The Diet Myth – by Dr. Tim Spector

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Why are we supposed to go low-carb, but get plenty of whole grains? Avoid saturated fat, but olive oil is one of the healthiest fats around? Will cheese kill us or save us? Even amongst the well-informed, there’s a lot of confusion. This book addresses these and many such topics.

A main theme of the book is howa lot of it relates to the state of our gut microbiome, and what is good or bad for that. He also discusses, for example, how microbes predict obesity better than genes, and the good news is: we can change our microbes a lot more easily than we can change our genes!

In the category of criticism, he repeats some decades-old bad science in some areas outside of his field (i.e. unrelated to nutrition), so that’s unfortunate, and/but doesn’t detract from the value of the book if we keep to the main topic.

Bottom line: if you’d like to understand better the physiology and microbiology behind why dieting does work for most people (and how to do it better), then this is a great book for that.

Click here to check out The Diet Myth, and learn the science behind the confusion!

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    Dr. Tracey Marks debunks 8 lies depression tells us, reminding us that a ‘broken brain’ needs time to heal, just like a broken leg.

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  • Eat Well With Arthritis – by Emily Johnson, with Dr. Deepak Ravindran

    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.

    Author Emily Johnson was diagnosed with arthritis in her early 20s, but it had been affecting her life since the age of 4. Suffice it to say, managing the condition has been integral to her life.

    She’s written this book with not only her own accumulated knowledge, but also the input of professional experts; the book contains insights from chronic pain specialist Dr. Deepak Ravindran, and gets an additional medical thumbs-up in a foreword by rheumatologist Dr. Lauren Freid.

    The recipes themselves are clear and easy, and the ingredients are not obscure. There’s information on what makes each dish anti-inflammatory, per ingredient, so if you have cause to make any substitutions, that’s useful to know.

    Speaking of ingredients, the recipes are mostly plant-based (though there are some chicken/fish ones) and free from common allergens—but not all of them are, so each of those is marked appropriately.

    Beyond the recipes, there are also sections on managing arthritis more generally, and information on things to get for your kitchen that can make your life with arthritis a lot easier!

    Bottom line: if you have arthritis, cook for somebody with arthritis, or would just like a low-inflammation diet, then this is an excellent book for you.

    Click here to check out Eat Well With Arthritis, and make your cooking work for you rather than against you!

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  • What is ‘doll therapy’ for people with dementia? And is it backed by science?

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    The way people living with dementia experience the world can change as the disease progresses. Their sense of reality or place in time can become distorted, which can cause agitation and distress.

    One of the best ways to support people experiencing changes in perception and behaviour is to manage their environment. This can have profound benefits including reducing the need for sedatives.

    One such strategy is the use of dolls as comfort aids.

    Jack Cronkhite/Shutterstock

    What is ‘doll therapy’?

    More appropriately referred to as “child representation”, lifelike dolls (also known as empathy dolls) can provide comfort for some people with dementia.

    Memories from the distant past are often more salient than more recent events in dementia. This means that past experiences of parenthood and caring for young children may feel more “real” to a person with dementia than where they are now.

    Hallucinations or delusions may also occur, where a person hears a baby crying or fears they have lost their baby.

    Providing a doll can be a tangible way of reducing distress without invalidating the experience of the person with dementia.

    Some people believe the doll is real

    A recent case involving an aged care nurse mistreating a dementia patient’s therapy doll highlights the importance of appropriate training and support for care workers in this area.

    For those who do become attached to a therapeutic doll, they will treat the doll as a real baby needing care and may therefore have a profound emotional response if the doll is mishandled.

    It’s important to be guided by the person with dementia and only act as if it’s a real baby if the person themselves believes that is the case.

    What does the evidence say about their use?

    Evidence shows the use of empathy dolls may help reduce agitation and anxiety and improve overall quality of life in people living with dementia.

    Child representation therapy falls under the banner of non-pharmacological approaches to dementia care. More specifically, the attachment to the doll may act as a form of reminiscence therapy, which involves using prompts to reconnect with past experiences.

    Interacting with the dolls may also act as a form of sensory stimulation, where the person with dementia may gain comfort from touching and holding the doll. Sensory stimulation may support emotional well-being and aid commnication.

    However, not all people living with dementia will respond to an empathy doll.

    fizkes/Shutterstock
    It depends on a person’s background. Shutterstock

    The introduction of a therapeutic doll needs to be done in conjunction with careful observation and consideration of the person’s background.

    Empathy dolls may be inappropriate or less effective for those who have not previously cared for children or who may have experienced past birth trauma or the loss of a child.

    Be guided by the person with dementia and how they respond to the doll.

    Are there downsides?

    The approach has attracted some controversy. It has been suggested that child representation therapy “infantilises” people living with dementia and may increase negative stigma.

    Further, the attachment may become so strong that the person with dementia will become upset if someone else picks the doll up. This may create some difficulties in the presence of grandchildren or when cleaning the doll.

    The introduction of child representation therapy may also require additional staff training and time. Non-pharmacological interventions such as child representation, however, have been shown to be cost-effective.

    Could robots be the future?

    The use of more interactive empathy dolls and pet-like robots is also gaining popularity.

    While robots have been shown to be feasible and acceptable in dementia care, there remains some contention about their benefits.

    While some studies have shown positive outcomes, including reduced agitation, others show no improvement in cognition, behaviour or quality of life among people with dementia.

    Advances in artificial intelligence are also being used to help support people living with dementia and inform the community.

    Viv and Friends, for example, are AI companions who appear on a screen and can interact with the person with dementia in real time. The AI character Viv has dementia and was co-created with women living with dementia using verbatim scripts of their words, insights and experiences. While Viv can share her experience of living with dementia, she can also be programmed to talk about common interests, such as gardening.

    These companions are currently being trialled in some residential aged care facilities and to help educate people on the lived experience of dementia.

    How should you respond to your loved one’s empathy doll?

    While child representation can be a useful adjunct in dementia care, it requires sensitivity and appropriate consideration of the person’s needs.

    People living with dementia may not perceive the social world the same way as a person without dementia. But a person living with dementia is not a child and should never be treated as one.

    Ensure all family, friends and care workers are informed about the attachment to the empathy doll to help avoid unintentionally causing distress from inappropriate handling of the doll.

    If using an interactive doll, ensure spare batteries are on hand.

    Finally, it is important to reassess the attachment over time as the person’s response to the empathy doll may change.

    Nikki-Anne Wilson, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), UNSW Sydney

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

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  • Before You Reach For That Tylenol…

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    First, on names: we’ve titled this with “Tylenol” because that’s a well-known brand name, but the drug name is paracetamol or acetaminophen:

    • paracetamol is the drug name used by the World Health Organization, and thus also most countries.
    • acetaminophen is the drug name used in Canada, Colombia, Iran, Japan, US, and Venezuela.

    They are absolutely the same drug.

    Firstly, obviously, do avoid overdose

    The safe dosage described on the packet is generally accurate (usually around 4g/day, spaced out at 1g per 4 hours), and the dose required for toxicity is generally about 10g, or 200mg/kg body weight, whichever is lower. Since a single dose usually contains 2x 500mg = 1g, that makes overdose all too easy.

    The amount required for toxicity can be misleading too, because that’s assuming…

    • a healthy liver
    • no other health problems
    • no other medications that interact or add to the toxicity
    • no medications that strain the liver (as with many pro-drugs, and drugs in general that are metabolized by the liver, which is lots).

    Which is a lot of assumptions! Especially given that the liver can only process so much at once, meaning that if your liver has a lot of things to do, it can get a backlog, and you think “I’m not taking anything with this painkiller that I shouldn’t” but your liver is still metabolizing the last of last night’s glass of wine and one of your regular medications from this morning, because previously it was still metabolizing things from the day before yesterday, and so on.

    See also: How To Regenerate Your Liver ← the liver is an incredible organ that does an amazing job, but it can’t do that if you don’t do this

    Please don’t overdose deliberately either. Intentional overdoses make up a very large portion of acetaminophen overdoses (exact figures vary from year to year and place to place, but it’s always high), and what a lot of people doing that don’t realize is:

    1. it’s a very unpleasant way to die. You’ll take it, you might get some initial symptoms within the first hours or you might not, then you’ll probably feel better, and then the next day or so, you’ll enter the organs-shutting-down stage that usually will take most of a week to kill you slowly and painfully. Often your kidneys will go first but it’ll usually be liver necrosis that deals the final blow.
    2. it’s very difficult to treat. Stomach-pumping might work if you get it within 1 hour of overdose, and activated charcoal might help if you get it within 2 hours. Acetylcysteine may reduce the toxicity if you get it within the 8–48 hour window (depending on the speed of gastric emptying), but whether or not that will help depends on the severity of the overdose and other factors, so this is not something to bet on. After 48 hours, a liver transplant is the last resort, without which, mortality is around 95%.

    Unfortunately, this means that a lot of people who do not intend to die horribly, and hoped to either die peacefully or else be saved, die horribly instead.

    Ok, that was not a cheerful topic but it is important, before moving on, we’ll just put this here for anyone it may benefit:

    How To Stay Alive (When You Really Don’t Want To) ← this is about suicidality, in yourself or others

    Secondly, that dosage is for occasional use only

    The problem often starts like this:

    ❝Due to its perceived safety, paracetamol has long been recommended as the first line drug treatment for osteoarthritis by many treatment guidelines, especially in older people who are at higher risk of drug-related complications❞

    People with chronic pain, whether high or low on the pain level of that chronic pain, can very easily get into a habit of “I’ll just take this to take the edge off”, for example when getting up in the morning (often a trigger for pain starting) or going to bed at night (one needs to sleep and the pain is a barrier to that).

    But… Those events, getting up and going to bed, it means that taking the drug also becomes part of one’s morning/evening routine—with many people even metering the doses out into pill organizers for the week, with this in mind.

    A large (n=582,961) study looked at two groups of people, all aged 65+:

    • 180,483 people who had been prescribed paracetamol repeatedly (≥2 prescriptions within six months)
    • 402,478 people of the same age who had never been prescribed paracetamol repeatedly

    The findings? Bearing in mind that “≥2 prescriptions within six months” is not something generally considered excessive…

    ❝Acetaminophen use was associated with an increased risk of peptic ulcer bleeding (aHR 1.24; 95% CI 1.16, 1.34), uncomplicated peptic-ulcers (aHR 1.20; 95% CI 1.10, 1.31), lower gastrointestinal-bleeding (aHR 1.36; 95% CI 1.29, 1.46), heart-failure (aHR 1.09; 95% CI 1.06, 1.13), hypertension (aHR 1.07; 95% CI 1.04, 1.11), and chronic kidney disease (aHR 1.19; 95% CI 1.13, 1.24).❞

    The researchers concluded:

    ❝Despite its perceived safety, acetaminophen is associated with several serious complications. Given its minimal analgesic effectiveness, the use of acetaminophen as the first-line oral analgesic for long-term conditions in older people requires careful reconsideration.❞

    You can see the study itself here: Incidence of side effects associated with acetaminophen in people aged 65 years or more: a prospective cohort study using data from the Clinical Practice Research Datalink

    What to use instead?

    It’s been established that taking aspirin regularly isn’t great either:

    See: Low-Dose Aspirin & Anemia and Aspirin, CVD Risk, & Potential Counter-Risks

    And as for ibuprofen, we don’t have an article about that yet, but it’s gut-unhealthy (harms your microbiome), and besides, anything it can do, ginger can do as well or better (in head-to-head trials; we’re not speaking hyperbolically here):

    Ginger Does A Lot More Than You Think ← in fact, it was even found as effective as the combination of acetaminophen, ibuprofen, and caffeine

    There are other options though, and as pain is complicated and there’s no one-size-fits-all solution, we’ve compiled the following:

    Take care!

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Related Posts

  • Lies I Taught in Medical School – by Dr. Robert Lufkin
  • The Autoimmune Cure – by Dr. Sara Gottfried

    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 featured Dr. Gottfried before, as well as another of her books (“Younger”), and this one’s a little different, and on the one hand very specific, while on the other hand affecting a lot of people.

    You may be thinking, upon reading the subtitle, “this sounds like Dr. Gabor Maté’s ideas” (per: “When The Body Says No”), and 1) you’d be right, and 2) Dr. Gottfried does credit him in the introduction and refers back to his work periodically later.

    What she adds to this, and what makes this book a worthwhile read in addition to Dr. Maté’s, is looking clinically at the interactions of the immune system and nervous system, but also the endocrine system (Dr. Gottfried’s specialty) and the gut.

    Another thing she adds is more of a focus on what she writes about as “little-t trauma”, which is the kind of smaller, yet often cumulative, traumas that often eventually add up over time to present as C-PTSD.

    While “stress increases inflammation” is not a novel idea, Dr. Gottfried takes it further, and looks at a wealth of clinical evidence to demonstrate the series of events that, if oversimplified, seem unbelievable, such as “you had a bad relationship and now you have lupus”—showing evidence for each step in the snowballing process.

    The style is a bit more clinical than most pop-science, but still written to be accessible to laypersons. This means that for most of us, it might not be the quickest read, but it will be an informative and enlightening one.

    In terms of practical use (and living up to its subtitle promise of “cure”), this book does also cover all sorts of potential remedial approaches, from the obvious (diet, sleep, supplements, meditation, etc) to the less obvious (ketamine, psilocybin, MDMA, etc), covering the evidence so far as well as the pros and cons.

    Bottom line: if you have or suspect you may have an autoimmune problem, and/or would just like to nip the risk of such in the bud (especially bearing in mind that the same things cause neuroinflammation and thus, putatively, depression and dementia too), then this is one for you.

    Click here to check out the Autoimmune Cure, and take care of your body and mind!

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  • Chetna’s Healthy Indian – by Chetna Makan

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    Indian food is wonderful—a subjective opinion perhaps, but a popular view, and one this reviewer certainly shares. And of course, cooking with plenty of vegetables and spices is a great way to get a lot of health benefits.

    There are usually downsides though, such as that in a lot of Indian cookbooks, every second thing is deep-fried, and what’s not deep-fried contains an entire day or more’s saturated fat content in ghee, and a lot of sides have more than their fair share of sugar.

    This book fixes all that, by offering 80 recipes that prioritize health without sacrificing flavor.

    The recipes are, as the title suggests, vegetarian, though many are not vegan (yogurt and cheese featuring in many recipes). That said, even if you are vegan, it’s pretty easy to veganize those with the obvious plant-based substitutions. If you have soy yogurt and can whip up vegan paneer yourself (here’s our own recipe for that), you’re pretty much sorted.

    The cookbook strikes a good balance of being neither complicated nor “did we really need a recipe for this?” basic, and delivers value in all of its recipes. The ingredients, often a worry for many Westerners, should be easily found if you have a well-stocked supermarket near you; there’s nothing obscure here.

    Bottom line: if you’d like to cook more Indian food and want your food to be exciting without also making your blood pressure exciting, then this is an excellent book for keeping you well-nourished, body and soul.

    Click here to check out Chetna’s Healthy Indian, and spice up your culinary repertoire!

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  • Stretching Scientifically – by Thomas Kurz

    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.

    People stretching incorrectly can, even if they don’t injure themselves, lose countless hours for negligible flexibility gains, and put the failure down to their body rather than the method. You can have better.

    This book’s all about what works, and not only that, but what works with specific goals in mind, beyond the generic “do the splits” and “touch your toes” etc, which are laudable goals but quite basic. A lot of the further goals he has in mind have to do not just with flexibility, but also functional dynamic strength and mobility, because it’s of less versatile use to have the flexibility only to get folded like laundry and not actually actively do the things you want to.

    He does also cover “regardless of age”, so no more worrying that you should have been trained for the ballet when you were eight and now all is lost. It isn’t.

    As for the writing style… The author, a physical fitness and rehabilitation coach and writer, wrote this book while at the Academy of Physical Education in Warsaw during the Soviet period, and it shows. It is very much straight-to-the-point, no nonsense, no waffle. Everything is direct and comes with a list of research citations and clear instructions.

    Bottom line: if you’ve been trying to improve your flexibility and not succeeding, let this old Soviet instructor have a go.

    Click here to check out Stretching Scientifically, and stretch scientifically!

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