The Joy of Saying No – by Natalie Lue

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Superficially, this seems an odd topic for an entire book. “Just say no”, after all, surely! But it’s not so simple as that, is it?

Lue looks into what underpins people-pleasing, first. Then, she breaks it down into five distinct styles of people-pleasing that each come from slightly different motivations and ways of perceiving how we interact with those around us.

Lest this seem overly complicated, those five styles are what she calls: gooding, efforting, avoiding, saving, suffering.

She then looks out how to have a healthier relationship with our yes/no decisions; first by observing, then by creating healthy boundaries. “Healthy” is key here; this isn’t about being a jerk to everyone! Quite the contrary, it involves being honest about what we can and cannot reasonably take on.

The last section is about improving and troubleshooting this process, and constitutes a lot of the greatest value of the book, since this is where people tend to err the most.

Bottom line: this book is informative, clear, and helpful. And far from disappointing everyone with “no”, we can learn to really de-stress our relationships with others—and ourselves.

Click here to check out The Joy of Saying No, and have more energy for the right “yes” items in your life!

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  • Aging Backwards – by Miranda Esmonde-White

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    In this book, there’s an upside and a downside to the author’s professional background:

    • Upside: Miranda Esmonde-White is a ballet-dancer-turned-physical-trainer, and it shows
    • Downside: Miranda Esmonde-White is not a scientist, and it shows

    She cites a lot of science, but she either does not understand it or else intentionally misrepresents it. We will assume the former. But as one example, she claims:

    “for every minute you exercise, you lengthen your life by 7 minutes”

    …which cheat code to immortality is absolutely not backed-up by the paper she cites for it. The paper, like most papers, was much more measured in its proclamations; “there was an association” and “with these conditions”, etc.

    Nevertheless, while she misunderstands lots of science along the way, her actual advice is good and sound. Her workout programs really will help people to become younger by various (important, life-changing!) metrics of biological age, mostly pertaining to mobility.

    And yes, this is a workout-based approach; we won’t read much about diet and other lifestyle factors here.

    Bottom line: it has its flaws, but nevertheless delivers on its premise of helping the reader to become biologically younger through exercises, mostly mobility drills.

    Click here to check out Aging Backwards, and age backwards!

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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.

    Don’t have an air purifier and want one?

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

    *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.

    Take care!

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  • Olfactory Training, Better

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    Anosmia, by any other name…

    The loss of the sense of smell (anosmia) is these days well-associated with COVID and Long-COVID, but also can simply come with age:

    National Institute of Aging | How Smell & Taste Change With Age

    …although it can also be something else entirely:

    ❝Another possibility is a problem with part of the nervous system responsible for smell.

    Some studies have suggested that loss of smell could be an early sign of a neurodegenerative disease, such as Alzheimer’s or Parkinson’s disease.

    However, a recent study of 1,430 people (average age about 80) showed that 76% of people with anosmia had normal cognitive function at the study’s end.❞

    Read more: Harvard Health | Is it normal to lose my sense of smell as I age?

    We’d love to look at and cite the paper that they cite, but they didn’t actually provide a source. We did find some others, though:

    ❝Olfactory capacity declines with aging, but increasing evidence shows that smell dysfunction is one of the early signs of prodromal neurodegenerative diseases such as Alzheimer’s and Parkinson’s disease.

    The loss of smell is considered a clinical sign of early-stage disease and a marker of the disease’s progression and cognitive impairment.❞

    ~ Dr. Irene Fatuzzo et al.

    Read more: Neurons, Nose, and Neurodegenerative Diseases: Olfactory Function and Cognitive Impairment

    What’s clear is the association; what’s not clear is whether one worsens the other, and what causal role each might play. However, the researchers conclude that both ways are possible, including when there is another, third, underlying potential causal factor:

    ❝Ongoing studies on COVID-19 anosmia could reveal new molecular aspects unexplored in olfactory impairments due to neurodegenerative diseases, shedding a light on the validity of smell test predictivity of cognitive dementia.

    The neuroepithelium might become a new translational research target (Neurons, Nose, and Neurodegenerative diseases) to investigate alternative approaches for intranasal therapy and the treatment of brain disorders. ❞

    ~ Ibid.

    Another study explored the possible mechanisms of action, and found…

    ❝Olfactory impairment was significantly associated with increased likelihoods of MCI, amnestic MCI, and non-amnestic MCI.

    In the subsamples, anosmia was significantly associated with higher plasma total tau and NfL concentrations, smaller hippocampal and entorhinal cortex volumes, and greater WMH volume, and marginally with lower AD-signature cortical thickness.

    These results suggest that cerebral neurodegenerative and microvascular lesions are common neuropathologies linking anosmia with MCI in older adults❞

    ~ Dr. Yi Dong et al.

    • MCI = Mild Cognitive Impairment
    • NfL = Neurofilament Light [Chain]
    • WMH = White Matter Hyperintensity
    • AD =Alzheimer’s Disease

    Read more: Anosmia, mild cognitive impairment, and biomarkers of brain aging in older adults

    How to act on this information

    You may be wondering, “this is fascinating and maybe even a little bit frightening, but how is this Saturday’s Life Hacks?”

    We wanted to set up the “why” before getting to the “how”, because with a big enough “why”, it’s much easier to find the motivation to act on the “how”.

    Test yourself

    Or more conveniently, you and a partner/friend/relative can test each other.

    Simply do like a “blind taste testing”, but for smell. Ideally these will be a range of simple and complex odors, and commercially available smell test kits will provide these, if you don’t want to make do with random items from your kitchen.

    If you’d like to use a clinical diagnostic tool, you can check out:

    Clinical assessment of patients with smell and taste disorders

    …and especially, this really handy diagnostic flowchart:

    Algorithm of evaluation of a patient who has olfactory loss

    Train yourself

    “Olfactory training” has been the got-to for helping people to regain their sense of smell after losing it due to COVID.

    In simple terms, this means simply trying to smell things that “should” have a distinctive odor, and gradually working up one’s repertoire of what one can smell.

    You can get some great tips here:

    AbScent | Useful Insights Into Smell Training

    Hack your training

    An extra trick was researched deeply in a recent study which found that multisensory integration helped a) initially regain the ability to smell things and b) maintain that ability later without the cross-sensory input.

    What that means: you will more likely be able to smell lemon while viewing the color yellow, and most likely of all to be able to smell lemon while actually holding and looking at a slice of lemon. Having done this, you’re more likely to be able to smell (and distinguish) the odor of lemon later in a blind smell test.

    In other words: with this method, you may be able to cut out many months of frustration of trying and failing to smell something, and skip straight to the “re-adding specific smells to my brain’s olfactory database” bit.

    Read the study: Olfactory training: effects of multisensory integration, attention towards odors and physical activity

    Or if you prefer, here’s a pop-science article based on that:

    One in twenty people has no sense of smell—here’s how they might get it back

    Take care!

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  • How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

    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 have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting good sleep is imperative.

    However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health?

    Our research attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each.

    Finding the right balance

    Current health guidelines recommend you stick to a sensible regime of moderate-to vigorous-intensity physical activity 2.5–5 hours per week.

    However mounting evidence now suggests how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping.

    Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours.

    At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model.

    Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity.

    When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk.

    You’re doing more physical activity than you think

    We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise.

    Our experimental evidence shows that interrupting our sitting regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch.

    While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk.

    It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies.

    The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time.

    Australia’s adult physical activity guidelines need updating

    Australia’s physical activity guidelines currently only recommend exercise intensity and time. A new set of guidelines are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements.

    While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night.

    Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening.

    It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.

    Christian Brakenridge, Postdoctoral research fellow at Swinburne University Centre for Urban Transitions, Swinburne University of Technology

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

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  • Metformin For Weight-Loss & More

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    Metformin Without Diabetes?

    Metformin is a diabetes drug; it works by:

    • decreasing glucose absorption from the gut
    • decreasing glucose production in the liver
    • increasing glucose sensitivity

    It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.

    It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).

    Today we’ll examine its off-label uses and see what the science says!

    A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.

    Other examples include modafinil against depression, and beta-blockers against anxiety.

    Why take it if not diabetic?

    There are many reasons people take it, including just general health and life extension:

    One of the cheapest diabetes drugs on the market can also slow aging and extend your life span. Here’s how

    However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:

    ❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞

    Source: Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up

    But, it seems it does more, as this more recent review found:

    Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.

    Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.

    Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞

    Source: Metformin for diabetes prevention: update of the evidence base

    We were wondering about that cardioprotective effect, so…

    Cardioprotective effect

    In short, another review (published a few months after the above one) confirmed the previous findings, and also added:

    ❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞

    Real World Data: Off-Label Metformin in Patients with Prediabetes is Associated with Improved Cardiovascular Outcomes

    We wondered about the weight loss implications of this, and…

    For weight loss

    The short version is, it works:

    …and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.

    Compared/contrasted with GLP-1 agonists

    It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:

    Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients

    Or if you prefer a reader-friendly pop-science version:

    Ozempic vs Metformin: Comparing The Two Diabetes Medications

    Is it safe?

    For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:

    • Usually contraindicated if you have kidney problems of any kind
    • Usually contraindicated if you have liver problems of any kind
    • May be contraindicated if you have issues with B12 levels

    See also: Metformin: Is it a drug for all reasons and diseases?

    Where can I get it?

    As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.

    However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).

    If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:

    Off-label indications of Metformin – Review of Literature

    Take care!

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  • Is white rice bad for me? Can I make it lower GI or healthier?

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    Rice is a culinary staple in Australia and around the world.

    It might seem like a given that brown rice is healthier than white and official public health resources often recommend brown rice instead of white as a “healthy swap”.

    But Australians definitely prefer white rice over brown. So, what’s the difference, and what do we need to know when choosing rice?

    Dragne Marius/Unsplash

    What makes rice white or brown?

    Rice “grains” are technically seeds. A complete, whole rice seed is called a “paddy”, which has multiple parts:

    1. the “hull” is the hard outer layer which protects the seed
    2. the “bran”, which is a softer protective layer containing the seed coat
    3. the “germ” or the embryo, which is the part of the seed that would develop into a new plant if was germinated
    4. the “endosperm”, which makes up most of the seed and is essentially the store of nutrients that feeds the developing plant as a seed grows into a plant.

    Rice needs to be processed for humans to eat it.

    Along with cleaning and drying, the hard hulls are removed since we can’t digest them. This is how brown rice is made, with the other three parts of the rice remaining intact. This means brown rice is regarded as a “wholegrain”.

    White rice, however, is a “refined” grain, as it is further polished to remove the bran and germ, leaving just the endosperm. This is a mechanical and not a chemical process.

    What’s the difference, nutritionally?

    Keeping the bran and the germ means brown rice has more magnesium, phosphorus, potassium B vitamins (niacin, folate, riboflavin and pyridoxine), iron, zinc and fibre.

    The germ and the bran also contain more bioactives (compounds in foods that aren’t essential nutrients but have health benefits), like oryzanols and phenolic compounds which have antioxidant effects.

    Brown rice
    Brown rice is cleaned and dried and the hard hulls are removed. Sung Min/Shutterstock

    But that doesn’t mean white rice is just empty calories. It still contains vitamins, minerals and some fibre, and is low in fat and salt, and is naturally gluten-free.

    White and brown rice actually have similar amounts of calories (or kilojoules) and total carbohydrates.

    There are studies that show eating more white rice is linked to a higher risk of type 2 diabetes. But it is difficult to know if this is down to the rice itself, or other related factors such as socioeconomic variables or other dietary patterns.

    What about the glycaemic index?

    The higher fibre means brown rice has a lower glycaemic index (GI), meaning it raises blood sugar levels more slowly. But this is highly variable between different rices within the white and brown categories.

    The GI system uses low (less than 55), medium (55–70) and high (above 70) categories. Brown rices fall into the low and medium categories. White rices fall in the medium and high.

    There are specific low-GI types available for both white and brown types. You can also lower the GI of rice by heating and then cooling it. This process converts some of the “available carbohydrates” into “resistant starch”, which then functions like dietary fibre.

    Are there any benefits to white rice?

    The taste and textural qualities of white and brown rices differ. White rice tends to have a softer texture and more mild or neutral flavour. Brown rice has a chewier texture and nuttier flavour.

    So, while you can technically substitute brown rice into most recipes, the experience will be different. Or other ingredients may need to be added or changed to create the desired texture.

    Removing more of the outer layers may also reduce the levels of contaminants such as pesticides.

    We don’t just eat rice

    Friends eat dinner on a rooftop terrace
    You’ll likely have vegetables and protein with your rice. Chay_Tee/Shutterstock

    Comparing white and brown rice seems like an easy way to boost nutritional value. But just because one food (brown rice) is more nutrient-dense doesn’t make the other food (white rice) “bad”.

    Ultimately, it’s not often that we eat just rice, so we don’t need the rice we choose to be the perfect one. Rice is typically the staple base of a more complex dish. So, it’s probably more important to think about what we eat with rice.

    Adding vegetables and lean proteins to rice-based dishes can easily add the micronutrients, bioactives and fibre that white rice is comparatively lacking, and this can likely do more to contribute to diet quality than eating brown rice instead.

    Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney

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

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