The Book of Lymph – by Lisa Levitt Gainsely
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The book starts with an overview of what lymph is and why it matters, before getting into the main meat of the book, which is lymphatic massage techniques to improve lymphatic flow/drainage throughout different parts of the body, and in the context of an assortment of common maladies that may merit particular attention.
There’s an element of aesthetic medicine here, and improving beauty, but there’s also a whole section devoted to such things as breast care and the like (bearing in mind, the lymphatic system is one of our main defenses against cancer). There’s also a lot about managing lymph in the context of chronic health conditions.
The style is light pop-science; the science is explained clearly throughout, but without academic citations every few lines as some books might have. The author is, after all, a practitioner (CLT) and/but not an academic.
Bottom line: if you’d like to improve your lymphatic health, whether for beauty or health maintenance or recovery, this book will walk you through it.
Click here to check out The Book of Lymph, and give yours some love!
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What should I eat (and avoid) while breastfeeding? How does my diet affect baby’s milk?
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Many people are familiar with the saying that a woman is “eating for two” during pregnancy. Although this is an exaggeration, nutritional needs do certainly increase during pregnancy to support the growing baby.
But what’s perhaps less known is that energy needs are actually even slightly higher during breastfeeding than during pregnancy.
Human breastmilk is a dynamic liquid and its composition (including carbohydrates, fats, proteins, vitamins and minerals) varies over the entire breastfeeding period, and even between feeds.
It can change depending on what mum is eating, environmental factors, and what the baby needs, through a biofeedback system (sometimes called “baby backwash”). For example, if a baby is starting to get sick, breastmilk will adjust to include more leukocytes, immune cells that fight infection.
So what should breastfeeding women be eating? And how does a mother’s diet influence the nutritional makeup of her milk?
Natalia Lebedinskaia/Getty Images Nutritional needs increase during breastfeeding
Fully breastfeeding mums can produce around 800 millilitres of milk a day in the first six months after birth, which has an energy content of roughly 3 kilojoules per gram.
Even factoring in using up excess fat stored during pregnancy, mums still need on average an extra 2,000 kilojoules to support milk production. This is roughly equivalent to adding a cheese sandwich, a handful of nuts and a banana on top of normal dietary intake.
Interestingly, requirements don’t drop off after the baby starts solids. In the second six months, milk production is thought to drop to an average of 600ml per day, as babies start to eat solid foods. But because maternal fat stores deplete by this stage, additional energy requirements remain similar.
Some nutrients are particularly important during breastfeeding, including protein, calcium, iron, iodine and vitamins.
For example, compared with a non-pregnant, non-breastfeeding woman, protein requirements increase by almost half when breastfeeding (from 0.75 grams to 1.1 grams per kg of body weight per day).
Meanwhile, iodine requirements almost double (from 150 micrograms per day to 270 micrograms per day). Iodine is important for thyroid function, and can impact baby’s growth and brain development.
It’s important women who are breastfeeding eat a variety of foods, including:
- high-protein foods (meat, fish, eggs, nuts, seeds, soy-based protein such as tofu and tempeh, legumes such as chickpeas, baked beans and lentils)
- dairy foods or alternatives (for dairy alternatives, check calcium is included)
- whole grains
- fruits and vegetables.
While making all that milk, drinking more water also becomes extremely important. Thirst is a good guide, but around 2.5 litres per day is generally recommended, or more if it’s hot or with exercise.
Is there anything I shouldn’t be eating?
What a mum consumes can pass into her breastmilk. For example, in one study, babies whose mothers drank small amounts of carrot juice while breastfeeding were more accepting of cereal flavoured with carrot juice compared with a control group of babies whose mothers drank water.
It’s therefore important to limit alcohol and caffeine, which can also pass though to the baby. No alcohol is the safest choice, but if you’re planning to have a drink, tools such as the Feed Safe app can be used to estimate when your breastmilk should be free of alcohol.
Up to 200mg of caffeine per day (equivalent to roughly a cup of brewed coffee, an energy or cola drink, or four cups of tea) is considered safe for breastfeeding.
Breastfeeding mums don’t need to take any particular foods out of their diet to prevent allergies in their baby. In fact, experts believe babies exposed to common allergens via breast milk could be less likely to develop allergies to these foods, however we need more research into this question.
Although relatively uncommon, babies can be allergic or intolerant to certain aspects of their mothers’ diet when breastfeeding. They may react in the form of colic or wind, reflux, mucus or blood in their poo, eczema or rash, or appear to be in pain.
In these cases, mum’s diet may need adjustment. The most common culprits include cows’ milk (the protein, not the lactose component), soy and egg.
It’s recommended to remove suspected foods from the diet for a minimum of three weeks. This should ideally be done with supervision from an Accredited Practising Dietitian who specialises in allergy, to ensure the mother’s nutritional needs continue to be met.
4 tips for breastfeeding mums
- it’s a good idea to get a blood test to check your vitamin D and iron levels – these can be depleted over pregnancy and are important for breastfeeding. If your levels are low, you can discuss options with your doctor
- iodine requirements are so much higher in breastfeeding that an iodine supplement of 150 micrograms a day is recommended to support infant growth and neurodevelopment
- have a variety of nutritious snacks that can be eaten with one hand for those late-night feeds, such as peeled boiled eggs, a peanut butter sandwich on wholegrain bread, or avocado and cheese on a rice cake. My personal favourite is homemade rocky road with dark chocolate, nuts, seeds and dried fruit
- keep a drink bottle with water nearby when breastfeeding.
The author’s home-made rocky road, which she gives as a gift to friends with new babies. Therese O’Sullivan/Author provided If you’re considering a gift for a family with a new baby, remember new parents’ personal needs often take a back seat when bub arrives, including eating well. Consider a hearty frozen meal, muffins with oats and nuts, a nice stainless steel water bottle, gourmet trail mix or even some homemade rocky road.
Therese O’Sullivan, Associate Professor in Nutrition and Dietetics, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing
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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 😎
❝Hi, is there any important difference between vitamin d2 and vitamin d3? Is one better than the other?❞
There is indeed! And one is better than the other!
Where they come from
You’ll find a lot of sources that will tell you “Vitamin D2 is from plants, D3 is from animals”, and in fact only the second half of that is true.
In nature, there are no plants that are known to produce vitamin D.
Vitamin D2, however, is produced by many fungi, as well as algae, neither of which are part of the Kingdom Plantae.
Vitamin D3, meanwhile, is produced by many animals (including humans).
When “the sun” is sometimes considered a source of vitamin D, that’s true only insofar as the sun is also a source of tomatoes, for example, which required the sun to grow. While we humans (and other animals) cannot photosynthesize in general, producing vitamin D is something we can do if exposed to UV light (such as from the sun).
However, of course exposure to UV light (such as from the sun) comes with other problems, so… Should we get sun exposure or not?
We weighed up the balance of evidence, here: The Sun Exposure Dilemma
If, like this writer, you are a mostly crepuscular being who avoids the sun, we have good news: mushrooms can do the sunbathing for us!
❝Exposing mushrooms to UV (from sunlight or in a laboratory) increases the amount of vitamin D in mushrooms by nearly eightfold. Putting five store-bought button mushrooms in the sun, or just one portobello mushroom, produces 24 µg of vitamin D, which translates to nearly 1000 international units, providing the amount of vitamin D one needs in an entire day, and the equivalent found in most vitamin D supplements.
If you’re wondering if the vitamin D from mushrooms actually makes it into your bloodstream, it does. A recent meta-analysis of randomized controlled trials showed that tanned (UV-exposed) mushrooms may be effective in increasing active vitamin D levels in adults with low levels of vitamin D, and studies (randomised controlled trials) have shown that it may be just as effective as supplements at increasing vitamin D levels in the blood (here, and here).
Some research is very positive, saying that putting your mushrooms in direct sunlight for 10–15 minutes may provide you with 100% of your daily vitamin D needs, and the vitamin D content in sunlight-exposed mushrooms may be retained with refrigeration for up to 8 days.
The production of vitamin D may be increased by a further 30% by placing them in the sun with the underside, or gills, facing up, or by 60% if you slice them.❞
Read all about it: Tan your mushrooms, not your skin
Which is better?
In few words: D3 is better.
They both do the exact same job, but with D3, you simply get more bang-for-buck:
❝The WMD in change in total 25(OH)D based on 12 daily dosed vitamin D2-vitamin D3 comparisons, analyzed using liquid chromatography-tandem mass spectrometry, was 10.39 nmol/L (40%) lower for the vitamin D2 group compared with the vitamin D3 group.
Vitamin D3 leads to a greater increase of 25(OH)D than vitamin D2, even if limited to daily dose studies, but vitamin D2 and vitamin D3 had similar positive impacts on their corresponding 25(OH)D hydroxylated forms.❞
Note: “WMD” here means “weighted mean difference”, not “weapons of mass destruction”
About that “and importance of BMI”, by the way: in persons with a BMI >25, there was no longer a difference between the two forms. Literally, no difference at all; the difference was reduced to 0%.
Another study found similarly, but with different numbers (finding a greater difference), and without recording BMI as a factor:
❝D3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations and produces 2- to 3-fold greater storage of vitamin D than does equimolar D2.❞
See the paper: Vitamin D3 Is More Potent Than Vitamin D2 in Humans
“Well that sucks, because I’m vegan”
Fear not, you can get vegan D3 too.
Much like “you can’t get vegan B12” (but you can; it’s made by yeast), there are vegan D3 supplements, made by lichen.
The trouble with lichen, when it comes to classifying it, it that it’s actually a hybrid colony of many small, strange things (beyond the scope of this article, but they are fascinating, so this writer is holding herself back by the scruff of the neck from explaining in detail), some of which are technically part of Kingdom Animalia, but it is hard to find even the most ardent vegan who will object to consuming bacteria, for example.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
But watch out with the doses, if supplementing vitamin D in either form, because…
Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much
Take care!
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Healthy Harissa Falafel Patties
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You can make these as regular falafel balls if you prefer, but patties are quicker and easier to cook, and are great for popping in a pitta.
You will need
For the falafels:
- 1 can chickpeas, drained, keep the chickpea water (aquafaba)
- 1 red onion, roughly chopped
- 2 tbsp chickpea flour (also called gram flour or garbanzo bean flour)
- 1 bunch parsley
- 1 tbsp harissa paste
- Extra virgin olive oil for frying
For the harissa sauce:
- ½ cup crème fraîche or plant-based equivalent (you can use our Plant-Based Healthy Cream Cheese recipe and add the juice of 1 lemon)*
- 1 tbsp harissa paste (or adjust this quantity per your heat preference)
*if doing this, rather than waste the zest of the lemon, you can add the zest to the falafels if you like, but it’s by no means necessary, just an option
For serving:
- Wholegrain pitta or other flatbread (you can use our Healthy Homemade Flatbreads recipe)
- Salad (your preference; we recommend some salad leaves, sliced tomato, sliced cucumber, maybe some sliced onion, that sort of thing)
Method
(we suggest you read everything at least once before doing anything)
1) Blend the chickpeas, 1 oz of the aquafaba, the onion, the parsley, and the harissa paste, until smooth. Then add in the chickpea flour until you get a thick batter. If you overdo it with the chickpea flour, add a little more of the aquafaba to equalize. Refrigerate the mixture for at least 30 minutes.
2) Heat some oil in a skillet, and spoon the falafel mixture into the pan to make the patties, cooking on both sides (you can use a spatula to gently turn them), and set them aside.
3) Mix the harissa sauce ingredients in a small bowl.
4) Assemble; best served warm, but enjoy it however you like!
Enjoy!
Want to learn more?
For those interested in more of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Capsaicin For Weight Loss And Against Inflammation
- Hero Homemade Hummus ← another great option
Take care!
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The Meds Most Likely To Produce A Dangerous “Prescribing Cascade” In Later Life
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First, what is a “prescribing cascade”?
It’s what happens when a medication causes a side effect (or even a bunch of side effects), which can then lead to a “side effect train” whereby the patient then has to take something else to treat the side effect, then something else to treat the side effect(s) of that medication, and so on, until they are taking an increasingly large stack of medications.
To use a common statin as an example, a book that we reviewed cites a case in which a woman’s LDL levels were high and she was prescribed simvastatin (Zocor), 20mg/day. Here’s what happened, in sequence:
- Her own non-statin self-prescription (with her doctor’s signature) worked, and she went back to her life, her work, and took up running.
- She started getting panic attacks. So, her doctor prescribed her sertraline (Zoloft) (a very common SSRI antidepressant) and when that didn’t fix it, paroxetine (Paxil). This didn’t work either… because the problem was not actually her mental health. The panic attacks got worse…
- Then, while exercising, she started noticing progressive arm and leg weakness. Her doctor finally took her off the simvastatin, and temporarily switched to ezetimibe (Zetia), a less powerful nonstatin drug that blocks cholesterol absorption, which change eased her arm and leg problem.
- As the Zetia was a stopgap measure, the doctor put her on atorvastatin (Lipitor). Now she got episodes of severe chest pressure, and a skyrocketing heart rate. She also got tremors and lost her body temperature regulation.
- So the doctor stopped the atorvastatin and tried rosovastatin (Crestor), on which she now suffered exhaustion (we’re not surprised, by this point) and muscle pains in her arms and chest.
- So the doctor stopped the rosovastatin and tried lovastatin (Mevacor), and now she had the same symptoms as before, plus light-headedness.
- So the doctor stopped the lovastatin and tried fluvastatin (Lescol). Same thing happened.
- So he stopped the fluvastatin and tried pravastatin (Pravachol), without improvement.
- So finally he took her off all these statins because the high LDL was less deleterious to her life than all these things.
- She did her own research, and went back to the doctor to ask for cholestyramine (Questran), which is a bile acid sequestrent and nothing to do with statins. She also asked for a long-acting niacin. In high doses, niacin (one of the B-vitamins) raises HDL (good) cholesterol, lowers LDL, and lowers tryglycerides.
You can find that book, here: The Truth About Statins – by Barbara H. Roberts, M.D.
The highest-risk meds to be aware of
Researchers (Dr. Lisa Ellet et al.) investigated the prevalance of this happening in people entering long-term residential aged care (a demographic already at increased risk for overmedication, and also easy to observe), and found that before entering aged care, 16.7% of residents had at least one statistically significant prescribing cascade, increasing to 25.1% after admission.
Of these, many cascades involved medicines already known to carry higher risks in older adults, including antipsychotics, benzodiazepines, and opioids.
In other words, bluntly, the meds most commonly given by doctors and other prescribers to make patients less bothersome to them.
That said, not for nothing did we use statins as an example above, because starting statins was associated with later initiation of several other medications, including antipsychotics and antidepressants, while benzodiazepine use was associated with later antipsychotic prescribing.
The lesson to be learned from this?
❝There’s a real opportunity here to intervene earlier through routine medication reviews, better monitoring of side effects and, where appropriate, deprescribing strategies❞
~ Dr. Gill Caughey, another researcher in this study
You can read this paper in full, here: Prescribing cascades potentially associated with harms before and after transition to long-term care facilities
Want to know more?
You might find these previous articles of ours of interest:
- Are You Taking PIMs? Getting Off The Overmedication Train ← “PIMs” stands for “potentially inappropriate medications”, be they prescribed purely in error, or as part of a prescribing cascade
- Medications That Shouldn’t Be Taken Long-term (With Natural Alternatives)
- The Common Meds That Make You More Likely To Die From A fall
- The Commonly-Prescribed Painkiller That Barely Works (And Is Dangerous)
- The Common Meds That Make You Much More Susceptible To Heatstroke ← especially important in the kind of weather many of us are having these days!
And for a more in-depth exploration than we have room for here, check out this book that we reviewed:
To Medicate or Not? That is the Question! – by Dr. Asha Bohannon
Take care!
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Dates vs Olives – Which is Healthier?
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Our Verdict
When comparing dates to olives, we picked the dates.
Why?
Both have their merits, but dates come out on top!
In terms of macros, dates have several times the fiber, carbs, and protein, while olives have more fat (healthy ones). On balance, we’ll call this round a tie.
In the category of vitamins, dates have more of vitamins B1, B2, B3, B5, B6, B7, B9, and K, while olives have more vitamin E, making this round an easy win for dates.
Looking at minerals next, dates have more magnesium, manganese, phosphorus, potassium, selenium, and zinc, while olives have more calcium, copper, and iron, yielding a 6:3 win to dates in this round.
In other considerations, olives have more polyphenols, even if dates are great for such too. So that’s a point for olives, finally.
Adding up the sections makes for an overall win for dates, but by all means enjoy either or both, as diversity is best!
Want to learn more?
You might like:
How Olives Can Help Protect Your Brain ← it’s about those polyphenols we mentioned
Enjoy!
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What Matters Most For Your Heart?
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Eat More (Of This) For Lower Blood Pressure
Heart disease remains the world’s #1 killer. We’d say “and in the US, it’s no different”, but in fact, the US is #1 country for heart disease. So, it’s worse and perhaps some extra care is in order.
But how?
What matters the most
Is it salt? Salt plays a part, but it’s not even close to the top problem:
Hypertension: Factors Far More Relevant Than Salt
Is it saturated fat? Saturated fat from certain sources plays more of a role than salt, but other sources may not be so much of an issue:
Can Saturated Fats Be Heart-Healthy?
Is it red meat? Red meat is not great for the heart (or for almost anything else, except perhaps anemia):
The Whys and Hows of Cutting Meats Out Of Your Diet
…but it’s still not the top dietary factor.
The thing many don’t eat
All the above are foodstuffs that a person wanting a healthier heart and cardiovascular system in general might (reasonably and usually correctly) want to cut down, but there’s one thing that most people need more of:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
And this is especially true for heart health:
❝Dietary fiber has emerged as a crucial yet underappreciated part of hypertension management.
Our comprehensive analysis emphasizes the evidence supporting the effectiveness of dietary fiber in lowering blood pressure and reducing the risk of cardiovascular events.❞
Specifically, she and her team found:
- Each additional 5g of fiber per day reduces blood pressure by 2.8/2.1 (systolic/diastolic, in mmHG)
- Dietary fiber works in several ways to improve cardiovascular health, including via gut bacteria, improved lipids profiles, and anti-inflammatory effects
- Most people are still only getting a small fraction (¼ to ⅓) of the recommended daily amount of fiber. To realize how bad that is, imagine if you consumed only ¼ of the recommended daily amount of calories every day!
You can read more about it here:
Dietary fiber critical in managing hypertension, international study finds
That’s a pop-science article, but it’s still very informative. If you prefer to read the scientific paper itself (or perhaps as well), you can find it below
Recommendations for the Use of Dietary Fiber to Improve Blood Pressure Control
Want more from your fiber?
Here’s yet another way fiber improves cardiometabolic health, hot off the academic press (the study was published just a couple of weeks ago):
How might fiber lower diabetes risk? Your gut could hold the clues
this pop-science article was based on this scientific paper
Gut Microbiota and Blood Metabolites Related to Fiber Intake and Type 2 Diabetes
Take care!
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