Superfood-Stuffed Squash

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This stuffed squash recipe is packed with so many nutrient-dense ingredients, yet it feels delightfully decadent—a great recipe to have up your sleeve ready for fall.

You will need

  • 1 large or two medium butternut squashes, halved lengthways and seeds removed (keep them; they are full of nutrients! You can sprout them, or dry them to use them at your leisure), along with some of the flesh from the central part above where the seeds are, so that there is room for stuffing
  • 2 cups low-sodium vegetable stock
  • 1 cup wild rice, rinsed
  • 1 medium onion, finely chopped
  • ½ cup walnuts, roughly chopped
  • ½ cup dried cranberries goji berries ← why goji berries? They have even more healthful properties than cranberries, and cranberries are hard to buy without so much added sugar that the ingredients list looks like “cranberries (51%), sugar (39%), vegetable oil (10%)”, whereas when buying goji berries, the ingredients list says “goji berries”, and they do the same culinary job.
  • ¼ cup pine nuts
  • ½ bulb garlic, minced
  • 1 tbsp dried thyme or 2 tsp fresh thyme, destalked
  • 1 tbsp dried rosemary or 2 tsp fresh rosemary, destalked
  • 1 generous handful fresh parsley, chopped
  • 1 tbsp chia seeds
  • 1 tbsp nutritional yeast
  • 1 tbsp black pepper, coarse ground
  • ½ tsp MSG or 1 tsp low-sodium salt
  • Extra virgin olive oil, for brushing and frying
  • Aged balsamic vinegar, to serve (failing this, make a balsamic vinegar reduction and use that; it should have a thicker texture but still taste acidic and not too sweet; the thickness should come from the higher concentration of grape must and its natural sugars; no need to add sugar)

Method

(we suggest you read everything at least once before doing anything)

1) Preheat the oven to 400°F / 200°C.

2) Brush the cut sides of the squash with olive oil; sprinkle with a pinch of MSG/salt and a little black pepper (grind it directly over the squash if you are using a grinder; hold the grinder high though so that it distributes evenly—waiters in restaurants aren’t just being dramatic when they do that with pepper or Parmesan or such)

3) Arrange them cut-sides-down on a baking tray lined with baking paper, and roast for at least 30 minutes or until tender.

4) While that is roasting, add the chia seeds to the wild rice, and cook them in the low-sodium vegetable stock, using a rice cooker if available. It should take about the same length of time, but if the rice is done first, set it aside, and if the squash is done first, turn the oven down low to keep it warm.

5) Heat some oil in a sauté pan (not a skillet without high sides; we’re going to need space in a bit), and fry the chopped onion until translucent and soft. We could say “about 5 minutes” but honestly it depends on your pan as well as the heat and other factors.

6) Add the seasonings (herbs, garlic, black pepper, MSG/salt, nooch), and cook for a further 2 minutes, stirring thoroughly to distribute evenly.

7) Add the rice, berries, and nuts, cooking for a further 2 minutes, stirring constantly, ensuring everything is heated evenly.

8) Remove the squash halves from the oven, turn them over, and spoon the mixture we just made into them, filling generously.

9) Drizzle a lashing of the aged balsamic vinegar (or balsamic vinegar reduction), to serve.

Enjoy!

Want to learn more?

For those interested in some of the science of what we have going on today:

Take care!

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  • Treadmill vs Road

    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.

    Have a question or a request? We love to hear from you!

    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 😎

    ❝Why do I get tired much more quickly running outside, than I do on the treadmill? Every time I get worn out quickly but at home I can go for much longer!❞

    Short answer: the reason is Newton’s laws of motion.

    In other words: on a treadmill, you need only maintain your position in space relative the the Earth while the treadmill moves beneath you, whereas on the road, you need to push against the Earth with sufficient force to move it relative to your body.

    Illustrative thought experiment to make that clearer: if you were to stand on a treadmill with roller skates, and hold onto the bar with even just one finger, you would maintain your speed as far as the treadmill’s computer is concerned—whereas to maintain your speed on a flat road, you’d still need to push with your back foot every few yards or so.

    More interesting answer: it’s a qualitatively different exercise (i.e. not just quantitively different). This is because of all that pushing you’re having to do on the road, while on a treadmill, the only pushing you have to do is just enough to counteract gravity (i.e. to keep you upright).

    As such, both forms of running are a cardio exercise (because simply moving your legs quickly, even without having to apply much force, is still something that requires oxygenated blood feeding the muscles), but road-running adds an extra element of resistance exercise for the muscles of your lower body. Thus, road-running will enable you to build-maintain muscle much more than treadmill-running will.

    Some extra things to bear in mind, however:

    1) You can increase the resistance work for either form of running, by adding weight (such as by wearing a weight vest):

    Weight Vests Against Osteoporosis: Do They Really Build Bone?

    …and while road-running will still be the superior form of resistance work (for the reasons we outlined above), adding a weight vest will still be improving your stabilization muscles, just as it would if you were standing still while holding the weight up.

    2) Stationary cycling does not have the same physics differences as stationary running. By this we mean: an exercise bike will require your muscles to do just as much pushing as they would on a road. This makes stationary cycling an excellent choice for high intensity resistance training (HIRT):

    HIIT, But Make It HIRT

    3) The best form of exercise is the one that you will actually do. Thus, when it’s raining sidewise outside, a treadmill inside will get exercise done better than no running at all. Similarly, a treadmill exercise session takes a lot less preparation (“switch it on”) than a running session outside (“get dressed appropriately for the weather, apply sunscreen if necessary, remember to bring water, etc etc”), and thus is also much more likely to actually occur. The ability to stop whenever one wants is also a reassuring factor that makes one much more likely to start. See for example:

    How To Do HIIT (Without Wrecking Your Body)

    Take care!

    Share This Post

  • 4 Tips To Stand Without Using Hands

    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.

    The “sit-stand” test, getting up off the floor without using one’s hands, is well-recognized as a good indicator of healthy aging, and predictor of longevity. But what if you can’t do it? Rather than struggling, there are exercises to strengthen the body to be able to do this vital movement.

    Step by step

    Teresa Shupe has been teaching Pilates professionally full-time for over 25 years, and here’s what she has to offer in the category of safe and effective ways of improving balance and posture while doing the sitting-to-standing movement:

    • Squat! Doing squats (especially deep ones) regularly strengthens all the parts necessary to effectively complete this movement. If your knees aren’t up to it at first, do the squats with your back against a wall to start with.
    • Roll! On your back, cross your feet as though preparing to stand, and rock-and-roll your body forwards. To start with you can “cheat” and use your fingertips to give a slight extra lift. This exercise builds mobility in the various necessary parts of the body, and also strengthens the core—as well as getting you accustomed to using your bodyweight to move your body forwards.
    • Lift! This one’s focusing on that last part, and taking it further. Because it may be difficult to get enough momentum initially, you can practice by holding small weights in your hands, to shift your centre of gravity forwards a bit. Unlike many weights exercises, in this case you’re going to transition to holding less weight rather than more, though.
    • Complete! Continue from the above, without weights now; use the blades of your feet to stand. If you need to, use your fingertips to give you a touch more lift and stability, and reduce the fingers that you use until you are using none.

    For more on each of these as well as a visual demonstration, enjoy this short video:

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

    Further reading

    For more exercises with a similar approach, check out:

    Mobility As A Sporting Pursuit

    Take care!

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  • What to Know About Stillbirths

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    Series: Stillbirths:When Babies Die Before Taking Their First Breath

    The U.S. has not prioritized stillbirth prevention, and American parents are losing babies even as other countries make larger strides to reduce deaths late in pregnancy.

    Every year, more than 20,000 pregnancies in the U.S. end in a stillbirth, the death of an expected child at 20 weeks or more of pregnancy. Research shows as many as 1 in 4 stillbirths may be preventable. We interviewed dozens of parents of stillborn children who said their health care providers did not tell them about risk factors or explain what to watch for while pregnant. They said they felt blindsided by what followed. They did not have the information needed to make critical decisions about what happened with their baby’s body, about what additional testing could have been done to help determine what caused the stillbirth, or about how to navigate the process of requesting important stillbirth documents.

    This guide is meant to help fill the void of information on stillbirths. It’s based on more than 150 conversations with parents, health care providers, researchers and other medical experts.

    Whether you’re trying to better prepare for a pregnancy or grieving a loss, we hope this will help you and your family. This guide does not provide medical advice. We encourage you to seek out other reliable resources and consult with providers you trust.

    We welcome your thoughts and questions at mailto:[email protected]. You can share your experience with stillbirth with us. If you are a health care provider interested in distributing this guide, let us know if we can help.

    Table of contents:

    What Is Stillbirth?

    Many people told us that the first time they heard the term stillbirth was after they delivered their stillborn baby. In many cases, the lack of information and awareness beforehand contributed to their heartache and guilt afterward.

    Stillbirth is defined in the U.S. as the death of a baby in the womb at 20 weeks or more of pregnancy. Depending on when it happens, stillbirth is considered:

    • Early: 20-27 weeks of pregnancy.
    • Late: 28-36 weeks of pregnancy.
    • Term: 37 or more weeks of pregnancy.

    About half of all stillbirths in the U.S. occur at 28 weeks or later.

    What is the difference between a stillbirth and a miscarriage?

    Both terms describe pregnancy loss. The distinction is when the loss occurs. A miscarriage is typically defined as a loss before the 20th week of pregnancy, while stillbirth is after that point.

    How common is stillbirth?

    Each year, about 1 in 175 deliveries in the U.S. are stillbirths — that’s about 60 stillborn babies every day — making it one of the most common adverse pregnancy outcomes, but it is rarely discussed.

    If you are surprised by that fact, you are not alone. Many people we spoke to did not know how common stillbirths are. Leandria Lee of Texas said she spent her 2021 pregnancy unaware that her daughter, Zuri Armoni, could die in the last phase of her pregnancy.

    “If I was prepared to know that something could happen, I don’t think it would have been as bad. But to not know and then it happens, it affects you,” she said of her stillbirth at 35 weeks.

    Some doctors have told us they don’t introduce the possibility of a stillbirth because they don’t want to create additional anxiety for patients.

    Other doctors say withholding information leaves patients unprepared.

    “We have this idea that we can’t scare the patient, which to me is very paternalistic,” said Dr. Heather Florescue, an OB-GYN near Rochester, New York, who works to inform doctors and patients about stillbirth prevention.

    What causes stillbirths?

    There is a lot we don’t know about stillbirths because there hasn’t been enough research. The cause of the stillbirth is unknown in about 1 in 3 cases.

    What we do know is that a number of factors may cause or increase the risk of a stillbirth, including:

    • The baby not growing as expected.
    • Placental abnormalities or problems with the umbilical cord.
    • Genetic or structural disorders that cause developmental issues.
    • High blood pressure before pregnancy or preeclampsia, a potentially fatal complication that usually appears late in pregnancy and causes high blood pressure.
    • Diabetes before or during pregnancy.
    • An infection in the fetus, the placenta or the pregnant person.
    • Smoking.
    • Being 35 or older.
    • Obesity.
    • Being pregnant with more than one baby.

    But not all doctors, hospitals or health departments perform tests to identify the potential cause of a stillbirth or determine if it could have been prevented. Even when a cause is identified, fetal death records are rarely updated. This means data is sometimes inaccurate. Researchers strongly encourage doctors to perform a stillbirth evaluation, which includes an examination of the placenta and umbilical cord, a fetal autopsy and genetic testing.

    If your hospital or doctor does not proactively offer one or more of these exams, you can ask them to conduct the tests. Research shows that placental exams may help establish a cause of death or exclude a suspected one in about 65% of stillbirths, while autopsies were similarly useful in more than 40% of cases.

    Are Stillbirths Preventable?

    Not all stillbirths are preventable, but some are. For pregnancies that last 37 weeks or more, one study found that nearly half of stillbirths are potentially preventable.

    Dr. Joanne Stone, who last year was president of the Society of Maternal-Fetal Medicine, leads the country’s first Rainbow Clinic at Mount Sinai Hospital in New York. The clinic is modeled on similar facilities in the United Kingdom that care for people who want to conceive again after a stillbirth. She said many doctors used to think there was nothing they could do to prevent stillbirth.

    “People just looked at it like, ‘Oh, it was an accident, couldn’t have been prevented,’” said Stone, who also is the system chair of the obstetrics, gynecology and reproductive science department at the Icahn School of Medicine. “But we know now there are things that we can do to try to prevent that from happening.”

    She said doctors can:

    • More closely monitor patients with certain risk factors, like high blood pressure, diabetes or obesity.
    • Ask about prior infant loss or other obstetrical trauma.
    • Carefully assess whether a baby’s growth is normal.
    • Work to diagnose genetic anomalies.
    • Teach patients how to track their baby’s movements and encourage them to speak up if they notice activity has slowed or stopped.
    • Deliver at or before 39 weeks if there are concerns.

    What are the risks of stillbirth over the course of a pregnancy?

    The risk of a stillbirth increases significantly toward the end of pregnancy, especially after 39 weeks. The risk is higher for people who get pregnant at 35 or older. The risk begins to climb even earlier, around 36 weeks, for people pregnant with twins.

    What you and your doctor can do to reduce the risk of stillbirth.

    While federal agencies in the U.S. have yet to come up with a checklist that may help reduce the risk of stillbirth, the Stillbirth Centre of Research Excellence in Australia has adopted a Safer Baby Bundle that lists five recommendations:

    1. Stop smoking.
    2. Regularly monitor growth to reduce the risk of fetal growth restriction, when the fetus is not growing as expected.
    3. Understand the importance of acting quickly if fetal movement decreases.
    4. Sleep on your side after 28 weeks.
    5. Talk to your doctor about when to deliver. Depending on your situation, it may be before your due date.

    The American College of Obstetricians and Gynecologists has compiled a list of tests and techniques doctors can use to try to reduce the risk of a stillbirth. They include:

    • A risk assessment to identify prenatal needs.
    • A nonstresstest, which checks the fetus’s heart rate and how it changes as the fetus moves.
    • A biophysical profile, which is done with an ultrasound to measure body movement, muscle tone and breathing, along with amniotic fluid volume.

    The group stressed that there is no test that can guarantee a stillbirth won’t happen and that individual circumstances should determine what tests are run.

    Are some people at higher risk for stillbirth?

    Black women are more than twice as likely to have a stillbirth as white women. There are a number of possible explanations for that disparity, including institutional bias and structural racism, and a patient’s pre-pregnancy health, socioeconomic status and access to health care. In addition, research shows that Black women are more likely than white women to experience multiple stressful life events while pregnant and have their concerns ignored by their health care provider. Similar racial disparities drive the country’s high rate of maternal mortality.

    How to find a provider you trust.

    Finding a doctor to care for you during your pregnancy can be a daunting process. Medical experts and parents suggest interviewing prospective providers before you decide on the right one.

    Here is a short list of questions you might want to ask a potential OB-GYN:

    • What is the best way to contact you if I have questions or concerns?
    • How do you manage inquiries after hours and on weekends? Do you see walk-ins?
    • How do you manage prenatal risk assessments?
    • What should I know about the risks of a miscarriage or stillbirth?
    • How do you decide when a patient should be induced?

    If a provider doesn’t answer your questions to your satisfaction, don’t be reluctant to move on. Dr. Ashanda Saint Jean, chair of the obstetrics and gynecology department at HealthAlliance Hospitals of the Hudson Valley in New York, said she encourages her patients to find the provider that meets their needs.

    “Seek out someone that is like-minded,” said Saint Jean “It doesn’t have to be that they’re the same ethnicity or the same race, but like-minded in terms of the goals of what that patient desires for their own health and prosperity.”

    What to know in the last trimester.

    The last trimester can be an uncomfortable and challenging time as the fetus grows and you get increasingly tired. During this critical time, your provider should talk to you about the following topics:

    • Whether you need a nonstress test to determine if the fetus is getting enough oxygen.
    • The best way to track fetal movements.
    • What to do if your baby stops moving.
    • Whether you are at risk for preeclampsia or gestational diabetes.

    Rachel Foran’s child, Eoin Francis, was stillborn at 41 weeks and two days. Foran, who lives in New York, said she believes that if her doctor had tracked her placenta, and if she had understood the importance of fetal movement, she and her husband might have decided to deliver sooner.

    She remembers that her son was “very active” until the day before he was stillborn.

    “I would have gone in earlier if someone had told me, ‘You’re doing this because the baby could die,’” she said of tracking fetal movement. “That would have been really helpful to know.”

    Researchers are looking at the best way to measure the health, blood flow and size of the placenta, but studies are still in their early stages.

    “If someone had been doing that with my son’s,” Foran said, “my son would be alive.”

    A placental exam and an autopsy showed that a small placenta contributed to Foran’s stillbirth.

    How often should you feel movement?

    Every baby and each pregnancy are different, so it is important to get to know what levels of activity are normal for you. You might feel movement around 20 weeks. You’re more likely to feel movement when you’re sitting or lying down. Paying attention to movement during the third trimester is particularly important because research shows that changes, including decreased movement or bursts of excessive activity, are associated with an increased risk of stillbirth. Most of the time, it’s nothing. But sometimes it can be a sign that your baby is in distress. If you’re worried, don’t rely on a home fetal doppler to reassure you. Reach out to your doctor.

    Saint Jean offers a tip to track movement: “I still tell patients each day to lay on their left side after dinner and record how many times their baby moves, because then that will give you an idea of what’s normal for your baby,” she said.

    Other groups recommend using the Count the Kicks app as a way of tracking fetal movements and establishing what is normal for that pregnancy. Although there is no scientific consensus that counting kicks can prevent stillbirths, the American College of Obstetricians and Gynecologists and other groups recommend that patients be aware of fetal movement patterns.

    Dr. Karen Gibbins is a maternal-fetal medicine specialist at Oregon Health & Science University who in 2018 had stillborn son named Sebastian. She said the idea that babies don’t move as much at the end of pregnancy is a dangerous myth.

    “You might hear that babies slow down at the end,” she said. “They don’t slow down. They just have a little less space. So their movements are a little different, but they should be as strong and as frequent.”

    What to Expect After a Stillbirth

    What might happen at the hospital?

    Parents are often asked to make several important decisions while they are still reeling from the shock and devastation of their loss. It’s completely understandable if you need to take some time to consider them.

    Some other things you can ask for (if medical personnel don’t offer them) are:

    • Blood work, a placental exam, an autopsy and genetic testing.
    • A social worker or counselor, bereavement resources and religious or chaplain support.
    • The option to be isolated from the labor rooms.
    • Someone to take photos of you and your baby, typically either a nurse or an outside group.
    • A small cooling cot that allows parents to spend more time with their babies after a stillbirth. If one is not available, you can ask for ice packs to put in the swaddle or the bassinet.
    • A mold of your baby’s hands and feet.
    • Information about burial or cremation services.
    • Guidance on what to do if your milk comes in.

    Getting an autopsy after a stillbirth.

    Whether to have an autopsy is a personal decision. It may not reveal a cause of death, but it might provide important information about your stillbirth and contribute to broader stillbirth research. Autopsies can be useful if you are considering another pregnancy in the future. Families also told us that an autopsy can help parents feel they did everything they could to try to understand why their baby died.

    But several families told us their health care providers didn’t provide them with the right information to help with that decision. Some aren’t trained in the advantages of conducting an autopsy after a stillbirth, or in when and how to sensitively communicate with parents about it. Some, for example, don’t explain that patients can still have an open-casket funeral or other service after an autopsy because the incisions can easily be covered by clothing. Others may not encourage an autopsy because they think they already know what caused the stillbirth or don’t believe anything could have been done to prevent it. In addition, not all hospitals have the capacity to do an autopsy, but there may be private autopsy providers that can perform one at an additional cost.

    You can read more about autopsies in our reporting.

    Paying for an autopsy after a stillbirth.

    If you decide you want an autopsy, you may wonder whether you need to pay out-of-pocket for it. Several families told us their providers gave them incomplete or incorrect information. Many larger or academic hospitals offer autopsies at no cost to patients. Some insurance companies also cover the cost of an autopsy after a stillbirth.

    When hospitals don’t provide an autopsy, they may give you names of private providers. That was the case for Rachel Foran. The hospital gave her and her husband a list of numbers to call if they wanted to pay for an autopsy themselves. The process, she said, shocked her.

    “I had just delivered and we had to figure out what to do with his body,” Foran said. “It felt totally insane that that was what we had to do and that we had to figure it out on our own.”

    An independent autopsy, records show, cost them $5,000.

    What is a certificate of stillbirth and how do I get one?

    A fetal death certificate is the official legal document that records the death. This is the document used to gather data on and track the number of stillbirths in the country. Many states also issue a certificate of stillbirth or a certificate of birth resulting in stillbirth, which acknowledge the baby’s birth. Families told us they appreciated having that document, since typical birth certificates are not issued for stillbirths. You can usually request a certificate from the vital records office.

    Grieving After a Stillbirth

    What are the effects of stillbirths on parents and families?

    Over and over, families told us the effects of losing a baby can reverberate for a lifetime.

    Bereavement support groups may help provide a space to share experiences and resources. Hospitals and birth centers may suggest a local grief group.

    We talked with Anna Calix, a maternal health expert who became active in perinatal loss prevention after her son Liam was stillborn on his due date in 2016. Calix leads grief support groups for people of color in English and Spanish.

    She suggested rededicating the time you would have spent taking care of a new baby to the grief process.

    “You can do that by addressing your own thoughts and feelings and really experiencing those feelings,” Calix said. “We like to push those feelings away or try to do something to distract and avoid, but no matter what we do, the feelings are there.”

    It’s important, she said, to give yourself permission to grow your connection with your child and work through thoughts of guilt or blame.

    What You Might Say and Do After a Loved One Experiences a Stillbirth

    Finding the right words can be difficult. The following are a few suggestions from parents who went through a stillbirth.

    Helpful:

    • Acknowledge the loss and offer condolences.
    • Ask if the baby was named and use the name.
    • Allow space for the family to talk about their baby.

    Unhelpful:

    • Avoid talking about the baby.
    • Minimize the loss or compare experiences.
    • Start statements with “at least.”

    Suggested phrases to avoid:

    • “You’re young. You can have more kids.”
    • “At least you have other children.”
    • “These things just happen.”
    • “Your baby is in a better place now.”

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  • Avoiding Razor Burn, Ingrown Hairs & Other Shaving Irritation

    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 Does The Video Help?

    Dr. Simi Adedeji’s incredibly friendly persona makes this video (below) on avoiding skin irritation, ingrown hairs, and razor burn after shaving a pleasure to watch.

    To keep things simple, she breaks down her guide into 10 simple tips.

    What Are The 10 Simple Tips?

    Tip 1: Prioritize Hydration. Shaving dry hair can lead to increased skin irritation, so Dr. Simi recommends moistening the hair by showering or using a warm, wet towel for 2-4 minutes before getting the razor out.

    Tip 2: Avoid Dry Shaving. Dry shaving not only removes hair but can also remove the protective upper layer of skin, which contributes to razor burn. To prevent this, simply use some shaving gel or cream.

    Tip 3: Keep Blades New and Sharp. This one’s simple: dull blades can cause skin irritation, whilst a sharp blade ensures a smoother and more comfortable shaving experience.

    Tip 4: Avoid Shaving the Same Area Repeatedly. Multiple passes over the same area can remove skin layers, leading to cuts and irritation. Aim to shave each area only once for safer results.

    Tip 5: Consider Hair Growth Direction. Shaving in the direction of hair growth results in less irritation, although it may not provide the closest shave.

    Tip 6: Apply Gentle Pressure While Shaving. Excessive pressure can lead to cuts and nicks. Use a gentle touch to reduce these risks.

    Tip 7: Incorporate Exfoliation into Your Routine. Exfoliating helps release trapped hairs and reduces the risk of ingrown hairs. For those with sensitive skin, it’s recommended to exfoliate either two days before or after shaving.

    Tip 8: Avoid Excessive Skin Stretching. Over-stretching the skin during shaving can cause hairs to become ingrown.

    Tip 9: Moisturize After Shaving. Shaving can compromise the skin barrier, leading to dryness. Using a moisturizer can be a simple fix.

    Tip 10: Regularly Rinse Your Blade. Make sure that, during the shaving process, you are rinsing your blade frequently to remove hair and skin debris. This keeps it sharp during your shave.

    If this summary doesn’t do it for you, then you can watch the full video here:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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  • Intermittent Fasting, Intermittently?

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    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 😎

    ❝Have you come across any research on alternate-day intermittent fasting—specifically switching between one day of 16:8 fasting and the next day of regular eating patterns? I’m curious if there are any benefits or drawbacks to this alternating approach, or if the benefits mainly come from consistent intermittent fasting?❞

    Short and unhelpful answer: no

    Longer and hopefully more helpful answer:

    As you probably know, usually people going for approaches based on the above terms either

    • practise 16:8 fasting (fast for 16 hours each day, eat during an 8-hour window) or
    • practise alternate-day fasting (fast for 24 hours, eat whenever for 24 hours, repeat)

    …which latter scored the best results in this large meta-analysis of studies:

    Effects of different types of intermittent fasting on metabolic outcomes: an umbrella review and network meta-analysis

    There is also the (popular) less extreme version of alternate-day fasting, sometimes called “eat stop eat”, which is not a very helpful description because that describes almost any kind of eating/fasting, but it usually refers to “once per week, take a day off from eating”.

    You can read more about each of these (and some other variants), here:

    Intermittent Fasting: What’s The Truth?

    What you are describing (doing 16:8 fasting on alternate days, eating whenever on the other days) is essentially: intermittent fasting, just with one 16-hour fast per 48 hours instead of per the usual 24 hours.

    See also: International consensus on fasting terminology ← the section on the terms “STF & PF” covers why this gets nudged back under the regular IF umbrella

    Good news: this means there is a lot of literature into the acute (i.e., occurring the same day, not long-term)* benefits of 16:8 IF, and that means that you will be getting those benefits, every second day.

    You remember that meta-analysis we posted above? While it isn’t mentioned in the conclusion (which only praised complete alternate-day fasting producing the best outcomes overall), sifting through the results data discovers that time-restricted eating (which is what you are doing, by these classifications) was the only fasting method to significantly reduce fasting blood glucose levels.

    (However, no significant differences were observed between any IF form and the reference (continuous energy restriction, CER, i.e. calorie-controlled) diets in fasting insulin and HbA1c levels)

    *This is still good news in the long-term though, because getting those benefits every second day is better than getting those benefits on no days, and this will have a long-term impact on your healthy longevity, just like how it is better to exercise every second day than it is to exercise no days, or better to abstain from alcohol every second day than it is to abstain on no days, etc.

    In short, by doing IF every second day, you are still giving your organs a break sometimes, and that’s good.

    All the same, if it would be convenient and practical for you, we would encourage you to consider either the complete alternate-day fasting (which, according to a lot of data, gives the best results overall),or time-restricted eating (TRE) every day (which, according to a lot of data, gives the best fasting blood sugar levels).

    You could also improve the TRE days by shifting to 20:4 (i.e., 20 hours fasting and 4 hours eating), this giving your organs a longer break on those days.

    Want to learn more?

    For a much more comprehensive discussion of the strengths and weaknesses of different approaches to intermitted fasting, check out:

    Complete Guide To Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting – By Dr. Jason Fung

    Enjoy!

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  • Food and exercise can treat depression as well as a psychologist, our study found. And it’s cheaper

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    Around 3.2 million Australians live with depression.

    At the same time, few Australians meet recommended dietary or physical activity guidelines. What has one got to do with the other?

    Our world-first trial, published this week, shows improving diet and doing more physical activity can be as effective as therapy with a psychologist for treating low-grade depression.

    Previous studies (including our own) have found “lifestyle” therapies are effective for depression. But they have never been directly compared with psychological therapies – until now.

    Amid a nation-wide shortage of mental health professionals, our research points to a potential solution. As we found lifestyle counselling was as effective as psychological therapy, our findings suggest dietitians and exercise physiologists may one day play a role in managing depression.

    Alexander Raths/shutterstock

    What did our study measure?

    During the prolonged COVID lockdowns, Victorians’ distress levels were high and widespread. Face-to-face mental health services were limited.

    Our trial targeted people living in Victoria with elevated distress, meaning at least mild depression but not necessarily a diagnosed mental disorder. Typical symptoms included feeling down, hopeless, irritable or tearful.

    We partnered with our local mental health service to recruit 182 adults and provided group-based sessions on Zoom. All participants took part in up to six sessions over eight weeks, facilitated by health professionals.

    Half were randomly assigned to participate in a program co-facilitated by an accredited practising dietitian and an exercise physiologist. That group – called the lifestyle program – developed nutrition and movement goals:

    Hands holding a bowl full of vegetables, with chopsticks.
    Lifestyle therapy aims to improve diet. Jonathan Borba/Pexels
    • eating a wide variety of foods
    • choosing high-fibre plant foods
    • including high quality fats
    • limiting discretionary foods, such as those high in saturated fats and added sugars
    • doing enjoyable physical activity.

    The second group took part in psychotherapy sessions convened by two psychologists. The psychotherapy program used cognitive behavioural therapy (CBT), the gold standard for treating depression in groups and when delivered remotely.

    In both groups, participants could continue existing treatments (such as taking antidepressant medication). We gave both groups workbooks and hampers. The lifestyle group received a food hamper, while the psychotherapy group received items such as a colouring book, stress ball and head massager.

    Lifestyle therapies just as effective

    We found similar results in each program.

    At the trial’s beginning we gave each participant a score based on their self-reported mental health. We measured them again at the end of the program.

    Over eight weeks, those scores showed symptoms of depression reduced for participants in the lifestyle program (42%) and the psychotherapy program (37%). That difference was not statistically or clinically meaningful so we could conclude both treatments were as good as each other.

    There were some differences between groups. People in the lifestyle program improved their diet, while those in the psychotherapy program felt they had increased their social support – meaning how connected they felt to other people – compared to at the start of the treatment.

    Participants in both programs increased their physical activity. While this was expected for those in the lifestyle program, it was less expected for those in the psychotherapy program. It may be because they knew they were enrolled in a research study about lifestyle and subconsciously changed their activity patterns, or it could be a positive by-product of doing psychotherapy.

    A woman in running shorts stretches her thigh.
    People in both groups reported doing more physical activity. fongbeerredhot/Shutterstock

    There was also not much difference in cost. The lifestyle program was slightly cheaper to deliver: A$482 per participant, versus $503 for psychotherapy. That’s because hourly rates differ between dietitians and exercise physiologists, and psychologists.

    What does this mean for mental health workforce shortages?

    Demand for mental health services is increasing in Australia, while at the same time the workforce faces worsening nation-wide shortages.

    Psychologists, who provide about half of all mental health services, can have long wait times. Our results suggest that, with the appropriate training and guidelines, allied health professionals who specialise in diet and exercise could help address this gap.

    Lifestyle therapies can be combined with psychology sessions for multi-disciplinary care. But diet and exercise therapies could prove particularly effective for those on waitlists to see a psychologists, who may be receiving no other professional support while they wait.

    Many dietitians and exercise physiologists already have advanced skills and expertise in motivating behaviour change. Most accredited practising dietitians are trained in managing eating disorders or gastrointestinal conditions, which commonly overlap with depression.

    There is also a cost argument. It is overall cheaper to train a dietitian ($153,039) than a psychologist ($189,063) – and it takes less time.

    Potential barriers

    Australians with chronic conditions (such as diabetes) can access subsidised dietitian and exercise physiologist appointments under various Medicare treatment plans. Those with eating disorders can also access subsidised dietitian appointments. But mental health care plans for people with depression do not support subsidised sessions with dietitians or exercise physiologists, despite peak bodies urging them to do so.

    Increased training, upskilling and Medicare subsidies would be needed to support dietitians and exercise physiologists to be involved in treating mental health issues.

    Our training and clinical guidelines are intended to help clinicians practising lifestyle-based mental health care within their scope of practice (activities a health care provider can undertake).

    Future directions

    Our trial took place during COVID lockdowns and examined people with at least mild symptoms of depression who did not necessarily have a mental disorder. We are seeking to replicate these findings and are now running a study open to Australians with mental health conditions such as major depression or bipolar disorder.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Adrienne O’Neil, Professor, Food & Mood Centre, Deakin University and Sophie Mahoney, Associate Research Fellow, Food and Mood Centre, Deakin University

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

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