
The Modern Art and Science of Mobility – by Aurélien Broussal-Derval
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We’ve reviewed mobility books before, so what makes this one stand out?
We’ll be honest: the illustrations are lovely.
The science, the information, the exercises, the routines, the programs… All these things are excellent too, but these can be found in many a book.
What can’t usually be found is very beautiful (yet no less clear) watercolor paintings and charcoal sketches as anatomical illustrations.
There are photos too (also of high quality), but the artistry of the paintings and sketches is what makes the reader want to spend time perusing the books.
At least, that’s what this reviewer found! Because it’s all very well having access to a lot of information (and indeed, I read so much), but making it enjoyable increases the chances of rereading it much more often.
As for the rest of the content, the book’s information is divided in categories:
- Pain (what causes it, what it means, and how to manage it)
- Breathing (yes, a whole section devoted to this, and it is aligned heavily to posture also, as well as psychological state and the effect of stress on tension, inflammation, and more)
- Movement (this is mostly about kinds of movement and ranges of movement)
- Mobility (this is about aggregating movements as a fully mobile human)
So, each builds on from the previous because any pain needs addressing before anything else, breathing (and with it, posture) comes next, then we learn about movement, then we bring it all together for mobility.
Bottom line: this is a beautiful and comprehensive book that will make learning a joy
Click here to check out The Modern Art and Science of Mobility, and learn and thrive!
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The Surprising Link Between Vitamin D & Pain
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Most people, or at least most women of a certain age, know that vitamin D is especially important to us as we get older (women of a certain age, because: increased osteoporosis risk especially for women and especially with untreated menopause, because estrogen and progesterone are also essential for healthy bone turnover*)
*Unless you’re a man with typical manly hormones, in which case, testosterone has you covered! But for the rest of us, estrogen and progesterone are what’s needed to avoid the increased risk, and for all of us, vitamin D is necessary to for health bone rebuilding.
However! While vitamin D is well-known amongst our demographic to be important for bone health (and quite well-known for being relevant to immune health*, too), its effects on some other systems are not so widely understood, and that’s what we’ll talk about today.
*See for example: Does Vitamin D Help Against COVID? ← short answer: vitamin D does so many things for your immune system, and/but no, protecting you from COVID is not one of them. However, it may reduce the risk of long COVID, at least.
First though, a quick vitamin D primer for anyone catching up:
- Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing
- Vit D + Calcium: Too Much Of A Good Thing? ← this also talks about safe and effective doses, and what goes wrong if you take too much
- How Taking Vitamin D Supplements Can Sabotage Your Vitamin D Levels
So, what’s this about vitamin D and pain?
It’s about how the body responds
Researchers (Dr. Mahdy Abdelhady et al.) investigated this matter and found that women with vitamin D deficiency who underwent surgery were about 3x more likely to experience moderate to severe postoperative pain and used substantially more opioid medication afterwards.
In numbers:
- It was an observational study with 184 women undergoing surgery between September 2024 and April 2025, with half of the participants deficient in vitamin D and half having higher levels.
- Patients with vitamin D levels below 30nmol/L were classified as deficient, while those above that threshold formed the comparison group (we could call it a control group, but since it was an observational study rather than a RCT, we don’t say that).
- Patients with low vitamin D required more fentanyl during* surgery and, on average, used 112 mg more tramadol after surgery through patient-controlled pain pumps.
- None of the patients reported extremely severe pain, but the vitamin D deficient group had many more cases of moderate pain scores between 4 and 6 on a 10-point scale.
- Nausea after surgery was more common in the vitamin D deficient group, and vomiting occurred only in that group, although the vomiting difference wasn’t statistically significant.
*Yes, pain relief is needed even while unconscious during general anesthesia, for reasons explained here: How Does Anesthesia Work?
As for why this happened the way it did: it’s an observational study so we can’t say for 100% sure, but the researchers believe it is likely mostly because of how vitamin D influences pain processing through its effects on inflammation and the immune system, which in turn also affect how the body responds to injury.
You can read this paper in full here: Association between preoperative vitamin D level and postoperative pain in patients undergoing breast cancer surgery: a prospective observational study
Want to learn more?
We’ve written quite a bit about pain management, including:
- Before You Reach For That Tylenol…
- How To Stop Pain Spreading
- How To Dial Down Your Pain
- Managing Chronic Pain (Realistically!)
- Get The Right Help For Your Pain
- The 7 Approaches To Pain Management
- Science-Based Alternative Pain Relief (When Painkillers Aren’t Helping, These Things Might)
Take care!
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Pistachios vs Walnuts – Which is Healthier?
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Our Verdict
When comparing pistachios to walnuts, we picked the pistachios.
Why?
Pistachios have more protein and fiber, while walnuts have more fat (though the fats are famously healthy, the same is true of the fats in pistachios).
In the category of vitamins, pistachios have several times more* of vitamins A, B1, B6, C, and E, while walnuts boast only a little more of vitamin B9. They are approximately equal on other vitamins they both contain.
*actually 25x more vitamin A, but the others are 2x, 3x, 4x more.
When it comes to minerals, things are more even; pistachios have more iron, phosphorus, potassium, and selenium, while walnuts have more copper, magnesium, manganese, and zinc. So this category’s a tie.
So given two clear wins for pistachios, and one tie, it’s evident that pistachios win the day.
However! Do enjoy both of these nuts; we often mention that diversity is good in general, and in this case, it’s especially true because of the different mineral profiles, and also because in terms of the healthy fats that they offer, pistachios offer more monounsaturated fats and walnuts offer more polyunsaturated fats; both are healthy, just different.
They’re about equal on saturated fat, in case you were wondering, as it makes up about 6% of the total fats in both cases.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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The Link Between Introversion & Sensory Processing
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We’ve talked before about how to beat loneliness and isolation, and how that’s important for all of us, including those of us on the less social end of the scale.
However, while we all need at least the option of social contact in order to be at our best, there’s a large portion of the population who also need to be able to retreat to somewhere quiet to recover from too much social goings-on.
Clinically speaking, this sometimes gets called introversion, or at least a negative score for extroversion on the “Big Five Inventory”, the only personality-typing system that actually gets used in science. Today we’re going to be focusing on a term that typically gets applied to those generally considered introverts:
The “highly sensitive person”
This makes it sound like a very rare snowflake condition, when in fact the diagnostic criteria yield a population bell curve of 30:40:30, whereupon 30% are in the band of “high sensitivity”, 40% “normal sensitivity” and the remaining 30% “low sensitivity”.
You may note that “high” and “low” together outnumber “normal”, but statistics is like that. It is interesting to note, though, that this statistical spread renders it not a disorder, so much as simply a description.
You can read more about it here:
Sensory-processing sensitivity and its relation to introversion and emotionality
What it means in practical terms
Such a person will generally seek solitude more frequently during the day than others will, and it’s not because of misanthropy (at least, statistically speaking it’s not; can’t speak for individuals!), but rather, it’s about needing downtime after what has felt like too much sensory processing resulting:
If this need for solitude is not met (sometimes it’s simply not practicable), then it can lead to overwhelm.
Sidenote about overwhelm: pick your battles! No, pick fewer than that. Put some back. That’s still too many 😜
Back to seriousness: if you’re the sort of person to walk into a room and immediately do the Sherlock Holmes thing of noticing everything about everyone, who is doing what, what has changed about the room since last time you were there, etc… Then that’s great; it’s a sign of a sharp mind, but it’s also a lot of information to process and you’re probably going to need a little decompression afterwards:
This is the biological equivalent of needing to let an overworked computer or phone cool down after excessive high-intensity use of its CPU.
The same goes if you’re the sort of person who goes into “performance mode” when in company, is “the life and soul of the party” etc, and/or perhaps “the elegant hostess”, but needs to then collapse afterwards because it’s more of a role you play than your natural inclination.
Take care of your battery
To continue the technological metaphor from earlier, if you repeatedly overuse a device without allowing it cooldown periods, it will break down (and if it’s a certain generation of iPhone, it might explode).
Similarly, if you repeatedly overuse your own highly sensitive senses (such as being often in social environment where there’s a lot going on) without allowing yourself adequate cooldown periods, you will break down (or indeed, explode: not literally, but some people are prone to emotional outbursts after bottling things up).
None of this is good for the health, not in the short term and not in the long term, either:
With that in mind, take care to take care of yourself, meeting your actual needs instead of just those that get socially assumed.
Want to take the test?
Here’s a two-minute test (results available immediately right there on-screen; no need to give your email or anything) 😎
Want to know more?
We reviewed this book about playing to one’s strengths in the context of sensitivity, a while back, and highly recommend it:
Sensitive – by Jenn Granneman and Andre Sólo
Enjoy!
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The Walking Adjustment That Delays The Need For Knee Surgery
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Walking is great! Except when it’s not.
Which in many cases, as you’ll have gathered from the title today, is about one’s knees.
See for example: Why 10,000 Steps Might Be Making Your Pain Worse (+ What To Do Instead)
That’s not to say that there aren’t solutions, and often the problem with our knees is not, in fact, a problem with our knees:
- Do This Before Walking To Suffer Less (It Takes 30 Seconds) ← when what feels like a problem in your knees is actually a lack of glute activation
- How To Make Downhill Walking Easier On The Knees ← famously more of a challenge than going uphill, in the case of dubious knees
- The Best Exercise to Stop Your Legs From Giving Out ← this one’s good if, like this writer, you have strong legs and/but also EDS or a similar connective tissue disorder that causes your joints to sometimes just fold like laundry for no obvious reason (it’s about the body’s misguided attempt to save you from something that’s not actually a problem but a tendon got confused so the muscle just dropped it)
But, what about walking and actual knee problems?
The small adjustment that makes a big difference
Researchers (Dr. Valentina Mazzoli et al.) did a randomized, placebo-controlled trial on gait retraining in patients with mild-to-moderate knee osteoarthritis.
How it worked: participants practiced walking with a slightly adjusted foot angle (toe in or out by 5–10°), tailored individually using motion capture and pressure-sensitive treadmills to reduce knee load. This wasn’t just “point and go”, however; to ensure proper use of the angle instructed, there were 6 weekly lab sessions with biofeedback (shin vibrations) to teach participants to maintain their new gait, followed by daily practice of at least 20 minutes.
How they did placebo: half of the participants were unknowingly given sham angles identical to their natural gait, controlling for placebo effects.
And the results: after one year, intervention participants reported pain relief similar to over-the-counter drugs and even some narcotics, plus slower cartilage deterioration* on MRI compared to the placebo group. And in case you’re wondering: yes, participants maintained their adjusted gait accurately (within 1° on average) upon testing after a year, and expressed enthusiasm since it required no devices or drugs.
*This is critical, and is what we were talking about in the title, as cartilage deterioration is the main driver of the need for knee surgery.
You can find the paper itself, here: Personalised gait retraining for medial compartment knee osteoarthritis: a randomised controlled trial
You may be thinking: that’s great, but how am I supposed to do that?
- In the medium-term, the researchers hope to streamline gait assessment and training with cheaper tools like smartphone video or wearables, for maximum accessibility.
- In the short-term, getting advice from a local physical therapist is recommended, as they may be able to identify the adjustments that would be best for you.
In a similar vein, small adjustments to squats can make them much more doable; see: Squat Variations for Painful Knees (No More Pain!)
Want to learn more?
We recommend:
Enjoy!
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Boost Your Digestive Enzymes
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’ll Try To Make This Easy To Digest
Do you have a digestion-related problem?
If so, you’re far from alone; around 40% of Americans have digestive problems serious enough to disrupt everyday life:
New survey finds forty percent of Americans’ daily lives are disrupted by digestive troubles
…which puts Americans just a little over the global average of 35%:
Mostly likely on account of the Standard American Diet, or “SAD” as it often gets abbreviated in scientific literature.
There’s plenty we can do to improve gut health, for example:
- Making Friends With Your Gut (You Can Thank Us Later)
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- How Much Difference Do Probiotic Supplements Make?
Today we’re going to be examining digestive enzyme supplements!
What are digestive enzymes?
Digestive enzymes are enzymes that break down food into stuff we can use. Important amongst them are:
- Protease: breaks down proteins (into amino acids)
- Amylase: breaks down starches (into sugars)
- Lipase: breaks down fats (into fatty acids)
All three are available as popular supplements to aid digestion. How does the science stack up for them?
Protease
For this, we only found animal studies like this one, but the results have been promising:
Amylase
Again, the studies for this alone (not combined with other enzymes) have been solely from animal agriculture; here’s an example:
The Effect of Exogenous Amylase Supplementation on the Nutritional Value of Peas
Lipase
Unlike for protease and amylase, now we have human studies as well, and here’s what they had to say:
❝Lipase supplementation significantly reduced stomach fullness without change of EGG.
Furthermore, lipase supplementation may be helpful in control of FD symptom such as postprandial symptoms❞
~ Dr. Seon-Young Park & Dr. Jong-Sun Rew
Read more: Is Lipase Supplementation before a High Fat Meal Helpful to Patients with Functional Dyspepsia?
(short answer: yes, it is)
More studies found the same, such as:
Lipase Supplementation before a High-Fat Meal Reduces Perceptions of Fullness in Healthy Subjects
All together now!
When we look at studies for combination supplementation of digestive enzymes, more has been done, and/but it’s (as you might expect) less specific.
The following paper gives a good rundown:
Pancrelipase Therapy: A Combination Of Protease, Amylase, & Lipase
Is it safe?
For most people it is quite safe, but if taking high doses for a long time it can cause problems, and also there may be complications if you have diabetes, are otherwise immunocompromised, or have some other conditions (listed towards the end of the above-linked paper, along with further information that we can’t fit in here).
As ever, check with your doctor/pharmacist if you’re not completely sure!
Want some?
We don’t sell them, but for your convenience, here’s an example product on Amazon that contains all three
Enjoy!
We’ll Try To Make This Easy To Digest
Do you have a digestion-related problem?
If so, you’re far from alone; around 40% of Americans have digestive problems serious enough to disrupt everyday life:
New survey finds forty percent of Americans’ daily lives are disrupted by digestive troubles
…which puts Americans just a little over the global average of 35%:
Mostly likely on account of the Standard American Diet, or “SAD” as it often gets abbreviated in scientific literature.
There’s plenty we can do to improve gut health, for example:
- Making Friends With Your Gut (You Can Thank Us Later)
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- How Much Difference Do Probiotic Supplements Make?
Today we’re going to be examining digestive enzyme supplements!
What are digestive enzymes?
Digestive enzymes are enzymes that break down food into stuff we can use. Important amongst them are:
- Protease: breaks down proteins (into amino acids)
- Amylase: breaks down starches (into sugars)
- Lipase: breaks down fats (into fatty acids)
All three are available as popular supplements to aid digestion. How does the science stack up for them?
Protease
For this, we only found animal studies like this one, but the results have been promising:
Amylase
Again, the studies for this alone (not combined with other enzymes) have been solely from animal agriculture; here’s an example:
The Effect of Exogenous Amylase Supplementation on the Nutritional Value of Peas
Lipase
Unlike for protease and amylase, now we have human studies as well, and here’s what they had to say:
❝Lipase supplementation significantly reduced stomach fullness without change of EGG.
Furthermore, lipase supplementation may be helpful in control of FD symptom such as postprandial symptoms❞
~ Dr. Seon-Young Park & Dr. Jong-Sun Rew
Read more: Is Lipase Supplementation before a High Fat Meal Helpful to Patients with Functional Dyspepsia?
(short answer: yes, it is)
More studies found the same, such as:
Lipase Supplementation before a High-Fat Meal Reduces Perceptions of Fullness in Healthy Subjects
All together now!
When we look at studies for combination supplementation of digestive enzymes, more has been done, and/but it’s (as you might expect) less specific.
The following paper gives a good rundown:
Pancrelipase Therapy: A Combination Of Protease, Amylase, & Lipase
Is it safe?
For most people it is quite safe, but if taking high doses for a long time it can cause problems, and also there may be complications if you have diabetes, are otherwise immunocompromised, or have some other conditions (listed towards the end of the above-linked paper, along with further information that we can’t fit in here).
As ever, check with your doctor/pharmacist if you’re not completely sure!
Want some?
We don’t sell them, but for your convenience, here’s an example product on Amazon that contains all three
Enjoy!
Don’t Forget…
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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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.
Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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