The Blood Sugar Solution – by Dr. Mark Hyman
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The main purpose of this book is combating metabolic disease, the amalgam of what’s often prediabetes (sometimes fully-fledged diabetes) and cardiovascular disease (sometimes fully-fledged heart disease).
To achieve this (after an introductory section explaining what the sociomedical problems are and why the sociomedical problems are happening), he offers a seven-step program; we’ll not keep those steps a mystery; they are:
- Boost your nutrition
- Regulate your hormones
- Reduce inflammation
- Improve your digestion
- Maximize detoxification
- Enhance energy metabolism
- Soothe your mind
Thereafter, it’s all about leading the reader by the hand through the steps; he also offers a six-week action plan, and a six-week meal plan with recipes.
The style is very sensationalist (too sensationalist for this reviewer’s personal taste) but nevertheless backed up with hard science when it comes to hard claims. So, if you don’t mind wading through (or skipping) some early chapters that are a bit “used car salesman” in feel, there’s actually a lot of good information, especially in the middle of the book, and useful practical guides in the middle and end.
Bottom line: if you want a good comprehensive science-based practical guide to addressing the risk of metabolic disease, this is that.
Click here to check out The Blood Sugar Solution, and look after yours!
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Gluten: What’s The Truth?
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Gluten: What’s The Truth?
We asked you for your health-related view of gluten, and got the above spread of results. To put it simply:
Around 60% of voters voted for “Gluten is bad if you have an allergy/sensitivity; otherwise fine”
The rest of the votes were split fairly evenly between the other three options:
- Gluten is bad for everyone and we should avoid it
- Gluten is bad if (and only if) you have Celiac disease
- Gluten is fine for all, and going gluten-free is a modern fad
First, let’s define some terms so that we’re all on the same page:
What is gluten?
Gluten is a category of protein found in wheat, barley, rye, and triticale. As such, it’s not one single compound, but a little umbrella of similar compounds. However, for the sake of not making this article many times longer, we’re going to refer to “gluten” without further specification.
What is Celiac disease?
Celiac disease is an autoimmune disease. Like many autoimmune diseases, we don’t know for sure how/why it occurs, but a combination of genetic and environmental factors have been strongly implicated, with the latter putatively including overexposure to gluten.
It affects about 1% of the world’s population, and people with Celiac disease will tend to respond adversely to gluten, notably by inflammation of the small intestine and destruction of enterocytes (the cells that line the wall of the small intestine). This in turn causes all sorts of other problems, beyond the scope of today’s main feature, but suffice it to say, it’s not pleasant.
What is an allergy/intolerance/sensitivity?
This may seem basic, but a lot of people conflate allergy/intolerance/sensitivity, so:
- An allergy is when the body mistakes a harmless substance for something harmful, and responds inappropriately. This can be mild (e.g. allergic rhinitis, hayfever) or severe (e.g. peanut allergy), and as such, responses can vary from “sniffly nose” to “anaphylactic shock and death”.
- In the case of a wheat allergy (for example), this is usually somewhere between the two, and can for example cause breathing problems after ingesting wheat or inhaling wheat flour.
- An intolerance is when the body fails to correctly process something it should be able to process, and just ejects it half-processed instead.
- A common and easily demonstrable example is lactose intolerance. There isn’t a well-defined analog for gluten, but gluten intolerance is nonetheless a well-reported thing.
- A sensitivity is when none of the above apply, but the body nevertheless experiences unpleasant symptoms after exposure to a substance that should normally be safe.
- In the case of gluten, this is referred to as non-Celiac gluten sensitivity
A word on scientific objectivity: at 10almonds we try to report science as objectively as possible. Sometimes people have strong feelings on a topic, especially if it is polarizing.
Sometimes people with a certain condition feel constantly disbelieved and mocked; sometimes people without a certain condition think others are imagining problems for themselves where there are none.
We can’t diagnose anyone or validate either side of that, but what we can do is report the facts as objectively as science can lay them out.
Gluten is fine for all, and going gluten-free is a modern fad: True or False?
Definitely False, Celiac disease is a real autoimmune disease that cannot be faked, and allergies are also a real thing that people can have, and again can be validated in studies. Even intolerances have scientifically measurable symptoms and can be tested against nocebo.
See for example:
- Epidemiology and clinical presentations of Celiac disease
- Severe forms of food allergy that can precipitate allergic emergencies
- Properties of gluten intolerance: gluten structure, evolution, and pathogenicity
However! It may not be a modern fad, so much as a modern genuine increase in incidence.
Widespread varieties of wheat today contain a lot more gluten than wheat of ages past, and many other molecular changes mean there are other compounds in modern grains that never even existed before.
However, the health-related impact of these (novel proteins and carbohydrates) is currently still speculative, and we are not in the business of speculating, so we’ll leave that as a “this hasn’t been studied enough to comment yet but we recognize it could potentially be a thing” factor.
Gluten is bad if (and only if) you have Celiac disease: True or False?
Definitely False; allergies for example are well-evidenced as real; same facts as we discussed/linked just above.
Gluten is bad for everyone and we should avoid it: True or False?
False, tentatively and contingently.
First, as established, there are people with clinically-evidenced Celiac disease, wheat allergy, or similar. Obviously, they should avoid triggering those diseases.
What about the rest of us, and what about those who have non-Celiac gluten sensitivity?
Clinical testing has found that of those reporting non-Celiac gluten sensitivity, nocebo-controlled studies validate that diagnosis in only a minority of cases.
In the following study, for example, only 16% of those reporting symptoms showed them in the trials, and 40% of those also showed a nocebo response (i.e., like placebo, but a bad rather than good effect):
This one, on the other hand, found that positive validations of diagnoses were found to be between 7% and 77%, depending on the trial, with an average of 30%:
Re-challenge Studies in Non-celiac Gluten Sensitivity: A Systematic Review and Meta-Analysis
In other words: non-Celiac gluten sensitivity is a thing, and/but may be over-reported, and/but may be in some part exacerbated by psychosomatic effect.
Note: psychosomatic effect does not mean “imagining it” or “all in your head”. Indeed, the “soma” part of the word “psychosomatic” has to do with its measurable effect on the rest of the body.
For example, while pain can’t be easily objectively measured, other things, like inflammation, definitely can.
As for everyone else? If you’re enjoying your wheat (or similar) products, it’s well-established that they should be wholegrain for the best health impact (fiber, a positive for your health, rather than white flour’s super-fast metabolites padding the liver and causing metabolic problems).
Wheat itself may have other problems, for example FODMAPs, amylase trypsin inhibitors, and wheat germ agglutinins, but that’s “a wheat thing” rather than “a gluten thing”.
That’s beyond the scope of today’s main feature, but you might want to check out today’s featured book!
For a final scientific opinion on this last one, though, here’s what a respected academic journal of gastroenterology has to say:
From coeliac disease to noncoeliac gluten sensitivity; should everyone be gluten-free?
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Beetroot For More Than Just Your Blood Pressure
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Beetroot is well-known for being good for blood pressure, but what else can it do?
Firstly, blood pressure, yes
This is because… Well, we’ll quote from a paper:
❝As a source of nitrate, beetroot ingestion provides a natural means of increasing in vivo nitric oxide (NO) availability and has emerged as a potential strategy to prevent and manage pathologies associated with diminished NO bioavailability, notably hypertension and endothelial function❞
Source: The Potential Benefits of Red Beetroot Supplementation in Health and Disease
That’s a little modest in its wording though, so let’s just be clear, it does work:
- The effects of dietary nitrate on blood pressure and endothelial function: a review of human intervention studies
- Clinical evidence demonstrating the utility of inorganic nitrate in cardiovascular health
- Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway
…where you can see that it significantly reduced systolic and diastolic blood pressure.
Note: this does mean that if you suffer conversely from hypotension (dangerously low blood pressure) you should probably skip the beetroot.
For your blood sugar levels, too
The fiber in whole beetroot or powdered beetroot extract (but not beetroot juice) is, as usual, good for balancing blood sugars. However, in the case of beetroot, it (probably because of the betalain content, specifically betanin) also improves insulin sensitivity, resulting in lower fasting and postprandial (after-dinner) insulin levels:
See also (cited in the above paper): Post-prandial effect of beetroot (beta vulgaris) juice on glucose and lipids levels of apparently healthy subjects
For your blood lipids, also
This one has less readily available research to support it, so in the category of “papers that aren’t paywalled into oblivion”, here’s one that concludes with the entertainingly specific:
❝Results: Beetroot juice intake increased plasma high density lipoprotein (t= -60.88, P<0.05). Triglyceride, total cholesterol, and low density lipoprotein were reduced (P<0.05). Compared with placebo, beetroot juice reduced the concentrations of triglyceride, total cholesterol, and low density lipoprotein (P<0.05).
Conclusion: Regular beetroot juice intake has significant effects on lipid profile in female soccer players, hence its suggestion for preventing diseases such as hypercholesterolemia and hypertension in female soccer players.❞
However, even if you are not a female soccer player, chances are it will have the same effect on your physiology as theirs (but, credit where it’s due, it’s right that they make claims about only what they know for sure).
Here’s the paper: Efficacy of Beetroot Juice Consumption on the Lipid Profile of Female Soccer Players
What’s good for your blood, is good for your brain
…and that’s just as true here:
When reading that, you’ll see that as well as two health outcome benefits (antidiabetic and anti-Alzheimer’s), there are also two mechanisms of action, which are:
- The blood sugar lowering, insulin sensitivity increasing, lipid improving, qualities we discussed already
- Its fabulous flavonoid content
These two things each in turn have a lot of other components and nuances, so here’s an infographic covering them ← this flowchart makes it all a lot clearer
On which note, those flavonoids aren’t the only active compounds present that result in…
Antioxidant & anti-inflammatory action
This one’s pretty straightforward, but it’s worth mentioning also that (as is commonly the case) what fights oxidation also fights cancer:
❝In recent years, the beetroot, especially the betalains (betanin) and nitrates it contains, now has received increasing attention for their effective biological activity.
Betalains have been proven to eliminate oxidative and nitrative stress by scavenging DPPH, preventing DNA damage, and reducing LDL.
It also has been found to exert antitumor activity by inhibiting cell proliferation, angiogenesis, inducing cell apoptosis, and autophagy.❞
Want to try some?
We don’t sell it, but you can easily grow your own or find it at your local supermarket; if you prefer it in supplement form, dried is better than juice (for a multitude of reasons), so here for your convenience is an example product on Amazon 😎
Enjoy!
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Nudge – by Richard Thaler & Cass Sunstein
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How often in life do we make a suboptimal decision that ends up plaguing us for a long time afterwards? Sometimes, a single good or bad decision can even directly change the rest of our life.
So, it really is important that we try to optimize the decisions we do make.
Professors Richard Thaler and Cass Sunstein look at all kinds of decision-making in this book. Their goal, as per the subtitle, is “improving decisions about health, wealth, and happiness”.
For the most part, the book concentrates on “nudges”. Small factors that influence our decisions one way or another.
Most importantly: that some of them are very good reasons to be nudged; others, very bad ones. And they often look similar.
Where this book excels is in highlighting the many ways we make decisions without even thinking about it… or we think about it, but only down a prescribed, foreseen track, to an externally expected conclusion (for example, an insurance company offering three packages, but two of them exist only to direct you to the “correct” choice).
A weakness of the book is that in some aspects it’s a little inconsistent. The authors describe their economic philosophy as “libertarian paternalism”, and as libertarians they’re against mandates, except when as paternalists they’re for them. But, if we take away their labels, this boils down to “some mandates can be good and some can be bad”, which would not be so inconsistent after all.
Bottom line: if you’d like to better understand your own decision-making processes through the eyes of policy-setting economists (especially Sunstein, who worked for the White House Office of Information & Regulatory Affairs) whose job it is to make sure you make the “right” decisions, then this is a very enlightening book.
Click here to check out Nudge and improve your decision-making clarity!
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When can my baby drink cow’s milk? It’s sooner than you think
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.
Parents are often faced with well-meaning opinions and conflicting advice about what to feed their babies.
The latest guidance from the World Health Organization (WHO) recommends formula-fed babies can switch to cow’s milk from six months. Australian advice says parents should wait until 12 months. No wonder some parents, and the health professionals who advise them, are confused.
So what do parents need to know about the latest advice? And when is cow’s milk an option?
What’s the updated advice?
Last year, the WHO updated its global feeding guideline for children under two years old. This included recommending babies who are partially or totally formula fed can have whole animal milks (for example, full-fat cow’s milk) from six months.
This recommendation was made after a systematic review of research by WHO comparing the growth, health and development of babies fed infant formula from six months of age with those fed pasteurised or boiled animal milks.
The review found no evidence the growth and development of babies who were fed infant formula was any better than that of babies fed whole, fresh animal milks.
The review did find an increase in iron deficiency anaemia in babies fed fresh animal milk. However, WHO noted this could be prevented by giving babies iron-rich solid foods daily from six months.
On the strength of the available evidence, the WHO recommended babies fed infant formula, alone or in addition to breastmilk, can be fed animal milk or infant formula from six months of age.
The WHO said that animal milks fed to infants could include pasteurised full-fat fresh milk, reconstituted evaporated milk, fermented milk or yoghurt. But this should not include flavoured or sweetened milk, condensed milk or skim milk.
If you’re choosing cow’s milk for your baby, make sure it’s whole milk rather than skim milk. Mr Adi/Shutterstock Why is this controversial?
Australian government guidelines recommend “cow’s milk should not be given as the main drink to infants under 12 months”. This seems to conflict with the updated WHO advice. However, WHO’s advice is targeted at governments and health authorities rather than directly at parents.
The Australian dietary guidelines are under review and the latest WHO advice is expected to inform that process.
OK, so how about iron?
Iron is an essential nutrient for everyone but it is particularly important for babies as it is vital for growth and brain development. Babies’ bodies usually store enough iron during the final few weeks of pregnancy to last until they are at least six months of age. However, if babies are born early (prematurely), if their umbilical cords are clamped too quickly or their mothers are anaemic during pregnancy, their iron stores may be reduced.
Cow’s milk is not a good source of iron. Most infant formula is made from cow’s milk and so has iron added. Breastmilk is also low in iron but much more of the iron in breastmilk is taken up by babies’ bodies than iron in cow’s milk.
Babies should not rely on milk (including infant formula) to supply iron after six months. So the latest WHO advice emphasises the importance of giving babies iron-rich solid foods from this age. These foods include:
- meat
- eggs
- vegetables, including beans and green leafy vegetables
- pulses, including lentils
- ground seeds and nuts (such as peanut or other nut butters, but with no added salt or sugar).
You may have heard that giving babies whole cow’s milk can cause allergies. In fact, whole cow’s milk is no more likely to cause allergies than infant formula based on cow’s milk.
If you’re introducing cow’s milk at six months, offer iron-rich foods too, such as meat or lentils. pamuk/Shutterstock What are my options?
The latest WHO recommendation that formula-fed babies can switch to cow’s milk from six months could save you money. Infant formula can cost more than five times more than fresh milk (A$2.25-$8.30 a litre versus $1.50 a litre).
For families who continue to use infant formula, it may be reassuring to know that if infant formula becomes hard to get due to a natural disaster or some other supply chain disruption fresh cow’s milk is fine to use from six months.
It is also important to know what has not changed in the latest feeding advice. WHO still recommends infants have only breastmilk for their first six months and then continue breastfeeding for up to two years or more. It is also still the case that infants under six months who are not breastfed or who need extra milk should be fed infant formula. Toddler formula for children over 12 months is not recommended.
All infant formula available in Australia must meet the same standard for nutritional composition and food safety. So, the cheapest infant formula is just as good as the most expensive.
What’s the take-home message?
The bottom line is your baby can safely switch from infant formula to fresh, full-fat cow’s milk from six months as part of a healthy diet with iron-rich foods. Likewise, cow’s milk can also be used to supplement or replace breastfeeding from six months, again alongside iron-rich foods.
If you have questions about introducing solids your GP, child health nurse or dietitian can help. If you need support with breastfeeding or starting solids you can call the National Breastfeeding Helpline (1800 686 268) or a lactation consultant.
Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University; Naomi Hull, PhD candidate, food security for infants and young children, University of Sydney, and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Daily Stoic – by Ryan Holiday & Stephen Hanselman
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What’s this, a philosophy book in a health and productivity newsletter? Well, look at it this way: Aristotle basically wrote the “How To Win Friends And Influence People” of his day, and Plato before him wrote a book about management.
In this (chiefly modern!) book, we see what the later Stoic philosophers had to say about getting the most out of life—which is also what we’re about, here at 10almonds!
We tend to use the word “stoic” in modern English to refer to a person who is resolute in the face of hardship. The traditional meaning does encompass that, but also means a lot more: a whole, rounded, philosophy of life.
Philosophy in general is not an easy thing into which to “dip one’s toe”. No matter where we try to start, it seems, it turns out there were a thousand other things we needed to read first!
This book really gets around that. The format is:
- There’s a theme for each month
- Each month has one lesson per day
- Each daily lesson starts with some words from a renowned stoic philosopher, and then provides commentary on such
- The commentary provides a jumping-off point and serves as a prompt to actually, genuinely, reflect and apply the ideas.
Unlike a lot of “a year of…” day-by-day books, this is not light reading, by the way, and you are getting a weighty tome for your money.
But, the page-length daily lessons are indeed digestible—which, again, is what we like at 10almonds!
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Eat To Avoid (Or Beat) PCOS
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Polycystic ovary syndrome, PCOS, affects very many people; around 1 in 5 women. It can show up unexpectedly, and usually the first-identified sign is irregular vaginal bleeding. We say “vaginal” rather than “menstrual” as it’s not technically menses, although it’ll look (and can feel) the same.
Like many “affects mostly women” conditions, science’s general position is “we don’t know what causes it or how to cure it”.
Quick book recommendation before we continue:
Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn
…is a top-tier book about medical misogyny. We’d say more here, but well, you can read our review there 🙂
What doesn’t work
Since PCOS is characterized by excessive androgen production, it is reasonable to expect that foods containing phytoestrogens (such as soy) may help. They won’t. The human body can’t use those as estrogen, and in fact, consuming unusually large quantities of phytoestrogens can actually get in the way of your own (or bioidentical) estrogen, by competing for the same receptors but not really doing the job.
But, you won’t get that problem from moderate consumption of soy; the warning is more for those tempted to self-medicate with megadoses, or are opting for dubious supplements such as Pueraria mirifica ← will have to do a research review on that one of these days, but suffice it to say meanwhile, it has some serious drawbacks
See also: What Does “Balance Your Hormones” Even Mean?
What can work
There are some supplement-based approaches that actually can help, and those are the ones that rather than trying to manufacture estrogen out of thin air, work to reduce testosterone and/or reduce the conversion of free testosterone to its more potent form, dihydrogen testosterone (DHT); here are two examples:
- Licorice, Digestion, & Hormones
- One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens ← this one has the most evidence of the two
What will work
…or at least, barring additional confounding factors, what the evidence strongly supports working. Here’s where we get into diet properly, and there are three main dietary approaches:
Low-GI diet: focus on high-fiber, low-carb foods (e.g. whole grains, legumes, berries, leafy greens). Eating this way results in improved insulin sensitivity, lower fasting insulin, cholesterol, triglycerides, waist circumference, and (for women) yes, lower testosterone levels.
See: What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest
High antioxidant diet: focus on foods rich in antioxidants (e.g. vitamin A, α-tocopherol specifically, vitamins C and D, and polyphenols) as these lower PCOS incidence.
See: 21 Most Beneficial Polyphenols & What Foods Have Them
Ketogenic diet: focus on high-fat, very low-carb foods (e.g. fatty fish, dairy, leafy greens). This significantly reduces androgen levels, improves insulin sensitivity, and regulates hormones. But… It’s recommended for short-term use only due to its negative health impacts from poor (i.e. narrow) nutritional coverage:
See: Ketogenic Diet: Burning Fat, Or Burning Out?
It is also reasonable to supplement, for example:
❝Omega-3 fatty acids and vitamin D have powerful anti-inflammatory and antioxidant properties that significantly improve insulin sensitivity and reduce androgen levels in metabolic syndromes like PCOS. A higher intake of omega-3 and vitamin E also alleviates mental health parameters and gene expression of PPAR-γ, IL-8, and TNF-α in women with PCOS.
Dietary supplements, such as antioxidants like N-acetylcysteine (NAC), vitamin D, inositol, and omega-3 fatty acids, and mineral supplements (zinc, magnesium selenium, and chromium) help in reducing insulin resistance. These supplements also enhance ovulatory function and decrease inflammation in PCOS patients.
Omega-3 fatty acid supplements improve biochemical parameters LH, LH/FSH, lipid profiles, and adiponectin levels and regularize the menstrual cycle in women with PCOS. A recent RCT also indicated that probiotic/symbiotic supplementation significantly improves triglyceride, insulin, and HDL levels in women with PCOS.❞
Source: The Role of Lifestyle Interventions in PCOS Management: A Systematic Review
Want to know more?
You might like this book that we reviewed a little while back:
PCOS Repair Protocol – by Tamika Woods
Take care!
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