonds have a slight edge. Almonds are higher in vitamins A, B2, B3, B9, and especially 27x higher in vitamin E, while cashews are higher in vitamins B1, B5, B6, C & K. So, a moderate win for almonds.
In the category of minerals, cashews do a bit better on average. Cashews have moderately more copper, iron, phosphorus, selenium, and zinc, while almonds boast 6x more calcium, and slightly more manganese and potassium. We say this one’s a slight win for cashews.
Adding the categories up, however, makes it clear that almonds win the day.
However, of course, enjoy both! Diversity is healthy. Just, if you’re going to choose between them, we recommend almonds.
Want to learn more?
You might like to read:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Almonds vs Walnuts – Which is Healthier?
- Pistachios vs Cashews – Which is Healthier?
- Why You Should Diversify Your Nuts!
- What Matters Most For Your Heart?
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One in twenty people has no sense of smell – here’s how they might get it back
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During the pandemic, a lost sense of smell was quickly identified as one of the key symptoms of COVID. Nearly four years later, one in five people in the UK is living with a decreased or distorted sense of smell, and one in twenty have anosmia – the total loss of the ability to perceive any odours at all. Smell training is one of the few treatment options for recovering a lost sense of smell – but can we make it more effective?
Smell training is a therapy that is recommended by experts for recovering a lost sense of smell. It is a simple process that involves sniffing a set of different odours – usually essential oils, or herbs and spices – every day.
The olfactory system has a unique ability to regenerate sensory neurons (nerve cells). So, just like physiotherapy where exercise helps to restore movement and function following an injury, repeated exposure to odours helps to recover the sense of smell following an infection, or other cause of smell loss (for example, traumatic head injury).
Several studies have demonstrated the effectiveness of smell training under laboratory conditions. But recent findings have suggested that the real-world results might be disappointing.
One reason for this is that smell training is a long-term therapy. It can take months before patients detect anything, and some people may not get any benefit at all.
In one study, researchers found that after three months of smell training, participation dropped to 88%, and further declined to 56% after six months. The reason given was that these people did not feel as though they noticed any improvement in their ability to smell.
Cross-modal associations
To remedy this, researchers are now investigating how smell training can be improved. One interesting idea is that information from our other senses, or “cross-modal associations”, can be applied to smell training to promote odour perception and improve the results.
Cross-modal associations are described as the tendency for sensory cues from different sensory systems to be matched. For example, brightness tends to be associated with loudness. Pitch is related to size. Colours are linked to temperature, and softness is matched with round shapes, while spiky shapes feel more rough. In previous studies, these associations have been shown to have a considerable influence on how sensory information is processed. Especially when it comes to olfaction.
Recent research has shown that the sense of smell is influenced by a combination of different sensory inputs – not just odours. Sensory cues such as colour, shape, and pitch are believed to play a role in the ability to correctly identify and name odours, and can influence perceptions of odour pleasantness and intensity.
In one study, participants were asked to complete a test that measured their ability to discriminate between different odours while they were presented with the colour red or yellow, an outline drawing of a strawberry or a lemon, or a combination of these colours and shapes. The results suggested that corresponding odour and colour associations (for example, the colour red and strawberry) were linked to increased olfactory performance compared with odours and colours that were not associated (for example, the colour yellow and strawberry).
People who associated strawberries with the colour red performed better on smell tests. GCapture/Shutterstock While projects focusing on harnessing these cross-modal associations to improve treatments for smell loss are underway, research has already started to deliver some promising results.
In a recent study that aimed to investigate whether the effects of smell training could be improved with the addition of cross-modal associations, participants watched a guidance video containing sounds that matched the odours that they were training with. The results suggest that cross-modal interactions plus smell training improved olfactory function compared to smell training alone.
The results reported in recent studies have been promising and offer new insights into the field of olfactory science. It is hoped that this will soon lead to the development of more effective treatment options for smell recovery.
In the meantime, smell training is one of the best things you can do for a lost sense of smell, so patients are encouraged to stick with it so that they give themselves the best chance at recovery.
Emily Spencer, PhD Candidate, Olfaction, Edinburgh Napier University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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