The Inflamed Mind – by Dr. Edward Bullmore
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Firstly, let’s note that this book was published in 2018, so the “radical new” approach is more like “tried and tested and validated” now.
Of course, inflammation in the brain is also linked to Alzheimer’s, Parkinson’s, and other neurodegenerative disorders, but that’s not the main topic here.
Dr. Bullmore, a medical doctor, psychiatrist, and neuroscientist with half the alphabet after his name, knows his stuff. We don’t usually include author bio information here, but it’s also relevant that he has published more than 500 scientific papers and is one of the most highly cited scientists worldwide in neuroscience and psychiatry.
What he explores in this book, with a lot of hard science made clear for the lay reader, is the mechanisms of action of depression treatments that aren’t just SSRIs, and why anti-inflammatory approaches can work for people with “treatment-resistant depression”.
The book was also quite prescient in its various declarations of things he expects to happen in the field in the next five years, because they’ve happened now, five years later.
Bottom line: if you’d like to understand how the mind and body affect each other in the cases of inflammation and depression, with a view to lessening either or both of those things, this is a book for you.
Click here to check out The Inflamed Mind, and take good care of yours!
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Stop Pain Spreading
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Put Your Back Into It (Or Don’t)!
We’ve written before about Managing Chronic Pain (Realistically!), and today we’re going to tackle a particular aspect of chronic pain management.
- It’s a thing where the advice is going to be “don’t do this”
- And if you have chronic pain, you will probably respond “yep, I do that”
However, it’s definitely a case of “when knowing isn’t the problem”, or at the very least, it’s not the whole problem.
Stop overcompensating and address the thing directly
We all do it, whether in chronic pain, or just a transient injury. But we all need to do less of it, because it causes a lot of harm.
Example: you have pain in your right knee, so you sit, stand, walk slightly differently to try to ease that pain. It works, albeit marginally, at least for a while, but now you also have pain in your left hip and your lumbar vertebrae, because of how you leaned a certain way. You adjust how you sit, stand, walk, to try to ease both sets of pain, and before you know it, now your neck also hurts, you have a headache, and you’re sure your digestion isn’t doing what it should and you feel dizzy when you stand. The process continues, and before long, what started off as a pain in one knee has now turned your whole body into a twisted aching wreck.
What has happened: the overcompensation due to the original pain has unduly stressed a connected part of the body, which we then overcompensate for somewhere else, bringing down the whole body like a set of dominoes.
For more on this: Understanding How Pain Can Spread
“Ok, but how? I can’t walk normally on that knee!”
We’re keeping the knee as an example here, but please bear in mind it could be any chronic pain and resultant disability.
Note: if you found the word “disability” offputting, please remember: if it adversely affects your abilities, it is a disability. Disabilities are not something that only happen to other people! They will happen to most of us at some point!
Ask yourself: what can you do, and what can’t you do?
For example:
- maybe you can walk, but not normally
- maybe you can walk normally, but not without great pain
- maybe you can walk normally, but not at your usual walking pace
First challenge: accept your limitations. If you can’t walk at your usual walking pace without great pain and/or throwing your posture to the dogs, then walk more slowly. To Hell with societal expectations that it shouldn’t take so long to walk from A to B. Take the time you need.
Second challenge: accept help. It doesn’t have to be help from another person (although it could be). It might be accepting the help of a cane, or maybe even a wheelchair for “flare-up” days. Society, especially American society which is built on ideas of self-sufficiency, has framed a lot of such options as “giving up”, but if they help you get about your day while minimizing doing further harm to your body, then they can be good and even health-preserving things. Same goes for painkillers if they help you from doing more harm to your body by balling up tension in a part of your body in a way that ends up spreading out and laying ruin to your whole body.
Speaking of which:
How Much Does It Hurt? Get The Right Help For Your Pain
After which, you might want to check out:
The 7 Approaches To Pain Management
and
Science-Based Alternative Pain Relief
Third challenge: deserves its own section, so…
Do what you can
If you have chronic pain (or any chronic illness, really), you are probably fed up of hearing how this latest diet will fix you, or yoga will fix you, and so on. But, while these things may not be miracle cures…
- A generally better diet really will lessen symptoms and avoid flare-ups (a low-inflammation diet is a great start for lessening the symptoms of a lot of chronic illnesses)
- Doing what exercise you can, being mindful of your limitations yes but still keeping moving as much as possible, will also prevent (or at least slow) deterioration. Consider consulting a physiotherapist for guidance (a doctor will more likely just say “rest, take it easy”, whereas a physiotherapist will be able to give more practical advice).
- Getting good sleep may be a nightmare in the case of chronic pain (or other chronic illnesses! Here’s to those late night hyperglycemia incidents for Type 1 Diabetics that then need monitoring for the next few hours while taking insulin and hoping it goes back down) but whatever you can do to prioritize it, do it.
Want to read more?
We reviewed a little while ago a great book about this; the title sounds like a lot of woo, but we promise the content is extremely well-referenced science:
…and if your issue is back pain specifically, we highly recommend:
Healing Back Pain: The Mind-Body Connection – by Dr. John Sarno
Take care!
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Missing Microbes – by Dr. Martin Blaser
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You probably know that antibiotic resistance is a problem, but you might not realize just what a many-headed beast antibiotic overuse is.
From growing antibiotic superbugs, to killing the friendly bacteria that normally keep pathogens down to harmless numbers (resulting in death of the host, as the pathogens multiply unopposed), to multiple levels of dangers in antibiotic overuse in the farming of animals, this book is scary enough that you might want to save it for Halloween.
But, Dr. Blaser does not argue against antibiotic use when it’s necessary; many people are alive because of antibiotics—he himself recovered from typhoid because of such.
The style of the book is narrative, but information-dense. It does not succumb to undue sensationalization, but it’s also far from being a dry textbook.
Bottom line: if you’d like to understand the real problems caused by antibiotics, and how we can combat that beyond merely “try not to take them unnecessarily”, this book is very worthy reading.
Click here to check out Missing Microbes, and learn more about yours!
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How much does your phone’s blue light really delay your sleep? Relax, it’s just 2.7 minutes
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It’s one of the most pervasive messages about technology and sleep. We’re told bright, blue light from screens prevents us falling asleep easily. We’re told to avoid scrolling on our phones before bedtime or while in bed. We’re sold glasses to help filter out blue light. We put our phones on “night mode” to minimise exposure to blue light.
But what does the science actually tell us about the impact of bright, blue light and sleep? When our group of sleep experts from Sweden, Australia and Israel compared scientific studies that directly tested this, we found the overall impact was close to meaningless. Sleep was disrupted, on average, by less than three minutes.
We showed the message that blue light from screens stops you from falling asleep is essentially a myth, albeit a very convincing one.
Instead, we found a more nuanced picture about technology and sleep.
Mangostar/Shutterstock What we did
We gathered evidence from 73 independent studies with a total of 113,370 participants of all ages examining various factors that connect technology use and sleep.
We did indeed find a link between technology use and sleep, but not necessarily what you’d think.
We found that sometimes technology use can lead to poor sleep and sometimes poor sleep can lead to more technology use. In other words, the relationship between technology and sleep is complex and can go both ways.
How is technology supposed to harm sleep?
Technology is proposed to harm our sleep in a number of ways. But here’s what we found when we looked at the evidence:
- bright screen light – across 11 experimental studies, people who used a bright screen emitting blue light before bedtime fell asleep an average of only 2.7 minutes later. In some studies, people slept better after using a bright screen. When we were invited to write about this evidence further, we showed there is still no meaningful impact of bright screen light on other sleep characteristics including the total amount or quality of sleep
- arousal is a measure of whether people become more alert depending on what they’re doing on their device. Across seven studies, people who engaged in more alerting or “exciting” content (for example, video games) lost an average of only about 3.5 minutes of sleep compared to those who engaged in something less exciting (for example, TV). This tells us the content of technology alone doesn’t affect sleep as much as we think
- we found sleep disruption at night (for example, being awoken by text messages) and sleep displacement (using technology past the time that we could be sleeping) can lead to sleep loss. So while technology use was linked to less sleep in these instances, this was unrelated to being exposed to bright, blue light from screens before bedtime.
Which factors encourage more technology use?
Research we reviewed suggests people tend to use more technology at bedtime for two main reasons:
- to “fill the time” when they’re not yet sleepy. This is common for teenagers, who have a biological shift in their sleep patterns that leads to later sleep times, independent of technology use.
- to calm down negative emotions and thoughts at bedtime, for apparent stress reduction and to provide comfort.
There are also a few things that might make people more vulnerable to using technology late into the night and losing sleep.
We found people who are risk-takers or who lose track of time easily may turn off devices later and sacrifice sleep. Fear of missing out and social pressures can also encourage young people in particular to stay up later on technology.
What helps us use technology sensibly?
Last of all, we looked at protective factors, ones that can help people use technology more sensibly before bed.
The two main things we found that helped were self-control, which helps resist the short-term rewards of clicking and scrolling, and having a parent or loved one to help set bedtimes.
We found having a parent or loved one to help set bedtimes encourages sensible use of technology. fast-stock/Shutterstock Why do we blame blue light?
The blue light theory involves melatonin, a hormone that regulates sleep. During the day, we are exposed to bright, natural light that contains a high amount of blue light. This bright, blue light activates certain cells at the back of our eyes, which send signals to our brain that it’s time to be alert. But as light decreases at night, our brain starts to produce melatonin, making us feel sleepy.
It’s logical to think that artificial light from devices could interfere with the production of melatonin and so affect our sleep. But studies show it would require light levels of about 1,000-2,000 lux (a measure of the intensity of light) to have a significant impact.
Device screens emit only about 80-100 lux. At the other end of the scale, natural sunlight on a sunny day provides about 100,000 lux.
What’s the take-home message?
We know that bright light does affect sleep and alertness. However our research indicates the light from devices such as smartphones and laptops is nowhere near bright or blue enough to disrupt sleep.
There are many factors that can affect sleep, and bright, blue screen light likely isn’t one of them.
The take-home message is to understand your own sleep needs and how technology affects you. Maybe reading an e-book or scrolling on socials is fine for you, or maybe you’re too often putting the phone down way too late. Listen to your body and when you feel sleepy, turn off your device.
Chelsea Reynolds, Casual Academic/Clinical Educator and Clinical Psychologist, College of Education, Psychology and Social Work, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Air Purifiers & Sleep
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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
❝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.❞
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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The Brain-Gut Highway: A Two-Way Street
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The Brain-Gut Two-Way Highway
This is Dr. Emeran Mayer. He has the rather niche dual specialty of being a gastroenterologist and a neurologist. He has published over 353 peer reviewed scientific articles, and he’s a professor in the Departments of Medicine, Physiology, and Psychiatry at UCLA. Much of his work has been pioneering medical research into gut-brain interactions.
We know the brain and gut are connected. What else does he want us to know?
First, that it is a two-way interaction. It’s about 90% “gut tells the brain things”, but it’s also 10% “brain tells the gut things”, and that 10% can make more like a 20% difference, if for example we look at the swing between “brain using that 10% communication to tell gut to do things worse” or “brain using that 10% communication to tell gut to do things better”, vs the midpoint null hypothesis of “what the gut would be doing with no direction from the brain”.
For example, if we are experiencing unmanaged chronic stress, that is going to tell our gut to do things that had an evolutionary advantage 20,000–200,000 years ago. Those things will not help us now. We do not need cortisol highs and adrenal dumping because we ate a piece of bread while stressed.
Read more (by Dr. Mayer): The Stress That Evolution Has Not Prepared Us For
With this in mind, if we want to look after our gut, then we can start before we even put anything in our mouths. Dr. Mayer recommends managing stress, anxiety, and depression from the head downwards as well as from the gut upwards.
Here’s what we at 10almonds have written previously on how to manage those things:
- No-Frills, Evidence-Based Mindfulness
- How To Set Anxiety Aside
- The Mental Health First-Aid You’ll Hopefully Never Need
Do eat for gut health! Yes, even if…
Unsurprisingly, Dr. Mayer advocates for a gut-friendly, anti-inflammatory diet. We’ve written about these things before:
…but there’s just one problem:
For some people, such as with IBS, Crohn’s, and colitis, the Mediterranean diet that we (10almonds and Dr. Mayer) generally advocate for, is inaccessible. If you (if you have those conditions) eat as we describe, a combination of the fiber in many vegetables and the FODMAPs* in many fruits, will give you a very bad time indeed.
*Fermentable Oligo-, Di-, Monosaccharides And Polyols
Dr. Mayer has the answer to this riddle, and he’s not just guessing; he and his team did science to it. In a study with hundreds of participants, he measured what happened with adherence (or not) to the Mediterranean diet (or modified Mediterranean diet) (or not), in participants with IBS (or not).
The results and conclusions from that study included:
❝Among IBS participants, a higher consumption of fruits, vegetables, sugar, and butter was associated with a greater severity of IBS symptoms. Multivariate analysis identified several Mediterranean Diet foods to be associated with increased IBS symptoms.
A higher adherence to symptom-modified Mediterranean Diet was associated with a lower abundance of potentially harmful Faecalitalea, Streptococcus, and Intestinibacter, and higher abundance of potentially beneficial Holdemanella from the Firmicutes phylum.
A standard Mediterranean Diet was not associated with IBS symptom severity, although certain Mediterranean Diet foods were associated with increased IBS symptoms. Our study suggests that standard Mediterranean Diet may not be suitable for all patients with IBS and likely needs to be personalized in those with increased symptoms.❞
In graphical form:
And if you’d like to read more about this (along with more details on which specific foods to include or exclude to get these results), you can do so…
- The study itself (full article): The Association Between a Mediterranean Diet and Symptoms of Irritable Bowel Syndrome
- Dr. Mayer’s blog (lay explanation): The Benefits of a Modified Mediterranean Diet for Irritable Bowel Syndrome
Want to know more?
Dr. Mayer offers many resources, including a blog, books, recipes, podcasts, and even a YouTube channel:
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Most People Who Start GLP-1 RAs Quit Them Within A Year (Here’s Why)
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Specifically, 54% quit within one year, with that number rising to 72% within two years.
We first wrote about GLP-1 receptor agonists (i.e. semaglutide drugs like Ozempic and Wegovy) a couple of years ago when popularity was just beginning to take off:
However, as we had room only to touch briefly on the side effects and what happens when you stop taking it, you might also want to check out:
What happens when I stop taking a drug like Ozempic or Mounjaro?
…and:
Notwithstanding all this information, there’s a lot of science that has still yet to be done. If you’re a regular 10almonds reader, you’ll be familiar with our research review articles—this one was more of a non-research review, i.e. looking at the great absence of evidence in certain areas, and the many cases of research simply not asking the right questions, for example:
❝Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.❞
Read in full: Semaglutide’s Surprisingly Unexamined Effects ← there are a lot more (equally concerning) items discussed in this article
Why people quit GLP-1 RAs
There was a large (n=125,474) study of US adults. The average age was about 54 years, and about 65% were female.
From the total data pool (i.e. not narrowing it down by demographic), 54% stopped within a year, and 72% within two years.
The factors most associated with discontinuation were:
- age above 65 years
- not having type 2 diabetes
The main reasons given for discontinuation were:
- High costs: self-explanatory, but it’s worth noting that people who stopped for this reason were more likely to restart later.
- Adverse side effects: the most common ones were nausea, vomiting, diarrhea, constipation, stomach pain, and loss of appetite. Rarer, but more seriously, side effects included: pancreatitis (severe abdominal pain, nausea, vomiting), gallbladder issues (gallstones, cholecystitis), kidney problems, severe allergic reactions (rash, swelling, difficulty breathing), hypoglycemia, especially if taken with insulin or other diabetes medications, changes in vision (worsening diabetic retinopathy), and an increased heart rate.
- Disappointingly little weight loss: the researchers noted that GLP-1 RA results are “heterogenous”, meaning, they differ a lot. For those for whom it didn’t work, quitting was more likely, for obvious reasons. See also: 10 Mistakes To Sabotage Your Ozempic Progress
- Successful weight loss: while it is widely known that if one stops taking GLP-1 RAs, weight regain is the usual next thing to happen, there are a lot of people who go onto GLP-1 RAs with the rationale “I’ll just use this to lose the weight, and then I’ll keep the weight off with my diet and lifestyle”. Which sounds reasonable, but because of the specific mechanisms of actions of GLP-1 RAs, it simply doesn’t work that way (and, as we mentioned above, there are reasons that you may, after stopping taking GLP-1 RAs, be more disposed to put weight on than you were before you started). So, by the best of current science (which admittedly is not amazing when it comes to this topic), it does seem that taking GLP-1 RAs is a lifetime commitment.
You can read the study itself here:
Want to get similar results, without GLP-1 RAs?
Then check out:
5 Ways To Naturally Boost The “Ozempic Effect” ← this is about natural ways of doing similar hormone-hacking to what GLP-1 RAs do
and
Ozempic vs Five Natural Supplements ← this is about metabolism-tweaking supplements
and
Hack Your Hunger ← this is about appetite management
Take care!
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