Do We Need Supplements, And Do They Work?

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Does our diet need a little help?

We asked you for your take on supplements, and got the above-illustrated, below-described set of results.

  • The largest minority of respondents (a little over a third) voted for “I just take something very specific”
  • The next most respondents voted for “I take so many supplements; every little helps!”
  • Almost as many voted for “I just take a vitamin or two / a multivitamin”
  • Fewest, about 8%, voted for “I get everything I need from my diet”

But what does the science say?

Food is less nutritious now than it used to be: True or False?

True or False depending on how you measure it.

An apple today and an apple from a hundred years ago are likely to contain the same amounts of micronutrients per apple, but a lower percentage of micronutrients per 100g of apple.

The reason for this is that apples (and many other food products; apples are just an arbitrary example) have been selectively bred (and in some cases, modified) for size, and because the soil mineral density has remained the same, the micronutrients per apple have not increased commensurate to the increase in carbohydrate weight and/or water weight. Thus, the resultant percentage will be lower, despite the quantity remaining the same.

We’re going to share some science on this, and/but would like to forewarn readers that the language of this paper is a bit biased, as it looks to “debunk” claims of nutritional values dropping while skimming over “yes, they really have dropped percentage-wise” in favor of “but look, the discrete mass values are still the same, so that’s just a mathematical illusion”.

The reality is, it’s no more a mathematical illusion than is the converse standpoint of saying the nutritional value is the same, despite the per-100g values dropping. After all, sometimes we eat an apple as-is; sometimes we buy a bag of frozen chopped fruit. That 500g bag of chopped fruit is going to contain less copper (for example) than one from decades past.

Here’s the paper, and you’ll see what we mean:

Mineral nutrient composition of vegetables, fruits and grains: The context of reports of apparent historical declines

Supplements aren’t absorbed properly and thus are a waste of money: True or False?

True or False depending on the supplement (and your body, and the rest of your diet)

Many people are suffering from dietary deficiencies of vitamins and minerals, that could be easily correctable by supplementation:

However, as this study by Dr. Fang Fang Zhang shows, a lot of vitamin and mineral supplementation does not appear to have much of an effect on actual health outcomes, vis-à-vis specific diseases. She looks at:

  • Cardiovascular disease
  • Cancer
  • Type 2 diabetes
  • Osteoporosis

Her key take-aways from this study were:

  • Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases
  • People using supplements tend to be older, female, and have higher education, income, and healthier lifestyles than people who do not use them
  • Use of supplements appreciably reduces the prevalence of inadequate intake for most nutrients but also increases the prevalence of excess intake for some nutrients
  • Further research is needed to assess the long term effects of supplements on the health of the general population and in individuals with specific nutritional needs, including those from low and middle income countries

Read her damning report: Health effects of vitamin and mineral supplements

On the other hand…

This is almost entirely about blanket vitamin-and-mineral supplementation. With regard to fish oil supplementation, many commercial fish oil supplements break down in the stomach rather than the intestines, and don’t get absorbed well. Additionally, many people take them in forms that aren’t pleasant, and thus result in low adherence (i.e., they nominally take them, but in fact they just sit on the kitchen counter for a year).

One thing we can conclude from this is that it’s good to check the science for any given supplement before taking it, and know what it will and won’t help for. Our “Monday Research Review” editions of 10almonds do this a lot, although we tend to focus on herbal supplements rather than vitamins and minerals.

We can get everything we need from our diet: True or False?

Contingently True (but here be caveats)

In principle, if we eat the recommended guideline amounts of various macro- and micro-nutrients, we will indeed get all that we are generally considered to need. Obviously.

However, this may come with:

  • Make sure to get enough protein… Without too much meat, and also without too much carbohydrate, such as from most plant sources of protein
  • Make sure to get enough carbohydrates… But only the right kinds, and not too much, nor at the wrong time, and without eating things in the wrong order
  • Make sure to get enough healthy fats… Without too much of the unhealthy fats that often exist in the same foods
  • Make sure to get the right amount of vitamins and minerals… We hope you have your calculators out to get the delicate balance of calcium, magnesium, potassium, phosphorus, and vitamin D right.

That last one’s a real pain, by the way. Too much or too little of one or another and the whole set start causing problems, and several of them interact with several others, and/or compete for resources, and/or are needed for the others to do their job.

And, that’s hard enough to balance when you’re taking supplements with the mg/µg amount written on them, never mind when you’re juggling cabbages and sardines.

On the topic of those sardines, don’t forget to carefully balance your omega-3, -6, and -9, and even within omega-3, balancing ALA, EPA, and DHA, and we hope you’re juggling those HDL and LDL levels too.

So, when it comes to getting everything we need from our diet, for most of us (who aren’t living in food deserts and/or experiencing food poverty, or having a medical condition that restricts our diet), the biggest task is not “getting enough”, it’s “getting enough of the right things without simultaneously overdoing it on the others”.

With supplements, it’s a lot easier to control what we’re putting in our bodies.

And of course, unless our diet includes things that usually can’t be bought in supermarkets, we’re not going to get the benefits of taking, as a supplement, such things as:

Etc.

So, there definitely are supplements with strong science-backed benefits, that probably can’t be found on your plate!

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  • Sweet Dreams Are Made Of Cheese (Or Are They?)

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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

    ❝In order to lose a little weight I have cut out cheese from my diet – and am finding that I am sleeping better. Would be interested in your views on cheese and sleep, and whether some types of cheese are worse for sleep than others. I don’t want to give up cheese entirely!❞

    In principle, there’s nothing in cheese that, biochemically, should impair sleep. If anything, its tryptophan content could aid good sleep.

    Tryptophan is found in many foods, including cheese, which (of common foods, anyway), for example cheddar cheese ranks second only to pumpkin seeds in tryptophan content.

    Tryptophan can be converted by the body into 5-HTP, which you’ve maybe seen sold as a supplement. Its full name is 5-hydroxytryptophan.

    5-HTP can, in turn, be used to make melatonin and/or serotonin. Which of those you will get more of, depends on what your body is being cued to do by ambient light/darkness, and other environmental cues.

    If you are having cheese and then checking your phone, for instance, or otherwise hanging out where there are white/blue lights, then your body may dutifully convert the tryptophan into serotonin (calm wakefulness) instead of melatonin (drowsiness and sleep).

    In short: the cheese will (in terms of this biochemical pathway, anyway) augment some sleep-inducing or wakefulness-inducing cues, depending on which are available.

    You may be wondering: what about casein?

    Casein is oft-touted as producing deep sleep, or disturbed sleep, or vivid dreams, or bad dreams. There’s no science to back any of this up, though the following research review is fascinating:

    Dreams of the Rarebit Fiend: food and diet as instigators of bizarre and disturbing dreams

    (it largely supports the null hypothesis of “not a causal factor” but does look at the many more likely alternative explanations, ranging from associated actually casual factors (such as alcohol and caffeine) and placebo/nocebo effect)

    Finally, simple digestive issues may be the real thing at hand:

    Association between digestive symptoms and sleep disturbance: a cross-sectional community-based study

    Worth noting that around two thirds of all people, including those who regularly enjoy dairy products, have some degree of lactose intolerance:

    Lactose Intolerance in Adults: Biological Mechanism and Dietary Management

    So, in terms of what cheese may be better/worse for you in this context, you might try experimenting with lactose-free cheese, which will help you identify whether that was the issue!

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  • Knee Cracking & Popping: Should You Be Worried?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Tom Walters (Doctor of Physical Therapy) explains about what’s going on behind our musical knees, and whether or not this synovial symphony is cause for concern.

    When to worry (and when not to)

    If the clicking/cracking/popping/etc does not come with pain, then it is probably being caused by the harmless movement of fluid within the joints, in this case specifically the patellofemoral joint, just behind the kneecap.

    As Dr. Walters says:

    ❝It is extremely important that people understand that noises from the knee are usually not associated with pathology and may actually be a sign of a healthy, well-lubricated joint. let’s be careful not to make people feel bad about their knee noise as it can negatively influence how they view their body!❞

    On the other hand, there is also such a thing as patellofemoral joint pain syndrome (PFPS), which is very common, and involves pain behind the kneecap, especially upon over-stressing the knee(s).

    In such cases, it is good to get that checked out by a doctor/physiotherapist.

    Dr. Walters advises us to gradually build up strength, and not try for too much too quickly. He also advises us to take care to strengthen our glutes in particular, so our knees have adequate support. Gentle stretching of the quadriceps and soft tissue mobilization with a foam roller, are also recommended, to reduce tension on the kneecap.

    For more on these things and especially about the exercises, enjoy:

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

    Want to learn more?

    You might like to read:

    How To Really Take Care Of Your Joints

    Take care!

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  • The Purple Parsnip’s Bioactive Brain Benefits (& more)

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    This Root Might Be A Guardian Angel

    Sometimes we go searching for supplements to research; sometimes supplements present themselves for examination! In this case, our attention was grabbed by a headline:

    Angelica gigas extract emerges as a potential treatment for vascular disease

    Angelica who?

    Angelica gigas, also called the purple parsnip (amongst other names), is a flowering plant native to Korea. It has assorted medicinal properties, and in this case, it was its heart-healthy benefits that were making news:

    ❝Ultimately, this study presents clearly evidence that Angelica gigas extract is a promising natural product-based functional food/herbal medicine candidate for preventing or regulating hyperlipidemic cardiovascular complications❞

    Source: Angelica gigas extract inhibits acetylation of eNOS via IRE1α sulfonation/RIDD-SIRT1-mediated posttranslational modification in vascular dysfunction

    But it has a lot more to offer…

    The root has various bioactive metabolites, but the compounds that most studies are most interested in are decursin and decursinol, for their neuroprotective and cognitive enhancement effects:

    ❝[C]rude extracts and isolated components from the root of A. gigas exhibited neuroprotective and cognitive enhancement effects.

    Neuronal damage or death is the most important factor for many neurodegenerative diseases.

    In addition, recent studies have clearly demonstrated the possible mechanisms behind the neuroprotective action of extracts/compounds from the root of A. gigas.❞

    That middle paragraph there? That’s one of the main pathogenic processes of Alzheimer’s, Parkinson’s, Huntington’s, and Multiple Sclerosis.

    Angelica gigas attenuates (reduces the force of) that process:

    ❝The published reports revealed that the extracts and isolated components from the root of A. gigas showed neuroprotective and cognitive enhancement properties through various mechanisms such as anti-apoptosis, antioxidative actions, inhibiting mRNA and protein expressions of inflammatory mediators and regulating a number of signaling pathways.

    In conclusion, the A. gigas root can serve as an effective neuroprotective agent by modulating various pathophysiological processes❞

    Read more: Neuroprotective and Cognitive Enhancement Potentials of Angelica gigas Nakai Root: A Review

    Beyond neuroprotection & cognitive enhancement

    …and also beyond its protection against vascular disease, which is what got our attention…

    Angelica gigas also has antioxidant properties, anti-cancer properties, and general immune-boosting properties.

    We’ve only so much room, so: those links above will take you to example studies for those things, but there are plenty more where they came from, so we’re quite confident in this one.

    Of course, what has antioxidant properties is usually anti-inflammatory, anti-cancer, and anti-aging, because these things are reliant on many of the same processes as each other, with a lot of overlap.

    Where can we get it?

    We don’t sell it, but here’s an example product on Amazon, for your convenience

    Enjoy!

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  • Undoing The Damage Of Life’s Hard Knocks

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    Sometimes, What Doesn’t Kill Us Makes Us Insecure

    We’ve written before about Complex PTSD, which is much more common than the more popularly understood kind:

    PTSD, But, Well…. Complex.

    Given that C-PTSD affects so many people (around 1 in 5, but really, do read the article above! It explains it better than we have room to repeat today), it seems like a good idea to share tips for managing it.

    (Last time, we took all the space for explaining it, so we just linked to some external resources at the end)

    What happened to you?

    PTSD has (as a necessity, as part of its diagnostic criteria) a clear event that caused it, which makes the above question easy to answer.

    C-PTSD often takes more examination to figure out what tapestry of circumstances (and likely but not necessarily: treatment by other people) caused it.

    Often it will feel like “but it can’t be that; that’s not that bad”, or “everyone has things like that” (in which case, you’re probably one of the one in five).

    The deeper questions

    Start by asking yourself: what are you most afraid of, and why? What are you most ashamed of? What do you fear that other people might say about you?

    Often there is a core pattern of insecurity that can be summed up in a simple, harmful, I-message, e.g:

    • I am a bad person
    • I am unloveable
    • I am a fake
    • I am easy to hurt
    • I cannot keep my loved ones safe

    …and so forth.

    For a bigger list of common insecurities to see what resonates, check out:

    Basic Fears/Insecurities, And Their Corresponding Needs/Desires

    Find where they came from

    You probably learned bad beliefs, and consequently bad coping strategies, because of bad circumstances, and/or bad advice.

    • When a parent exclaimed in anger about how stupid you are
    • When a partner exclaimed in frustration that always mess everything up
    • When an employer told you you weren’t good enough

    …or maybe they told you one thing, and showed you the opposite. Or maybe it was entirely non-verbal circumstances:

    • When you gambled on a good idea and lost everything
    • When you tried so hard at some important endeavour and failed
    • When you thought someone could be trusted, and learned the hard way that you were wrong

    These are “life’s difficult bits”, but when we’ve lived through a whole stack of them, it’s less like a single shattering hammer-blow of PTSD, and more like the consistent non-stop tap tap tap that ends up doing just as much damage in the long run.

    Resolve them

    That may sound a bit like a “and quickly create world peace” level of task, but we have tools:

    Ask yourself: what if…

    …it had been different? Take some time and indulge in a full-blown fantasy of a life that was better. Explore it. How would those different life lessons, different messages, have impacted who you are, your personality, your behaviour?

    This is useful, because the brain is famously bad at telling real memories from false ones. Consciously, you’ll know that one was an exploratory fantasy, but to your brain, it’s still doing the appropriate rewiring. So, little by little, neuroplasticity will do its thing.

    Tell yourself a better lie

    We borrowed this one from the title of a very good book which we’ve reviewed previously.

    This idea is not about self-delusion, but rather that we already express our own experiences as a sort of narrative, and that narrative tends to contain value judgements that are often not useful, e.g. “I am stupid”, “I am useless”, and all the other insecurities we mentioned earlier. Some simple examples might be:

    • “I had a terrible childhood” → “I have come so far”
    • “I should have known better” → “I am wiser now”
    • “I have lost so much” → “I have experienced so much”

    So, replacing that self-talk can go a long way to re-writing how secure we feel, and therefore how much trauma-response (ideally: none!) we have to stimuli that are not really as threatening as we sometimes feel they are (a hallmark of PTSD in general).

    Here’s a guide to more ways:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    Take care!

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  • A new government inquiry will examine women’s pain and treatment. How and why is it different?

    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 Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.

    The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.

    The gender pain gap

    Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.

    Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.

    These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.

    It feels worse

    Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.

    Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.

    Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.

    woman lies in bed in pain
    Women seem to feel pain more acutely and often feel ignored by doctors.
    Shutterstock

    Medical misogyny

    Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.

    Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.

    It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.

    Misogyny exists in research too

    Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.

    The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.

    These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.

    When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.

    So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.

    What will the inquiry involve?

    Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.

    Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.

    The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.The Conversation

    Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia

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

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  • The Natural Facelift – by Sophie Perry

    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.

    First, what this book isn’t: it’s mostly not about beauty, and it’s certainly not about ageist ideals of “hiding” aging.

    The author herself discusses the privilege that is aging (not everyone gets to do it) and the importance of taking thankful pride in our lived-in bodies.

    The title and blurb belie the contents of the book rather. Doubtlessly the publisher felt that extrinsic beauty would sell better than intrinsic wellbeing. As for what it’s actually more about…

    Ever splashed your face in cold water to feel better? This book’s about revitalising the complex array of facial muscles (there are anatomical diagrams) and the often-tired and very diverse tissues that cover them, complete with the array of nerve endings very close to your CNS (not to mention the vagus nerve running just behind your jaw), and some of the most important blood vessels of your body, serving your brain.

    With all that in mind, this book, full of useful therapeutic techniques, is a very, very far cry from “massage like this and you’ll look like you got photoshopped”.

    The style varies, as some parts of explanation of principles, or anatomy, and others are hands-on (literally) guides to the exercises, but it is all very clear and easy to understand/follow.

    Bottom line: aspects of conventional beauty may be a side-effect of applying the invigorating exercises described in this book. The real beauty is—literally—more than skin-deep.

    Click here to check out The Natural Facelift, and order yours!

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