Switchcraft – by Dr. Elaine Fox

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How do we successfully balance “a mind is like a parachute: it only works if it’s open”, with the importance of also actually having some kind of personal integrity and consistency?

Dr. Fox recommends that we focus on four key attributes:

  • Mental agility
  • Self-awareness
  • Emotional awareness
  • Situational awareness

If this sounds a little wishy-washy, it isn’t—she delineates and explains each in detail. And most importantly: how we can build and train each one.

Mental agility, for example, is not about being able to rapidly solve chess problems or “answer these riddles three”. It’s more about:

  • Adaptability
  • Balancing our life
  • Challenging (and if appropriate, changing) our perspective
  • Developing our mental competence

This sort of thing is the “meat” of the book. Meanwhile, self-awareness is more a foundational conscious knowledge of one’s own “pole star” values, while emotional awareness is a matter of identifying and understanding and accepting what we feel—anything less is self-sabotage! And situational awareness is perhaps most interesting:

Dr. Fox advocates for “trusting one’s gut feelings”. With a big caveat, though!

If we trust our gut feelings without developing their accuracy, we’re just going to go about being blindly prejudiced and often wrong. So, a whole section of the book is devoted to honing this and improving our ability to judge things as they really are—rather than as we expect.

Bottom line: this book is a great tool for not only challenging our preconceptions about how we think, but giving us the resources to be adaptable and resilient without sacrificing integrity.

Click here to check out Switchcraft on Amazon and level up your thinking!

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  • Why a common asthma drug will now carry extra safety warnings about depression

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    Australia’s Therapeutic Goods Administration (TGA) recently issued a safety alert requiring extra warnings to be included with the asthma and hay fever drug montelukast.

    The warnings are for users and their families to look for signs of serious behaviour and mood-related changes, such as suicidal thoughts and depression. The new warnings need to be printed at the start of information leaflets given to both patients and health-care providers (sometimes called a “boxed” warning).

    So why did the TGA issue this warning? And is there cause for concern if you or a family member uses montelukast? Here’s what you need to know.

    First, what is montelukast?

    Montelukast is a prescription drug also known by its brand names which include Asthakast, Lukafast, Montelair and Singulair. It’s used to manage the symptoms of mild-to-moderate asthma and seasonal hay fever in children and adults.

    Asthma occurs when the airways tighten and produce extra mucus, which makes it difficult to get air into the lungs. Likewise, the runny nose characteristic of hay fever occurs due to the overproduction of mucus.

    Leukotrienes are an important family of chemicals found throughout the airways and involved in both mucus production and airway constriction. Montelukast is a cysteinyl leukotriene receptor antagonist, meaning it blocks the site in the airways where the leukotrienes work.

    Montelukast can’t be used to treat acute asthma (an asthma attack), as it takes time for the tablet to be broken down in the stomach and for it to be absorbed into the body. Rather, it’s taken daily to help prevent asthma symptoms or seasonal hay fever.

    It can be used alongside asthma puffers that contain corticosteriods and drugs like salbutamol (Ventolin) in the event of acute attacks.

    What is the link to depression and suicide?

    The possibility that this drug may cause behavioural changes is not new information. Manufacturers knew this as early as 2007 and issued warnings for possible side-effects including depression, suicidality and anxiousness.

    The United Kingdom’s Medicines and Healthcare products Regulatory Agency has required a warning since 2008 but mandated a more detailed warning in 2019. The United States’ Food and Drug Administration has required boxed warnings for the drug since 2020.

    A child using an inhaler.
    Montelukast can help children and adults with asthma. adriaticfoto/Shutterstock

    Montelukast is known to potentially induce a number of behaviour and mood changes, including agitation, anxiety, depression, irritability, obsessive-compulsive symptoms, and suicidal thoughts and actions.

    Initially a 2009 study that analysed data from 157 clinical trials involving more than 20,000 patients concluded there were no completed suicides due to taking the drug, and only a rare risk of suicide thoughts or attempts.

    The most recent study, published in November 2024, examined data from more than 100,000 children aged 3–17 with asthma or hay fever who either took montelukast or used only inhaled corticosteroids.

    It found montelukast use was associated with a 32% higher incidence of behavioural changes. The behaviour change with the strongest association was sleep disturbance, but montelukast use was also linked to increases in anxiety and mood disorders.

    In the past ten years, around 200 incidences of behavioural side-effects have been reported to the TGA in connection with montelukast. This includes 57 cases of depression, 60 cases of suicidal thoughts and 17 suicide attempts or incidents of intentional self-injury. There were seven cases where patients taking the drug did complete a suicide.

    This is of course tragic. But these numbers need to be seen in the context of the number of people taking the drug. Over the same time period, more than 200,000 scripts for montelukast have been filled under the Pharmaceutical Benefits Scheme.

    Overall, we don’t know conclusively that montelukast causes depression and suicide, just that it seems to increase the risk for some people.

    CT images of the brain.
    We’re still not sure how the drug can act on the brain to lead to behaviour changes. Elif Bayraktar/Shutterstock

    And if it does change behaviour, we don’t fully understand how this happens. One hypothesis is that the drug and its breakdown products (or metabolites) affect brain chemistry.

    Specifically, it might interfere with how the brain detoxifies the antioxidant glutathione or alter the regulation of other brain chemicals, such as neurotransmitters.

    Why is the TGA making this change now?

    The new risk warning requirement comes from a meeting of the Australian Advisory Committee on Medicines where they were asked to provide advice on ways to minimise the risk for the drug given current international recommendations.

    Even though the 2024 review didn’t highlight any new risks, to align with international recommendations, and help address consumer concerns, the advisory committee recommended a boxed warning be added to drug information sheets.

    If you have asthma and take montelukast (or your child does), you should not just stop taking the drug, because this could put you at risk of an attack that could be life threatening. If you’re concerned, speak to your doctor who can discuss the risks and benefits of the medication for you, and, if appropriate, prescribe a different medication.

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

    Nial Wheate, Professor of Pharmaceutical Chemistry, Macquarie University

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

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  • Potatoes & Anxiety

    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? 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

    ❝My other half considers potatoes a wonder food, except when fried. I don’t. I find, when I am eating potatoes I put on weight; and, when I’m not eating them, I lose it. Also, although I can’t swear to it, potatoes also make me feel a little anxious (someone once told me it could have something to do with where they are on the “glycemic index”). What does the science say?❞

    The glycemic index of potatoes depends on the kind of potato (obviously) and also, less obviously, how it’s prepared. For a given white potato, boiling (which removes a lot of starch) might produce a GI of around 60, while instant mash (basically: potato starch) can be more like 80. For reference, pure glucose is 100. And you probably wouldn’t take that in the same quantity you’d take potato, and expect to feel good!

    So: as for anxiety, it could be, since spiked blood sugars can cause mood swings, including anxiety.

    Outside of the matter of blood sugars, the only reference we could find for potatoes causing anxiety was fried potatoes specifically:

    ❝frequent fried food consumption, especially fried potato consumption, is strongly associated with 12% and 7% higher risk of anxiety and depression, respectively❞

    Source: High fried food consumption impacts anxiety and depression due to lipid metabolism disturbance and neuroinflammation

    …which heavily puts the blame not on the potatoes themselves, but on acrylamide (the orange/brown stuff that is made by the Maillard reaction of cooking starches in the absence of water, e.g. by frying, roasting, etc).

    Here’s a very good overview of that, by the way:

    A Review on Acrylamide in Food: Occurrence, Toxicity, and Mitigation Strategies

    Back on the core topic of potatoes and GI and blood sugar spikes and anxiety, you might benefit from a few tweaks that will allow you to enjoy potatoes without spiking blood sugars:

    10 Ways To Balance Blood Sugars

    Enjoy!

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  • Savor: Mindful Eating, Mindful Life – by Thich Nhat Hanh and Dr. Lilian Cheung

    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.

    We’ve talked about mindful eating before at 10almonds, so here’s a book about it. You may wonder how much there is to say!

    As it happens, there’s quite a bit. The authors, a Buddhist monk (Hanh) and a Harvard nutritionist (Dr. Cheung) explore the role of mindful eating in our life.

    There is an expectation that we the reader want to lose weight. If we don’t, those parts of the book will be a “miss” for us, but still contain plenty of other value.

    Most of the same advices can be applied equally to other aspects of health, in any case. A lot of that comes from the book’s Buddhist principles, including the notion that:

    1. We are experiencing suffering
    2. Suffering has a cause
    3. What has a cause can have an end
    4. The way to this end is mindfulness

    As such, the process itself is also mindfulness all the way through:

    1. To be mindful of our suffering (and not let it become background noise to be ignored)
    2. To be mindful of the cause of our suffering (rather than dismissing it as just how things are)
    3. To be mindful of how to address that, and thus end the suffering (rather than despairing in inaction)
    4. To engage mindfully in the process of doing so (and thus not fall into the trap of thinking “job done”)

    And, as for Dr. Cheung? She also has input throughout, with practical advice about the more scientific side of rethinking one’s diet.

    Bottom line: this is an atypical book, and/but perhaps an important one. Certainly, at the very least it may be one to try if more conventional approaches have failed!

    Click here to check out “Savor” on Amazon today, and get mindful!

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Related Posts

  • Get On It! – by Jane Aronovitch, Miriane Taylor, & Colleen Craig
  • The Best Form Of Sugar During Exercise

    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 😎

    ❝What is the best form of sugar for an energy kick during exercise? Both type of sugar eg glicoae fructose dextrose etc and medium, ie drink, gel, solids etc❞

    Great question! Let’s be clear first that we’re going to answer this specifically for the context of during exercise.

    Because, if you’re not actively exercising strenuously right at the time when you’re taking the various things we’re going to be talking about, the results will not be the same.

    For scenarios that are anything less than “I am exercising right now and my muscles (not joints, or anything else) are feeling the burn”, then instead please see this:

    Snacks & Hacks: Eating For Energy (In Ways That Actually Work)

    Because, to answer your question, we’re going to be going 100% against the first piece of advice in that article, which was “Skip the quasi-injectables”, i.e., anything marketed as very quick release. Those things are useful for diabetics to have handy just in case of needing to urgently correct a hypo, but for most people most of the time, they’re not. See also:

    Which Sugars Are Healthier, And Which Are Just The Same?

    However…

    When strenuously exercising in a way that is taxing our muscles, we do not have to worry about the usual problem of messing up our glucose metabolism by overloading our body with sugars faster than it can use it (thus: it has to hurriedly convert glucose and shove it anywhere it’ll fit to put it away, which is very bad for us), because right now, in the exercise scenario we’re describing, the body is already running its fastest metabolism and is grabbing glucose anywhere it can find it.

    Which brings us to our first key: the best type of sugar for this purpose is glucose. Because:

    • glucose: the body can use immediately and easily convert whatever’s spare to glycogen (a polysaccharide of glucose) for storage
    • fructose: the body cannot use immediately and any conversion of fructose to glycogen has to happen in the liver, so if you take too much fructose (without anything to slow it down, such as the fiber in whole fruit), you’re not only not going to get usable energy (the sugar is just going to be there in your bloodstream, circulating, not getting used, because it doesn’t trigger insulin release and insulin is the gatekeeper that allows sugar to be used), but also, it’s going to tax the liver, which if done to excess, is how we get non-alcoholic fatty liver disease.
    • sucrose: is just a disaccharide of glucose and fructose, so it first gets broken down into those, and then its constituent parts get processed as above. Other disaccharides you’ll see mentioned sometimes are maltose and lactose, but again, they’re just an extra step removed from useful metabolism, so to save space, we’ll leave it at that for those today.
    • dextrose: is just glucose, but when the labeller is feeling fancy. It’s technically informational because it specifies what isomer of glucose it is, but basically all glucose found in food is d-glucose, i.e. dextrose. Other isomers of glucose can be synthesized (very expensively) in laboratories or potentially found in obscure places (the universe is vast and weird), but in short: unless someone’s going to extreme lengths to get something else, all glucose we encounter is dextrose, and all (absolutely all) dextrose is glucose.

    We’d like to show scientific papers contesting these head-to-head for empirical proof, but since the above is basic chemistry and physiology, all we could find is papers taking this for granted and stating in their initial premise that sports drinks, gels, bars usually contain glucose as their main sugar, potentially with some fructose and sucrose. Like this one:

    A Comprehensive Study on Sports and Energy Drinks

    As for how to take it, again this is the complete opposite of our usual health advice of “don’t drink your calories”, because in this case, for once…

    (and again, we must emphasize: only while actively doing strenuous exercise that is making specifically your muscles burn, not your joints or anything else; if your joints are burning you need to rest and definitely don’t spike your blood sugars because that will worsen inflammation)

    …just this once, we do want those sugars to be zipping straight into the blood. Which means: liquid is best for this purpose.

    And when we say liquid: gel is the same as a drink, so far as the body is concerned, provided the body in question is adequately hydrated (i.e., you are also drinking water).

    Here are a pair of studies (by the same team, with the same general methodology), testing things head-to-head, with endurance cyclists on 6-hour stationary cycle rides:

    CHO Oxidation from a CHO Gel Compared with a Drink during Exercise

    Meanwhile, liquid beat solid, but only significantly so from the 90-minute mark onwards, and even that significant difference was modest (i.e. it’s clinically significant, it’s a statistically reliable result and improbable as random happenstance, but the actual size of the difference was not huge):

    Oxidation of Solid versus Liquid CHO Sources during Exercise

    We would hypothesize that the reason that liquids only barely outperformed solids for this task is precisely because the solids in question were also designed for the task. When a company makes a fast-release energy bar, they don’t load it with fiber to slow it down. Which differentiates this greatly from, say, getting one’s sugars from whole fruit.

    If the study had compared apples to apple juice, we hypothesize the results would have been very different. But alas, if that study has been done, we couldn’t find it.

    Today has been all about what’s best during exercise, so let’s quickly finish with a note on what’s best before and after:

    Before: What To Eat, Take, And Do Before A Workout

    After: Overdone It? How To Speed Up Recovery After Exercise

    Take care!

    Don’t Forget…

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  • Gentle Nutrition – by Rachel Hartley, RD, LD

    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 subtitle here claims “a non-diet approach”, but doesn’t everything, nowadays? Even books titled “The such-and-such Diet” tend to also assure us “it’s not actually a diet; it’s just a way of eating”, as if a diet is not—by definition—a way of eating. Usually what they want to communicate is that it’s not a restrictive diet, usually meaning not restrictive in quantity, or not restrictive in food type (rarely both).

    This book is about intuitive eating, which is about as non-restrictive as any dietary approach can be, since it doesn’t restrict food type at at all, and it doesn’t restrict quantity in advance—rather, we learn to pay closer attention to our full signals.

    No wait, we don’t. This time, it’s not about “full”, it’s about “satisfied”. This comes in two forms:

    1. A principle somewhat akin to the “eat until 80% full” idea
    2. A principle of ensuring the good is culinarily satisfying

    This latter is important, if we want to have a good relationship with eating, and it also helps reduce portion sizes, when we truly take the time to mindfully savor a tasty morsel, rather than wolf down a plate of mediocre food.

    The style is one that balance being encouraging with delivering science to back up that encouragement. This not only means encouragement to take up this dietary approach, but also, encouragement to let go of things like calorie-counting and BMI.

    The recipes arranged per meal type, and indeed include things not found in many healthy eating books, such as gyoza dumplings, gnocchi, wontons, and shortbread. The recipes are mostly not, by default, vegan, vegetarian, gluten-free, dairy-free, or such. So if you have your own food restriction(s), the number of usable recipes will be diminished, barring any substitutions you can make yourself.

    Bottom line: this is more about about how to go about intuitive eating, than it is a book with a lot of nutritional information (though there is some of that too). If you’d like to get going with intuitive eating, then this book can help.

    Click here to check out Gentle Nutrition, and nourish gently!

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  • Healing Back Pain – by Dr. John Sarno

    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.

    Often when we review books with titles like this one, we preface it with a “what it’s not: a think-yourself-better book”.

    In this case… It is, in fact, a think-yourself-better book. However, its many essay-length rave reviews caught our attention, and upon reading, we can report: its ideas are worth reading.

    The focus of this book is on TMS, or “Tension Myoneural Syndrome”, to give it its full name. The author asserts (we cannot comment on the accuracy) that many cases of TMS are misdiagnosed as other things, from sciatica to lupus. When other treatments fail, or are simply not available (no cure for lupus yet, for example) or are unenticing (risky surgeries, for example), he offers an alternative approach.

    Dr. Sarno lays out the case for TMS being internally fixable, since our muscles and nerves are all at the command of our brain. Rather than taking a physical-first approach, he takes a psychological-first approach, before building into a more holistic model.

    The writing style is… A little dated and salesey and unnecessarily padded, to be honest, but the content makes it worthwhile.

    Bottom line: if you have back pain, then the advice of this book, priced not much more than a box of top brand painkillers, seems a very reasonable thing to try.

    Click here to check out Healing Back Pain, and see if it works for you!

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