Supergreen Superfood Salad Slaw
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When it comes to “eating the rainbow”, in principle green should be the easiest color to get in, unless we live in a serious food desert (or serious food poverty). In practice, however, a lot of meals could do with a dash more green. This “supergreen superfood salad slaw” is remarkably versatile, and can be enjoyed as a very worthy accompaniment to almost any main.
You will need
For the bits:
- ½ small green cabbage, finely diced
- 7 oz tenderstem broccoli, finely chopped
- 2 stalks celery, finely chopped (if allergic, simply omit)
- ½ cucumber, diced into small cubes
- 2 oz kale, finely shredded
- 4 green (spring) onions, thinly sliced
For the dressing:
- 1 cup cashews (if allergic, substitute 1 cup roasted chickpeas)
- ½ cup extra virgin olive oil
- 2 oz baby spinach
- 1 oz basil leaves
- 1 oz chives
- ¼ bulb garlic
- 2 tbsp nutritional yeast
- 1 tbsp chia seeds
- Juice of two limes
Method
(we suggest you read everything at least once before doing anything)
1) Combine the ingredients from the “bits” category in a bowl large enough to accommodate them comfortably
2) Blend the ingredients from the “dressing” category in a blender until very smooth (the crux here is you do not want any stringy bits of spinach remaining)
3) Pour the dressing onto the bits, and mix well to combine. Refrigerate, ideally covered, until ready to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Spinach vs Kale – Which is Healthier?
- Brain Food? The Eyes Have It!
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Healing After Loss – by Martha Hickman
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Mental health is also just health, and this book’s about an underexamined area of mental health. We say “underexamined”, because for something that affects almost everyone sooner or later, there’s not nearly so much science being done about it as other areas of mental health.
This is not a book of science per se, but it is a very useful one. The format is:
Each calendar day of the year, there’s a daily reflection, consisting of:
- A one-liner insight about grief, quoted from somebody
- A page of thoughts about this
- A one-liner summary, often formulated as a piece of advice
The book is not religious in content, though the author does occasionally make reference to God, only in the most abstract way that shouldn’t be offputting to any but the most stridently anti-religious readers.
Bottom line: if this is a subject near to your heart, then you will almost certainly benefit from this daily reader.
Click here to check out Healing After Loss, and indeed heal after loss
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You Are Not a Before Picture – by Alex Light
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It’s that time of year, and many of us are looking at what we’ll do in the coming days, weeks, and months to level-up our health. So… Is this a demotivational book?
Quite the opposite! It’s rather a case of an often much-needed reminder to ensure that our plans are really our own, and really are what’s best for us. Why wouldn’t they be, you ask?
Much of diet culture (ubiquitous! From magazine covers to movie stars to the models advertising anything from health insurance to water filters) has us reaching for “body goals” that are not possible without a different skeleton and genes and compromises and post-production edits.
Alex Light—herself having moved from the fashion and beauty industry into health education—sets out in a clear, easy-reading manner, how we can look after ourselves, not be neglectful of our bodies, and/but also not get distracted into unhelpful, impossible, castles-in-the-air.
Bottom line: you cannot self-hate your way into good health, and good health will always be much more attainable than a body that’s just not yours. This book can help you sort out which is which.
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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
PeopleImages.com – Yuri A/Shutterstock What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Experts used to think an ACL tear couldn’t heal without surgery – now there’s evidence it can. SKYKIDKID/Shutterstock Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
For people who opt to try rehabilitation, the option of having surgery later is still there. PeopleImages.com – Yuri A/Shutterstock Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Can you drink your fruit and vegetables? How does juice compare to the whole food?
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Do you struggle to eat your fruits and vegetables? You are not alone. Less than 5% of Australians eat the recommended serves of fresh produce each day (with 44% eating enough fruit but only 6% eating the recommended vegetables).
Adults should aim to eat at least five serves of vegetables (or roughly 375 grams) and two serves of fruit (about 300 grams) each day. Fruits and vegetables help keep us healthy because they have lots of nutrients (vitamins, minerals and fibre) and health-promoting bioactive compounds (substances not technically essential but which have health benefits) without having many calories.
So, if you are having trouble eating the rainbow, you might be wondering – is it OK to drink your fruits and vegetables instead in a juice or smoothie? Like everything in nutrition, the answer is all about context.
Darina Belonogova/Pexels It might help overcome barriers
Common reasons for not eating enough fruits and vegetables are preferences, habits, perishability, cost, availability, time and poor cooking skills. Drinking your fruits and vegetables in juices or smoothies can help overcome some of these barriers.
Juicing or blending can help disguise tastes you don’t like, like bitterness in vegetables. And it can blitz imperfections such as bruises or soft spots. Preparation doesn’t take much skill or time, particularly if you just have to pour store-bought juice from the bottle. Treating for food safety and shipping time does change the make up of juices slightly, but unsweetened juices still remain significant sources of nutrients and beneficial bioactives.
Juicing can extend shelf life and reduce the cost of nutrients. In fact, when researchers looked at the density of nutrients relative to the costs of common foods, fruit juice was the top performer.
So, drinking my fruits and veggies counts as a serve, right?
How juice is positioned in healthy eating recommendations is a bit confusing. The Australian Dietary Guidelines include 100% fruit juice with fruit but vegetable juice isn’t mentioned. This is likely because vegetable juices weren’t as common in 2013 when the guidelines were last revised.
The guidelines also warn against having juice too often or in too high amounts. This appears to be based on the logic that juice is similar, but not quite as good as, whole fruit. Juice has lower levels of fibre compared to fruits, with fibre important for gut health, heart health and promoting feelings of fullness. Juice and smoothies also release the sugar from the fruit’s other structures, making them “free”. The World Health Organization recommends we limit free sugars for good health.
But fruit and vegetables are more than just the sum of their parts. When we take a “reductionist” approach to nutrition, foods and drinks are judged based on assumptions made about limited features such as sugar content or specific vitamins.
But these features might not have the impact we logically assume because of the complexity of foods and people. When humans eat varied and complex diets, we don’t necessarily need to be concerned that some foods are lower in fibre than others. Juice can retain the nutrients and bioactive compounds of fruit and vegetables and even add more because parts of the fruit we don’t normally eat, like the skin, can be included.
Juicing or blending might mean you eat different parts of the fruit or vegetable. flyingv3/Shutterstock So, it is healthy then?
A recent umbrella review of meta-analyses (a type of research that combines data from multiple studies of multiple outcomes into one paper looked at the relationship between 100% juice and a range of health outcomes.
Most of the evidence showed juice had a neutral impact on health (meaning no impact) or a positive one. Pure 100% juice was linked to improved heart health and inflammatory markers and wasn’t clearly linked to weight gain, multiple cancer types or metabolic markers (such as blood sugar levels).
Some health risks linked to drinking juice were reported: death from heart disease, prostate cancer and diabetes risk. But the risks were all reported in observational studies, where researchers look at data from groups of people collected over time. These are not controlled and do not record consumption in the moment. So other drinks people think of as 100% fruit juice (such as sugar-sweetened juices or cordials) might accidentally be counted as 100% fruit juice. These types of studies are not good at showing the direct causes of illness or death.
What about my teeth?
The common belief juice damages teeth might not stack up. Studies that show juice damages teeth often lump 100% juice in with sweetened drinks. Or they use model systems like fake mouths that don’t match how people drinks juice in real life. Some use extreme scenarios like sipping on large volumes of drink frequently over long periods of time.
Juice is acidic and does contain sugars, but it is possible proper oral hygiene, including rinsing, cleaning and using straws can mitigate these risks.
Again, reducing juice to its acid level misses the rest of the story, including the nutrients and bioactives contained in juice that are beneficial to oral health.
Juice might be more convenient and could replace less healthy drinks. PintoArt/Shutterstock So, what should I do?
Comparing whole fruit (a food) to juice (a drink) can be problematic. They serve different culinary purposes, so aren’t really interchangeable.
The Australian Guide to Healthy Eating recommends water as the preferred beverage but this assumes you are getting all your essential nutrients from eating.
Where juice fits in your diet depends on what you are eating and what other drinks it is replacing. Juice might replace water in the context of a “perfect” diet. Or juice might replace alcohol or sugary soft drinks and make the relative benefits look very different.
On balance
Whether you want to eat your fruits and vegetables or drink them comes down to what works for you, how it fits into the context of your diet and your life.
Smoothies and juices aren’t a silver bullet, and there is no evidence they work as a “cleanse” or detox. But, with society’s low levels of fruit and vegetable eating, having the option to access nutrients and bioactives in a cheap, easy and tasty way shouldn’t be discouraged either.
Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Breakfasting For Health?
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Breakfast Time!
In yesterday’s newsletter, we asked you for your health-related opinions on the timings of meals.
But what does the science say?
Quick recap on intermittent fasting first:
Today’s article will rely somewhat on at least a basic knowledge of intermittent fasting, what it is, and how and why it works.
Armed with that knowledge, we can look at when it is good to break the fast (i.e. breakfast) and when it is good to begin the fast (i.e. eat the last meal of the day).
So, if you’d like a quick refresher on intermittent fasting, here it is:
Intermittent Fasting: We Sort The Science From The Hype
And now, onwards!
One should eat breakfast first thing: True or False?
True! Give or take one’s definition of “first thing”. We did a main feature about this previously, and you can read a lot about the science of it, and see links to studies:
The Circadian Rhythm: Far More Than Most People Know
In case you don’t have time to read that now, we’ll summarize the most relevant-to-today’s-article conclusion:
The optimal time to breakfast is around 10am (this is based on getting sunlight around 8:30am, so adjust if this is different for you)
It doesn’t matter when we eat; calories are calories & nutrients are nutrients: True or False?
Broadly False, for practical purposes. Because, indeed calories are calories and nutrients are nutrients at any hour, but the body will do different things with them depending on where we are in the circadian cycle.
For example, this study in the Journal of Nutrition found…
❝Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain.
Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.❞
Read in full: Meal Frequency and Timing Are Associated with Changes in Body Mass Index
We should avoid eating too late at night: True or False?
False per se, True in the context of the above. Allow us to clarify:
There is nothing inherently bad about eating late at night; there is no “bonus calorie happy hour” before bed.
However…
If we are eating late at night, that makes it difficult to breakfast in the morning (as is ideal) and still maintain a >16hr fasting window as is optimal, per:
❝the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake❞
~ Dr. Françoise Wilhelmi de Toledo et al.
So in other words: since the benefits of intermittent fasting start at 12 hours into the fast, you’re not going to get them if you’re breakfasting at 10am and also eating in the evening.
Summary:
- It is best to eat breakfast around 10am, generally (ideally after some sunlight and exercise)
- While there’s nothing wrong with eating in the evening per se, doing so means that a 10am breakfast will eliminate any fasting benefits you might otherwise get
- If a “one meal a day, and that meal is breakfast” lifestyle doesn’t suit you, then one possible good compromise is to have a large breakfast, and then a smaller meal in the late afternoon / early evening.
One last tip: the above is good, science-based information. Use it (or don’t), as you see fit. We’re not the boss of you:
- Maybe you care most about getting the best circadian rhythm benefits, in which case, prioritizing breakfast being a) in the morning and b) the largest meal of the day, is key
- Maybe you care most about getting the best intermittent fasting benefits, in which case, for many people’s lifestyle, a fine option is skipping eating in the morning, and having one meal in the late afternoon / early evening.
Take care!
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How Likely Are You To Live To 100?
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How much hope can we reasonably have of reaching 100?
Yesterday, we asked you: assuming a good Health-Related Quality of Life (HRQoL), how much longer do you hope to live?
We got the above-depicted, below-described, set of responses:
- A little over 38% of respondents hope to live another 11–20 years
- A little over 31% hope to live another 31–40 years
- A little over 7% will be content to make it to the next decade
- One (1) respondent hopes to live longer than an additional 100 years
This is interesting when we put it against our graph of how old our subscribers are:
…because it corresponds inversely, right down to the gap/dent in the 40s. And—we may hypothesize—that one person under 18 who hopes to live to 120, perhaps.
This suggests that optimism remains more or less constant, with just a few wobbles that would probably be un-wobbled with a larger sample size.
In other words: most of our education-minded, health-conscious subscriber-base hope to make it to the age of 90-something, while for the most part feeling that 100+ is overly optimistic.
Writer’s anecdote: once upon a time, I was at a longevity conference in Brussels, and a speaker did a similar survey, but by show of hands. He started low by asking “put your hands up if you want to live at least a few more minutes”. I did so, with an urgency that made him laugh, and say “Don’t worry; I don’t have a gun hidden up here!”
Conjecture aside… What does the science say about our optimism?
First of all, a quick recap…
To not give you the same information twice, let’s note we did an “aging mythbusting” piece already covering:
- Aging is inevitable: True or False?
- Aging is, and always will be, unstoppable: True or False?
- We can slow aging: True or False?
- It’s too early to worry about… / It’s too late to do anything about… True or False?
- We can halt aging: True or False?
- We can reverse aging: True or False?
- But those aren’t really being younger, we’ll still die when our time is up: True or False?
You can read the answers to all of those here:
Age & Aging: What Can (And Can’t) We Do About It?
Now, onwards…
It is unreasonable to expect to live past 100: True or False?
True or False, depending on your own circumstances.
First, external circumstances: the modal average person in Hong Kong is currently in their 50s and can expect to live into their late 80s, while the modal average person in Gaza is 14 and may not expect to make it to 15 right now.
To avoid extremes, let’s look at the US, where the modal average person is currently in their 30s and can expect to live into their 70s:
United States Mortality Database
Now, before that unduly worries our many readers already in their 70s…
Next, personal circumstances: not just your health, but your socioeconomic standing. And in the US, one of the biggest factors is the kind of health insurance one has:
SOA Research Institute | Life Expectancy Calculator 2021
You may note that the above source puts all groups into a life expectancy in the 80s—whereas the previous source gave 70s.
Why is this? It’s because the SOA, whose primary job is calculating life insurance risks, is working from a sample of people who have, or are applying for, life insurance. So it misses out many people who die younger without such.
New advances in medical technology are helping people to live longer: True or False?
True, assuming access to those. Our subscribers are mostly in North America, and have an economic position that affords good access to healthcare. But beware…
On the one hand:
The number of people who live past the age of 100 has been on the rise for decades
On the other hand:
The average life expectancy in the U.S. has been on the decline for three consecutive years
COVID is, of course, largely to blame for that, though:
❝The decline of 1.8 years in life expectancy was primarily due to increases in mortality from COVID-19 (61.2% of the negative contribution).
The decline in life expectancy would have been even greater if not for the offsetting effects of decreases in mortality due to cancer (43.1%)❞
Source: National Vital Statistics Reports
The US stats are applicable to Canada, the UK, and Australia: True or False?
False: it’s not quite so universal. Differences in healthcare systems will account for a lot, but there are other factors too:
- Life expectancy in Canada fell for the 3rd year in a row. What’s happening?
- UK life expectancy lagging behind rest of G7 except the US
- Australians are living longer but what does it take to reach 100 years old?
Here’s an interesting (UK-based) tool that calculates not just your life expectancy, but also gives the odds of living to various ages (e.g. this writer was given odds of living to 87, 96, 100).
Check yours here:
Office of National Statistics | Life Expectancy Calculator
To finish on a cheery note…
Data from Italian centenarians suggests a “mortality plateau”:
❝The risk of dying leveled off in people 105 and older, the team reports online today in Science.
That means a 106-year-old has the same probability of living to 107 as a 111-year-old does of living to 112.
Furthermore, when the researchers broke down the data by the subjects’ year of birth, they noticed that over time, more people appear to be reaching age 105.❞
Pop-sci source: Once you hit this age, aging appears to stop
Actual paper: The plateau of human mortality: demography of longevity pioneers
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