The Brain Nutrient That 90% Of Americans Don’t Get Enough Of

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Spoiler: it’s choline

Underconsumed and underappreciated

Choline is essential for:

  • methylation and brain metabolism
  • mood and cognitive regulation
  • cell membrane integrity
  • acetylcholine production (important for memory and general signaling)
  • and more

…which all add up to making it quite unfortunate that about 90% of Americans do not get an adequate intake of this vital nutrient!

Source: Choline: The Underconsumed and Underappreciated Essential Nutrient

Per some recent research, this does appear to have an important effect on mental health: a meta-analysis of 25 brain spectroscopy studies (370 people with anxiety disorders, 342 controls) found a consistent pattern—people with anxiety disorders had about 8% lower cortical choline-containing compounds (tCho), especially in the prefrontal cortex, that being a region that’s very important for emotional regulation, decision-making, and stress control.

This is notable because it’s one of the first biomarkers found across multiple anxiety disorders (generalized anxiety disorder, panic disorder, and social anxiety disorder), suggesting anxiety may involve measurable metabolic changes—not just psychological symptoms.

As for why this happens, the researchers suggest that chronic hyperarousal and elevated norepinephrine* (so, “fight-or-flight” activation) may increase the brain’s demand for choline faster than supply can bring it, thus lowering measurable brain choline over time.

*You can learn more about this here: Neurotransmitter Cheatsheet

There were other biomarkers too, for example reduced levels N-acetylaspartate (NAA), a marker associated with neuronal integrity, were also seen in some cortical analyses, which suggest further neuronal stress/dysfunction—but that’s beyond the scope of our article today.

If you do want to read in more detail though, here’s the paper itself: Transdiagnostic reduction in cortical choline-containing compounds in anxiety disorders: a ¹H-magnetic resonance spectroscopy meta-analysis

As for where to get choline in terms of foods, animal organ meats are generally rich in it but come with other health risks; less risky choline-rich food sources include eggs (especially the yolks) and soybeans.

Learn more: Food sources of choline and their contribution to choline adequacy in U.S. older adults ← eggs scored best!

See also:

And for nuance: Vegetarian & Vegan Diets: Good Or Bad For Brain Health?

Of course, ensuring you meet your recommended choline intake through diet is a good idea for general brain health, but please do note that this should complement, not replace, other approaches such as therapy, medication if needed, sleep, exercise, and so forth.

See also:

Want to raise your choline levels?

Dietary intake is all well and good, but you might want to consider:

Citicoline: Better Than Dietary Choline?

Take care!

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  • Improve Your Insulin Sensitivity!

    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 written before about blood sugar management, for example:

    10 Ways To Balance Blood Sugars ← this one really is the most solid foundation possible; if you do nothing else, do these 10 things!

    And as for why we care:

    Good (Or Bad) Health Starts With Your Blood

    …because the same things that cause type 2 diabetes, go on to cause many other woes, with particularly strong comorbidities in the case of Alzheimer’s disease and other dementias, as well as heart disease of various kinds, and a long long laundry list of immune dysfunctions / inflammatory disorders in general.

    In short, if you can’t keep your blood sugars even, the rest of your health will fall like so many dominoes.

    Getting a baseline

    Are you counting steps? Counting calories? Monitoring your sleep? Heart rate zones? These all have their merits:

    But something far fewer people do unless they have diabetes or are very enthusiastic about personal health, is to track blood sugars:

    Here’s how: Track Your Blood Sugars For Better Personalized Health

    And for understanding some things to watch out for when using a continuous glucose monitor:

    Continuous Glucose Monitors Without Diabetes: Pros & Cons

    Writer’s anecdote: I decided to give one a try for a few months, and so far it has been informative, albeit unexciting. It seems that with my diet (mostly whole-foods plant based, though I do have a wholegrain wheat product about twice per week (usually: flatbread once, pasta once) which is… Well, we could argue it’s whole-food plant based, but let’s be honest, it’s a little processed), my blood sugars don’t really have spikes at all; the graph looks more like gently rolling low hills (which is good). However! Even so, by experimenting with it, I can see for myself what differences different foods/interventions make to my blood sugars, which is helpful, and it also improves my motivation for intermittent fasting. It also means that if I think “hmm, my energy levels are feeling low; I need a snack” I can touch my phone to my arm and find out if that is really the reason (so far, it hasn’t been). I expect that as I monitor my blood sugars continuously and look at the data frequently, I’ll start to get a much more intuitive feel for my own blood sugars, in much the same way I can generally intuit my hormone levels correctly after years of taking-and-testing.

    So much for blood sugars. Now, what about insulin?

    Step Zero

    If taking care of blood sugars is step one, then taking care of insulin is step zero.

    Often’s it’s viewed the other way around: we try to keep our blood sugars balanced, to reduce the need for our bodies to produce so much insulin that it gets worn out. And that’s good and fine, but…

    To quote what we wrote when reviewing “Why We Get Sick” last month:

    ❝Dr. Bikman makes the case that while indeed hyper- or hypoglycemia bring their problems, mostly these are symptoms rather than causes, and the real culprit is insulin resistance, and this is important for two main reasons:

    1. Insulin resistance occurs well before the other symptoms set in (which means: it is the thing that truly needs to be nipped in the bud; if your fasting blood sugars are rising, then you missed “nipping it in the bud” likely by a decade or more)
    2. Insulin resistance causes more problems than “mere” hyperglycemia (the most commonly-known result of insulin resistance) does, so again, it really needs to be considered separately from blood sugar management.

    This latter, Dr. Bikman goes into in great detail, linking insulin resistance (even if blood sugar levels are normal) to all manner of diseases (hence the title).

    You may be wondering: how can blood sugar levels be normal, if we have insulin resistance?

    And the answer is that for as long as it is still able, your pancreas will just faithfully crank out more and more insulin to deal with the blood sugar levels that would otherwise be steadily rising. Since people measure blood sugar levels much more regularly than anyone checks for actual insulin levels, this means that one can be insulin resistant for years without knowing it, until finally the pancreas is no longer able to keep up with the demand—then that’s when people finally notice.❞

    You can read the full book review here:

    Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease and How to Fight It – by Dr. Benjamin Bikman

    Now, testing for insulin is not so quick, easy, or accessible as testing for glucose, but it can be worthwhile to order such a test—because, as discussed, your insulin levels could be high even while your blood sugars are still normal, and it won’t be until the pancreas finally reaches breaking point that your blood sugars show it.

    So, knowing your insulin levels can help you intervene before your pancreas reaches that breaking point.

    We can’t advise on local services available for ordering blood tests (because they will vary depending on location), but a simple Google search should suffice to show what’s available in your region.

    Once you know your insulin levels (or even if you don’t, but simply take the principled position that improving insulin sensitivity will be good regardless), you can set about managing them.

    Insulin sensitivity is important, because the better it is (higher insulin sensitivity), the less insulin the pancreas has to make to tidy up the same amount of glucose into places that are good for it to go—which is good. In contrast, the worse it is (higher insulin resistance), the more insulin the pancreas has to make to do the same blood sugar management. Which is bad.

    What to do about it

    We imagine you will already be eating in a way that is conducive to avoiding or reversing type 2 diabetes, but for anyone who wants a refresher,

    See: How To Prevent And Reverse Type 2 Diabetes

    …which yes, as well as meaning eating/avoiding certain foods, does recommend intermittent fasting. For anyone who wants a primer on that,

    See: Intermittent Fasting: Methods & Benefits

    There are also drugs you may want to consider:

    Metformin Without Diabetes, For Weight-Loss & More

    And “nutraceuticals” that sound like drugs, for example:

    Glutathione’s Benefits: The Usual And The Unique ← the good news is, it’s found in several common foods

    You may have heard the hype about “nature’s Ozempic”, and berberine isn’t exactly that (works in mostly different ways), but its benefits do include improving insulin sensitivity:

    Berberine For Metabolic Health

    Lastly, while eating for blood sugar management is all well and good, do be aware that some things affect insulin levels without increased blood sugar levels. So even if you’re using a CGM, you may go blissfully unaware of an insulin spike, because there was no glucose spike on the graph—and in contrast, there could even be a dip in blood sugar levels, if you consumed something that increased insulin levels without providing glucose at the same time, making you think “I should have some carbs”, which visually on the graph would even out your blood sugars, but invisibly, would worsen the already-extant insulin spike.

    Read more about this: Strange Things Happening In The Islets Of Langerhans: When Carbs, Proteins, & Fats Switch Metabolic Roles

    Now, since you probably can’t test your insulin at a moment’s notice, the way to watch out for this is “hmm, I ate some protein/fats (delete as applicable) without carbs and my blood sugars dipped; I know what’s going on here”.

    Want to know more?

    We heartily recommend the “Why We Get Sick” book we linked above, as this focuses on insulin resistance/sensitivity itself!

    However, a very good general primer on blood sugar management (and thus, by extension, at least moderately good insulin management), is:

    Glucose Revolution: The Life-Changing Power of Balancing Your Blood Sugar – by Jessie Inchauspé

    Enjoy!

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  • Air Purifiers & Sleep

    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

    ❝I’ve read that air pollution has a negative effect on sleep quality and duration. Since I live next to a busy road, I was wondering whether I should invest in an air purifier. What are 10Almonds’s views?❞

    Going straight to the science, there are two questions here:

    • Does air pollution negatively affect sleep quality and duration?
    • Does the use of an air purify actually improve the air quality in the way(s) necessary to make a difference?

    We thought we’d have to tackle these questions separately, but we did find one study that addressed your question directly. It was a small study (n=30 if you believe the abstract; n=29 if you read the paper itself—one person dropped out); the results were modest but clear:

    ❝The purifier filter was associated with increased total sleep time for an average of 12 min per night, and increased total time in bed for an average of 19 min per night relative to the placebo.

    There were several sleep and mood outcomes for which no changes were observed, and time awake after sleep onset was higher for the purifier filter. Air quality was better during the high-efficiency particulate air filter condition.

    These findings offer positive indications that environmental interventions that improve air quality can have benefits for sleep outcomes in healthy populations who are not exhibiting clinical sleep disturbances.❞

    Source: Can air purification improve sleep quality? A 2-week randomised-controlled crossover pilot study in healthy adults

    In the above-linked paper’s introduction, it does establish the deleterious effect of air pollution on a wide variety of health metrics, including sleep, this latter evidenced per Caddick et al. (2018): A review of the environmental parameters necessary for an optimal sleep environment

    Now, you may be wondering: is an extra 12 minutes per night worth it?

    That’s your choice to make, but we would argue that it is. We can make many choices in our lives that affect our health slightly for the better or the worse. If we make a stack of choices in a particular direction, the effects will also stack, if not outright compound.

    So in the case of sleep, it might be (arbitrary numbers for the sake of illustration):

    • Get good exercise earlier in the day (+3%)
    • Get good food earlier in the day (+2.5%)
    • Practice mindfulness/meditation before bed (+2.5%)
    • Have a nice dark room (+5%)
    • Have fresh bedding (+2.5%)
    • Have an air purifier running (+3%)

    Now, those numbers are, as we said, arbitrary*, but remember that percentages don’t add up; they compound. So that “+3%” starts being a lot more meaningful than if it were just by itself.

    *Confession: the figure of 3% for the air purifier wasn’t entirely arbitrary; it was based on 100(12/405) = 80/27 ≈ 3, wherein the 405 figure was an approximation of the average total time (in minutes) spent sleeping with placebo, based on a peep at their results graph. There are several ways the average could be reasonably calculated, but 6h45 (i.e., 405 minutes) was an approximate average of those reasonable approximate averages.

    So, 12 minutes is a 3% improvement on that.

    Don’t have an air purifier and want one?

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

    Take care!

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  • Are your Kidneys Ok? Detect Early To Protect Kidney Health (Here’s How)

    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.

    Tomorrow (at time of publication) will be World Kidney Day (WKD). Perhaps not the most well-known initiative, but it celebrates its 21st year this year!

    For those of us who celebrated our own 21st year quite some time ago now, it’s as good a reason as any to check in on our kidney health.

    Here are some things they’d like us to know about Chronic Kidney Disease (CKD):

    ❝CKD is a silent disease, people with CKD have no signs or symptoms until the late stage of the disease.
    CKD usually does not go away, instead, it progresses, unless early treatment to slow or halt the disease is ensured.
    CKD can progress to kidney failure – a condition when kidneys cannot maintain their function anymore, posing a life-threatening risk.
    CKD ranks number 7 in the top ten causes of death among noncommunicable diseases worldwide.
    CKD increases the risk of premature death from associated cardiovascular disease.
    CKD is more common among certain ethnic groups due in part to high rates of diabetes and high blood pressure.
    CKD is more common among women, here is why.❞

    Source: World Kidney Day: Your Amazing Kidneys

    How can we check our kidney health?

    There are clinical tests that can be done (they’ll just need a urine sample from you; ask your doctor about it), but there’s some screening that can be done at home already:

    Are Your Kidneys Healthy? Take This One-Minute Quiz To Find out

    👆 this is about medical indicators; there are also non-medical factors that affect risk, including:

    • Where someone lives
    • Where they work
    • The foods they eat
    • How much exercise they do
    • If they are able to get the medical care they need

    For more information on this, see: Keeping Your Kidneys Healthy (Especially After 60) ← there’s a lot more to it than just hydration!

    What can we do for our kidney health, besides the obvious “hydrate”?

    Some top things to do include:

    Hydrate, yes. See also: Things Many People Forget When It Comes To Hydration

    Don’t smoke. It’s bad for everything, including your kidneys. So, just don’t. See also: Addiction Myths That Are Hard To Quit

    Look after your blood. Not just “try to keep it inside your body”, but also:

    Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.

    Watch your over-the-counter pill intake. A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.

    Keep an eye on your urine. Hydration is only one side of the story, and our urine can say quite a bit about our health. Indeed, we have written about this before:

    12 Things Your Urine Says About Your Health (Test At Home) ← no special equipment required!

    On which note, see also: To Pee Or Not To Pee ← spoiler: there’s a flood of reasons to not hold your pee

    Want to know more?

    Check out the WKD website’s…

    8 Golden Rules Of Kidney Disease Prevention

    Take care!

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  • 5 Tools To Reduce Stress

    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. Ruth Machin advises:

    Five things to do

    Starting with the innermost part, and progressing to the outermost part:

    • Journaling: writing regularly—whether full sentences or just a few words—can help express emotions, clear your head, and improve happiness and memory. Use prompts like “What went well today?” and try to journal at the same time each day, especially in the evening to sleep more restfully.
    • Slow breathing: activating the parasympathetic nervous system (the “rest and digest” mode) through slow breathing can help calm your stress response. Just a few minutes a day can make a difference.
    • Gentle movement: light, intentional movement like walking in nature, stretching, yoga, or even pottering around the garden helps bring you back into your body and reduces stress without needing to be a workout.
    • Digital switch-off cues: instead of abrupt screen cut-offs, create a routine cue to signal the end of screen time—like putting your phone in a drawer—to help your brain wind down.
    • Social connection: prioritize meaningful (and ideally, in-person) interactions with people who “get” you. Strong social ties improve well-being and even extend life expectancy, while poor connection increases heart disease risk. Schedule it like any important commitment.

    For more on all of these, enjoy:

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

    Want to learn more?

    You might also like:

    How To Reduce Chronic Stress

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Artichoke vs Bamboo Shoots – Which is Healthier?

    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.

    Our Verdict

    When comparing artichoke to bamboo shoots, we picked the artichoke.

    Why?

    Both have their merits, but there is a clear winner:

    In terms of macros, artichoke has more than 2x the fiber, for a little under 2x the carbs, and more protein, making it the more nutrient-dense option in this category.

    In the category of vitamins, artichoke has more of vitamins B3, B5, B7, B9, C, and K, while bamboo has more of vitamins B1, B6, and E, yielding a 6:3 victory to artichoke here.

    Looking at minerals, artichoke has more calcium, copper, iron, magnesium, and phosphorus, while bamboo has more potassium, selenium, and zinc, giving a 5:3 win to artichoke in this round.

    In other considerations, artichoke is also higher in polyphenols, so that’s another point in its favor too.

    Adding up the sections makes for a clear overall win for artichoke, but by all means do enjoy either or both, as diversity is best!

    Want to learn more?

    You might like:

    Don’t Be Bamboozled By Bamboo! ← including how to eat bamboo, for those unfamiliar with such, as we have been asked about it 🙂

    Enjoy!

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  • If You’re Getting Acne Now & Didn’t Before, This Is Why

    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. Andrea Suarez, dermatologist, explains:

    Ringing the changes

    It’s not just you! Acne in women—especially up the 40s—is very common and that prevalence seems to be increasing, but greater awareness, social media visibility, and more people seeking diagnosis also make it seem even more common than it is.

    In women in particular, it’s often more inflammatory, persistent, and concentrated around the jaw, chin, and mouth.

    If you guessed the reason is mostly hormonal, you’re right: hormones—particularly androgens and insulin-like growth factor (IGF)—stimulate oil production and inflammation, and even normal hormone levels can trigger acne if your skin is more sensitive to them.

    And yes, this happens because of all kinds of hormonal changes, as menstrual cycles, pregnancy, breastfeeding, starting or stopping hormonal contraception, let alone hormone replacement therapy (HRT), perimenopause, and menopause can all provoke new or worsening acne later in life.

    It’s not all about sex hormones though; high-glycemic foods and drinks, refined sugars, and frequent snacking raise insulin and IGF, which can also worsen inflammation and sebum production, while overall eating patterns matter more than any single food.

    And more hormones: because chronic stress and poor sleep raise cortisol, and thus also slow down healing, increase inflammation, and create a cycle where stress worsens acne and acne itself becomes a source of stress.

    There are more things too—otherwise unrelated metabolic issues, pollution, paradoxically overdoing skincare, genetics even, but the above more-discussed things are the main drivers, and thus the main things to try to manage.

    Which will come as a surprise to many who focus on skincare as the be-all and end-all of skin health!

    For more on all of this, enjoy:

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

    Want to learn more?

    You might also like:

    The Diets & Supplements That Can Mess Up Your Skin

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: