The Kitchen Prescription – by Saliha Mahmood Ahmed

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One of the biggest challenges facing anyone learning to cook more healthily, is keeping it tasty. What to cook when your biggest comfort foods all contain things you “should” avoid?

Happily for us, Dr. Ahmed is here with a focus on comfort food that’s good for your gut health. It’s incidentally equally good for the heart and good against diabetes… but Dr. Ahmed is a gastroenterologist, so that’s where she’s coming from with these.

There’s a wide range of 101 recipes here, including many tagged vegetarian, vegan, and/or gluten-free, as appropriate.

While this is not a vegetarian cookbook, Dr. Ahmed does consider the key components of a good diet to be, in order of quantity that should be consumed:

  1. Fruits and vegetables
  2. Whole grains
  3. Legumes
  4. Pulses
  5. Nuts and seeds

…and as such, the recipes are mostly plant-based.

The recipes are from all around the world, and/but the ingredients are mostly things that are almost universal. In the event that something might be hard-to-get, she suggests an appropriate substitution.

The recipes are straightforward and clear, as well as being beautifully illustrated.

All in all, a fine addition to anyone’s kitchen!

Get your copy of The Kitchen Prescription from Amazon today!

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  • Which Sugars Are Healthier, And Which Are Just The Same?

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    From Apples to Bees, and High-Fructose Cs

    We asked you for your (health-related) policy on sugar. The trends were as follows:

    • About half of all respondents voted for “I try to limit sugar intake, but struggle because it’s in everything”
    • About a quarter of all respondents voted for “Refined sugar is terrible; natural sugars (e.g. honey, agave) are fine”
    • About a quarter of all respondents voted for “Sugar is sugar and sugar is bad; I avoid it entirely”
    • One (1) respondent voted for “Sugar is an important source of energy, so I consume plenty”

    Writer’s note: I always forget to vote in these, but I’d have voted for “I try to limit sugar intake, but struggle because it’s in everything”.

    Sometimes I would like to make my own [whatever] to not have the sugar, but it takes so much more time, and often money too.

    So while I make most things from scratch (and typically spend about an hour cooking each day), sometimes store-bought is the regretfully practical timesaver/moneysaver (especially when it comes to condiments).

    So, where does the science stand?

    There has, of course, been a lot of research into the health impact of sugar.

    Unfortunately, a lot of it has been funded by sugar companies, which has not helped. Conversely, there are also studies funded by other institutions with other agendas to push, and some of them will seek to make sugar out to be worse than it is.

    So for today’s mythbusting overview, we’ve done our best to quality-control studies for not having financial conflicts of interest. And of course, the usual considerations of favoring high quality studies where possible Large sample sizes, good method, human subjects, that sort of thing.

    Sugar is sugar and sugar is bad: True or False?

    False and True, respectively.

    • Sucrose is sucrose, and is generally bad.
    • Fructose is fructose, and is worse.

    Both ultimately get converted into glycogen (if not used immediately for energy), but for fructose, this happens mostly* in the liver, which a) taxes it b) goes very unregulated by the pancreas, causing potentially dangerous blood sugar spikes.

    This has several interesting effects:

    • Because fructose doesn’t directly affect insulin levels, it doesn’t cause insulin insensitivity (yay)
    • Because fructose doesn’t directly affect insulin levels, this leaves hyperglycemia untreated (oh dear)
    • Because fructose is metabolized by the liver and converted to glycogen which is stored there, it’s one of the main contributors to non-alcoholic fatty liver disease (at this point, we’re retracting our “yay”)

    Read more: Fructose and sugar: a major mediator of non-alcoholic fatty liver disease

    *”Mostly” in the liver being about 80% in the liver. The remaining 20%ish is processed by the kidneys, where it contributes to kidney stones instead. So, still not fabulous.

    Fructose is very bad, so we shouldn’t eat too much fruit: True or False?

    False! Fruit is really not the bad guy here. Fruit is good for you!

    Fruit does contain fructose yes, but not actually that much in the grand scheme of things, and moreover, fruit contains (unless you have done something unnatural to it) plenty of fiber, which mitigates the impact of the fructose.

    • A medium-sized apple (one of the most sugary fruits there is) might contain around 11g of fructose
    • A tablespoon of high-fructose corn syrup can have about 27g of fructose (plus about 3g glucose)

    Read more about it: Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C-peptide in non-insulin-dependent diabetes mellitus and normal subjects

    However! The fiber content (in fruit) mitigates the impact of the fructose almost entirely anyway.

    And if you take fruits that are high in sugar and/but high in polyphenols, like berries, they now have a considerable net positive impact on glycemic health:

    You may be wondering: what was that about “unless you have done something unnatural to it”?

    That’s mostly about juicing. Juicing removes much (or all) of the fiber, and if you do that, you’re basically back to shooting fructose into your veins:

    Natural sugars like honey, agave, and maple syrup, are healthier than refined sugars: True or False?

    TrueSometimes, and sometimes marginally.

    This is partly because of the glycemic index and glycemic load. The glycemic index scores tail off thus:

    • table sugar = 65
    • maple syrup = 54
    • honey = 46
    • agave syrup = 15

    So, that’s a big difference there between agave syrup and maple syrup, for example… But it might not matter if you’re using a very small amount, which means it may have a high glycemic index but a low glycemic load.

    Note, incidentally, that table sugar, sucrose, is a disaccharide, and is 50% glucose and 50% fructose.

    The other more marginal health benefits come from that fact that natural sugars are usually found in foods high in other nutrients. Maple syrup is very high in manganese, for example, and also a fair source of other minerals.

    But… Because of its GI, you really don’t want to be relying on it for your nutrients.

    Wait, why is sugar bad again?

    We’ve been covering mostly the more “mythbusting” aspects of different forms of sugar, rather than the less controversial harms it does, but let’s give at least a cursory nod to the health risks of sugar overall:

    That last one, by the way, was a huge systematic review of 37 large longitudinal cohort studies. Results varied depending on what, specifically, was being examined (e.g. total sugar, fructose content, sugary beverages, etc), and gave up to 200% increased cancer risk in some studies on sugary beverages, but 95% increased risk is a respectable example figure to cite here, pertaining to added sugars in foods.

    And finally…

    The 56 Most Common Names for Sugar (Some Are Tricky)

    How many did you know?

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  • Mineral-Rich Mung Bean Pancakes

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    Mung beans are rich in an assortment of minerals, especially iron, copper, phosphorus, and magnesium. They’re also full of protein and fiber! What better way to make pancakes healthy?

    You will need

    • ½ cup dried green mung beans
    • ½ cup chopped fresh parsley
    • ½ cup chopped fresh dill
    • ¼ cup uncooked wholegrain rice
    • ¼ cup nutritional yeast
    • 1 tsp MSG, or 2 tsp low-sodium salt
    • 2 green onions, finely sliced
    • 1 tbsp extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Soak the mung beans and rice together overnight.

    2) Drain and rinse, and blend them in a blender with ¼ cup of water, to the consistency of regular pancake batter, adding more water (sparingly) if necessary.

    3) Transfer to a bowl and add the rest of the ingredients except for the olive oil, which latter you can now heat in a skillet over a medium-high heat.

    4) Add a few spoonfuls of batter to the pan, depending on how big you want the pancakes to be. Cook on both sides until you get a golden-brown crust, and repeat for the rest of the pancakes.

    5) Serve! As these are savory pancakes, you might consider serving them with a little salad—tomatoes, olives, and cucumbers go especially well.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • 5 Steps To Beat Overwhelm

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    Dealing With Overwhelm

    Whether we live a hectic life in general, or we usually casually take each day as it comes but sometimes several days gang up on us at once, everyone gets overwhelmed sometimes.

    Today we’re going to look at how to deal with it healthily.

    Step 1: Start anywhere

    It’s easy to get stuck in “analysis paralysis” and not know how to tackle an unexpected large problem. An (unhealthy) alternative is to try to tackle everything at once, and end up doing nothing very well.

    Even the most expert juggler will not successfully juggle 10 random things thrown unexpectedly at them.

    So instead, just pick any part of the the mountain of to-dos, and start.

    If you do want a little more finesse though, check out:

    Procrastination, And How To Pay Off The To-Do List Debt

    Step 2: Accept what you’re capable of

    This one works both ways. It means being aware of your limitations yes, but also, of your actual abilities:

    • Is the task ahead of you really beyond what you are capable of?
    • Could you do it right now without hesitation if a loved one’s life depended on it?
    • Could you do it, but there’s a price to pay (e.g. you can do it but it’ll wipe you out in some other life area)?

    Work out what’s possible and acceptable to you, and make a decision. And remember, it could be that someone else could do it, but everyone has taken the “if you want something doing, give it to someone busy” approach. It’s flattering that people have such confidence in our competence, but it is also necessary to say “no” sometimes, or at least enlisting help.

    Step 3: Listen to your body

    …like a leader listening to an advisory council. Your perception of tiredness, pain, weakness, and all your emotions are simply messengers. Listen to the message! And then say “thank you for the information”, and proceed accordingly.

    Sometimes that will be in the way the messengers seem to be hoping for!

    Sometimes, however, maybe we (blessed with a weighty brain and not entirely a slave to our limbic system) know better, and know when it’s right to push through instead.

    Similarly, that voice in your head? You get to decide where it goes and doesn’t. On which note…

    Step 4: Be responsive, not reactive

    We wrote previously on the difference between these:

    A Bone To Pick… Up And Then Put Back Where We Found It

    Measured responses will always be better than knee-jerk reactions, unless it is literally a case of a split-second making a difference. 99% of our problems in life are not so; usually the problem will still be there unchanged after a moment’s mindful consideration, so invest in that moment.

    You’ve probably heard the saying “give me six hours to chop down a tree, and I’ll spend the first four sharpening the axe”. In this case, that can be your mind. Here’s a good starting point:

    No-Frills, Evidence-Based Mindfulness

    And if your mental state is already worse than that, mind racing with threats (real or perceived) and doom-laden scenarios, here’s how to get out of that negative spiral first, so that you can apply the rest of this:

    The Off-Button For Your Brain

    Do remember to turn it on again afterwards, though

    Step 5: Transcend discomfort

    This is partly a callback to step 3, but it’s now coming from a place of a clear ready mind, so the territory should be looking quite different now. Nevertheless, it’s entirely possible that your clear view shows discomfort ahead.

    You’re going to make a conscious decision whether or not to proceed through the discomfort (and if you’re not, then now’s the time to start calmly and measuredly looking at alternative plans; delegating, ditching, etc).

    If you are going to proceed through discomfort, then it can help to frame the discomfort as simply a neutral part of the path to getting where you want. Maybe you’re going to be going way out of your comfort zone in order to deal with something, and if that’s the case, make your peace with it now, in advance.

    “Certainly it hurts” / “Well, what’s the trick then?” / “The trick, William Potter, is not minding that it hurts”

    (lines from a famous scene from the 1962 movie Lawrence of Arabia)

    It’s ok to say to yourself (if it’s what you decide is the right thing to do) “Yep, this experience is going to suck terribly, but I’m going to do it anyway”.

    See also (this being about Radical Acceptance):

    What’s The Worst That Could Happen?

    Take care!

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Related Posts

  • The Osteoporosis Breakthrough – by Dr. Doug Lucas
  • Pinch of Nom – by Kate Allinson & Kay Allinson

    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.

    “Home-style recipes”, because guess where most readers live!

    And: slimming, because trimming the waistline a little is a goal for many after holiday indulgences.

    The key idea here is healthy recipes that “don’t taste like diet food”—often by just switching out a couple of key ingredients, to give a significantly improved nutritional profile while remaining just as tasty, especially when flavors are enhanced with clever spicing and seasoning.

    The food is simple to prepare, while being “special” enough that it could be used very credibly for entertaining too. For that matter, a strength of the book is its potential for use as a creative springboard, if you’re so inclined—there are lots of good ideas in here.

    The recipes themselves are all you’d expect them to be, and presented clearly in an easy-to-follow manner.

    Bottom line: if you’ve ever wanted to cook healthily but you need dinner on the table in the very near future and are stuck for ideas, this book is exactly what you need.

    Click here to check out Pinch of Nom, and liven up your healthy cooking!

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  • People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?

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    Dementia is the second leading cause of death for Australians aged over 65. More than 421,000 Australians currently live with dementia and this figure is expected to almost double in the next 30 years.

    There is ongoing public discussion about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is now lawful in all six states, but is not available for a person living with dementia.

    The Australian Capital Territory has begun debating its voluntary assisted dying bill in parliament but the government has ruled out access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to revisit the issue in three years.

    The Northern Territory is also considering reform and has invited views on access to voluntary assisted dying for dementia.

    Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, called for the law to be widened to allow access.

    Others argue permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.

    Inside Creative House/Shutterstock

    Australian laws exclude access for dementia

    Current Australian voluntary assisted dying laws exclude access for people who seek to qualify because they have dementia.

    In New South Wales, the law specifically states this.

    In the other states, this occurs through a combination of the eligibility criteria: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.

    This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.

    What happens internationally?

    Voluntary assisted dying laws in some other countries allow access for people living with dementia.

    One mechanism, used in the Netherlands, is through advance directives or advance requests. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.

    Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “ten minutes to midnight” approach.

    But these approaches have challenges

    International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are reluctant to act on advance directives.

    Particularly challenging are scenarios where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.

    Older man looks confused
    What if the person changes their mind? Jokiewalker/Shutterstock

    Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.

    Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.

    Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.

    More thought is needed before changing our laws

    There is public demand to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation present an opportunity to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.

    The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “must include a review of the eligibility criteria”. And the ACT bill requires the review to consider “advanced care planning”.

    Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.

    Holding hands
    The legislation undergoes a mandatory review. Jenny Sturm/Shutterstock

    This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.

    This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.

    Any future law reform should be evidence-based and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.

    Ben White, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, Queensland University of Technology; Casey Haining, Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology; Lindy Willmott, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, Queensland University of Technology, and Rachel Feeney, Postdoctoral research fellow, Queensland University of Technology

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

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  • Why We Get Sick – by Dr. Benjamin Bikman

    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.

    There’s a slightly buried lede here in that the title doesn’t offer this spoiler, but we will: the book is about insulin resistance.

    However, unlike the books we’ve reviewed about blood sugar management, this time the focus is really and truly on insulin itself—and that makes some important differences:

    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.

    The book is divided into sections:

    1. The Problem: What Is Insulin Resistance
    2. The Cause: What Makes Us Insulin Resistant
    3. How We Can Fight Insulin Resistance

    The first two parts are essential for the reader’s understanding, but the third part is the practical part, with appropriately practical advice on the most insulin-friendly ways to exercise, eat, fast, and more. He also talks drugs, and discusses the pros and cons of various interventions—but of course, far better is the lifestyle management of insulin.

    The style is mostly very pop-science in overall presentation, and then occasionally gets very dense at times, but when that happens, he will then tend to follow it with an easier-to-understand explanation, to ensure that nothing remains opaque.

    Bottom line: if you care about your metabolic health and don’t mind reading a book where you may have to read a paragraph or two twice sometimes, then this is a top-tier book on insulin resistance and how to prevent/reverse it.

    Click here to check out Why We Get Sick, and stay well instead!

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