The Pegan Diet – by Dr. Mark Hyman
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First things first: the title of the book is a little misleading. “Pegan” is a portmanteau of “paleo” and “vegan”, making it sound like it will be appropriate for both of those dietary practices. Instead:
- Dr. Hyman offers advice about eating the right grains and legumes (inappropriate for a paleo diet)
- He also offers such advice as “be picky about poultry, eggs, and fish”, and “avoid dairy—mostly” (inappropriate for a vegan diet).
So, since his paleo vegan diet is neither paleo nor vegan, what actually is it?
It’s a whole foods diet that encourages the enjoyment of a lot of plants, and discretion with regard to the quality of animal products.
It’s a very respectable approach to eating, even if it didn’t live up to the title.
The style is somewhat sensationalist, while nevertheless including plenty of actual science in there too—so the content is good, even if the presentation isn’t what this reviewer would prefer.
He has recipes; they can be a little fancy (e.g. “matcha poppy bread with rose water glaze”) which may not be to everyone’s taste, but they are healthy.
Bottom line: the content is good; the style you may love or hate, and again, don’t be misled by the title.
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Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?
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Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”
“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.
No further details have been released about the Princess of Wales’ treatment.
But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.
It’s not the same as preventing cancer
To prevent cancer developing, lifestyle changes such as diet, exercise and sun protection are recommended.
Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at high risk of breast cancer.
Aspirin can also be used for those at high risk of bowel and other cancers.
How can chemotherapy be used as preventive therapy?
In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.
If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.
If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate around the body .
The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer coming back. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.
With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.
If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.
How effective is preventive therapy?
The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.
Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The first chemotherapy tested improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.
Preventive chemotherapy is usually given for three to six months.
How does chemotherapy work?
Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.
Chemotherapy is not selective for cancer cells. It kills any dividing cells.
But cancers consist of a higher proportion of dividing cells than the normal body cells. A greater proportion of the cancer is killed with each course of chemotherapy.
Normal cells can recover between courses, which are usually given three to four weeks apart.
What are the side effects?
The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.
The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.
Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.
Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.
There are also generalised symptoms such as fatigue.
Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.
Ian Olver, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Psychology Sunday: Family Estrangment & How To Fix It
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Estrangement, And How To Heal It
We’ve written before about how deleterious to the health loneliness and isolation can be, and what things can be done about it. Today, we’re tackling a related but different topic.
We recently had a request to write about…
❝Reconciliation of relationships in particular estrangement mother adult daughter❞
And, this is not only an interesting topic, but a very specific one that affects more people than is commonly realized!
In fact, a recent 800-person study found that more than 43% of people experienced family estrangement of one sort or another, and a more specific study of more than 2,000 mother-child pairs found that more than 11% of mothers were estranged from at least one adult child.
So, if you think of the ten or so houses nearest to you, probably at least one of them contains a parent estranged from at least one adult child. Maybe it’s yours. Either way, we hope this article will give you some pause for thought.
Which way around?
It makes a difference to the usefulness of this article whether any given reader experiencing estrangement is the parent or the adult child. We’re going to assume the reader is the parent. It also makes a difference who did the estranging. That’s usually the adult child.
So, we’re broadly going to write with that expectation.
Why does it happen?
When our kids are small, we as parents hold all the cards. It may not always feel that way, but we do. We control our kids’ environment, we influence their learning, we buy the food they eat and the clothes they wear. If they want to go somewhere, we probably have to take them. We can even set and enforce rules on a whim.
As they grow, so too does their independence, and it can be difficult for us as parents to relinquish control, but we’re going to have to at some point. Assuming we are good parents, we just hope we’ve prepared them well enough for the world.
Once they’ve flown the nest and are living their own adult lives, there’s an element of inversion. They used to be dependent on us; now, not only do they not need us (this is a feature not a bug! If we have been good parents, they will be strong without us, and in all likelihood one day, they’re going to have to be), but also…
We’re more likely to need them, now. Not just in the “oh if we have kids they can look after us when we’re old” sense, but in that their social lives are growing as ours are often shrinking, their family growing, while ours, well, it’s the same family but they’re the gatekeepers to that now.
If we have a good relationship, this goes fine. However, it might only take one big argument, one big transgression, or one “final straw”, when the adult child decides the parent is more trouble than they’re worth.
And, obviously, that’s going to hurt. But it’s pretty much how it pans out, according to studies:
Here be science: Tensions in the Parent and Adult Child Relationship: Links to Solidarity and Ambivalence
How to fix it, step one
First, figure out what went wrong.
Resist any urge to protect your own feelings with a defensive knee-jerk “I don’t know; I was a good, loving parent”. That’s a very natural and reasonable urge and you’re quite possibly correct, but it won’t help you here.
Something pushed them away. And, it will almost certainly have been a push factor from you, not a pull factor from whoever is in their life now. It’s easy to put the blame externally, but that won’t fix anything.
And, be honest with yourself; this isn’t a job interview where we have to present a strength dressed up as a “greatest weakness” for show.
You can start there, though! If you think “I was too loving”, then ok, how did you show that love? Could it have felt stifling to them? Controlling? Were you critical of their decisions?
It doesn’t matter who was right or wrong, or even whether or not their response was reasonable. It matters that you know what pushed them away.
How to fix it, step two
Take responsibility, and apologize. We’re going to assume that your estrangement is such that you can, at least, still get a letter to them, for example. Resist the urge to argue your case.
Here’s a very good format for an apology; please consider using this template:
The 10-step (!) apology that’s so good, you’ll want to make a note of it
You may have to do some soul-searching to find how you will avoid making the same mistake in the future, that you did in the past.
If you feel it’s something you “can’t change”, then you must decide what is more important to you. Only you can make that choice, but you cannot expect them to meet you halfway. They already made their choice. In the category of negotiation, they hold all the cards now.
How to fix it, step three
Now, just wait.
Maybe they will reply, forgiving you. If they do, celebrate!
Just be aware that once you reconnect is not the time to now get around to arguing your case from before. It will never be the time to get around to arguing your case from before. Let it go.
Nor should you try to exact any sort of apology from them for estranging you, or they will at best feel resentful, wonder if they made a mistake in reconnecting, and withdraw.
Instead, just enjoy what you have. Many people don’t get that.
If they reply with anger, maybe it will be a chance to reopen a dialogue. If so, family therapy could be an approach useful for all concerned, if they are willing. Chances are, you all have things that you’d all benefit from talking about in a calm, professional, moderated, neutral environment.
You might also benefit from a book we reviewed previously, “Parent Effectiveness Training”. This may seem like “shutting the stable door after the horse has bolted”, but in fact it’s a very good guide to relationship dynamics in general, and extensively covers relations between parents and adult children.
If they don’t reply, then, you did your part. Take solace in knowing that much.
Some final thoughts:
At the end of the day, as parents, our kids living well is (hopefully) testament to that we prepared them well for life, and sometimes, being a parent is a thankless task.
But, we (hopefully) didn’t become parents for the plaudits, after all.
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Oven-Roasted Ratatouille
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This is a supremely low-effort, high-yield dish. It’s a nutritional tour-de-force, and very pleasing to the tastebuds too. We use flageolet beans in this recipe; they are small immature kidney beans. If they’re not available, using kidney beans or really any other legume is fine.
You will need
- 2 large zucchini, sliced
- 2 red peppers, sliced
- 1 large eggplant, sliced and cut into semicircles
- 1 red onion, thinly sliced
- 2 cans chopped tomatoes
- 2 cans flageolet beans, drained and rinsed (or 2 cups same, cooked, drained, and rinsed)
- ½ bulb garlic, crushed
- 2 tbsp extra virgin olive oil
- 1 tbsp balsamic vinegar
- 1 tbsp black pepper, coarse ground
- 1 tbsp nutritional yeast
- 1 tbsp red chili pepper flakes (omit or adjust per your heat preferences)
- ½ tsp MSG or 1 tsp low-sodium salt
- Mixed herbs, per your preference. It’s hard to go wrong with this one, but we suggest leaning towards either basil and oregano or rosemary and thyme. We also suggest having some finely chopped to go into the dish, and some held back to go on the dish as a garnish.
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉ / 180℃.
2) Mix all the ingredients (except the tomatoes and herbs) in a big mixing bowl, ensuring even distribution.
2) Add the tomatoes. The reason we didn’t add these before is because it would interfere with the oil being distributed evenly across the vegetables.
3) Transfer to a deep-walled oven tray or an ovenproof dish, and roast for 30 minutes.
4) Stir, add the chopped herbs, stir again, and return to the oven for another 30 minutes.
5) Serve (hot or cold), adding any herb garnish you wish to use.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Capsaicin For Weight Loss And Against Inflammation
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
Take care!
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Do CBD Gummies Work?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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 take CBD gummies. I don’t know if they are worth buying. Can you find a study on the effectiveness of gummies❞
If you take them, and you’re not sure whether they’re worth it, then it sounds like you’re not getting any observable benefit from them?
If so, that would seem to answer your question, since presumably the reason that you are taking them is for relaxation and/or pain relief, so if you’re not getting the results you want, then no, they are not worth it.
However! CBD gummies are an incredibly diverse and not-well-studied product, so far, given the relative novelty of their legality. By diverse we mean, they’re not well-standardized.
In other words: the CBD gummies you get could be completely unlike CBD gummies from a different source.
CBD itself (i.e. in forms other than just gummies, and mostly as oil) has been studied somewhat better, and we did a main feature on it here:
And while we’re at it:
Cannabis Myths vs Reality ← This one is about cannabis products in general, and includes discussion of THC content and effects, which might not be so relevant to you, but may to some readers.
Companies selling CBD and CBD gummies may make bold claims that are not yet backed by science, so if you are buying them for those reasons, you might want to be aware:
Selling cannabidiol products in Canada: a framing analysis of advertising claims by online retailers
One thing that we would add is that even though CBD is generally recognized as safe, it is possible to overdose on CBD gummies, so do watch your limits:
A Case of Toxicity from Cannabidiol Gummy Ingestion
Take care!
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Gut Health 2.0
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Gene Expression & Gut Health
This is Dr. Tim Spector. After training in medicine and becoming a consultant rheumatologist, he’s turned his attention to medical research, and is these days a specialist in twin studies, genetics, epigenetics, microbiome, and diet.
What does he want us to know?
For one thing: epigenetics are for more than just getting your grandparents’ trauma.
More usefully: there are things we can do to improve epigenetic factors in our body
DNA is often seen as the script by which our body does whatever it’s going to do, but it’s only part of the story. Thinking of DNA as some kind of “magical immutable law of reality” overlooks (to labor the metaphor) script revisions, notes made in the margins, directorial choices, and ad-lib improvizations, as well as the quality of the audience’s hearing and comprehension.
Hence the premise of one of Dr. Spector’s older books, “Identically Different: Why We Can Change Our Genes”
(*in fact, it was his first, from all the way back in 2013, when he’d only been a doctor for 34 years)
Gene expression will trump genes every time, and gene expression is something that can often be changed without getting in there with CRISPR / a big pair of scissors and some craft glue.
How this happens on the micro level is beyond the scope of today’s article; part of it has to do with enzymes that get involved in the DNA transcription process, and those enzymes in turn are despatched or not depending on hormonal messaging—in the broadest sense of “hormonal”; all the body’s hormonal chemical messengers, not just the ones people think of as hormones.
However, hormonal messaging (of many kinds) is strongly influenced by something we can control relatively easily with a little good (science-based) knowledge: the gut.
The gut, the SAD, and the easy
In broad strokes: we know what is good for the gut. We’ve written about it before at 10almonds:
Making Friends With Your Gut (You Can Thank Us Later)
This is very much in contrast with what in scientific literature is often abbreviated “SAD”, the Standard American Diet, which is very bad for the gut.
However, Dr. Spector (while fully encouraging everyone to enjoy an evidence-based gut-healthy diet) wanted to do one better than just a sweeping one-size-fits-all advice, so he set up a big study with 15,000 identical twins; you can read about it here: TwinsUK
The information that came out of that was about a lot more than just gene expression and gut health, but it did provide the foundation for Dr. Spector’s next project, ZOE.
ZOE crowdsources huge amounts of data including individual metabolic responses to standardized meals in order to predict personalized food responses based on individual biology and unique microbiome profile.
In other words, it takes the guesswork out of a) knowing what your genes mean for your food responses b) tailoring your food choices with your genetic expression in mind, and c) ultimately creating a positive feedback loop to much better health on all levels.
Now, this is not an ad for ZOE, but if you so wish, you can…
- Get the free ZOE gut health guide (this is good, but generic, gut health information)
- Take the ZOE home gut health test (quiz followed by offers of lab tests)
- Browse the ZOE Health Academy, its education wing
Want to know more?
Dr. Spector has a bunch of books out, including some that we’ve reviewed previously:
- Spoon-Fed: Why Almost Everything We’ve Been Told About Food Is Wrong
- The Diet Myth: The Real Science Behind What We Eat
- Food for Life: The New Science of Eating Well
You can also check out our own previous main feature, which wasn’t about Dr. Spector’s work but was very adjacent:
The Brain-Gut Highway: A Two-Way Street
Enjoy!
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Common Hospital Blood Pressure Mistake (Don’t Let This Happen To You Or A Loved One)
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There’s a major issue in healthcare, Dr. Suneel Dhand tells us, pertaining to the overtreatment of hypertension in hospitals. Here’s how to watch out for it and know when to question it:
Under pressure
When patients, particularly from older generations, are admitted to the hospital, their blood pressure often fluctuates due to illness, dehydration, and other factors. Despite this, they are often continued on their usual blood pressure medications, which can lead to dangerously low blood pressure.
Why does this happen? The problem arises from rigid protocols that dictate stopping blood pressure medication only if systolic pressure is below a certain threshold, often 100. However, Dr. Dhand argues that 100 is already low*, and administering medication when blood pressure is close to this can cause it to drop dangerously lower
*10almonds note: low for an adult, anyway, and especially for an older adult. To be clear: it’s not a bad thing! That is the average systolic blood pressure of a healthy teenager and it’s usually the opposite of a problem if we have that when older (indeed, this very healthy writer’s blood pressure averages 100/70, and suffice it to say, it’s been a long time since I was a teenager). But it does mean that we definitely don’t want to take medications to artificially lower it from there.
Low blood pressure from overtreatment can lead to severe consequences, requiring emergency interventions to stabilize the patient.
Dr. Dhand’s advice for patients and families is:
- Ensure medication accuracy: make sure the medical team knows the correct blood pressure medications and dosages for you or your loved one.
- Monitor vital signs: actively check blood pressure readings, especially if they are in the low 100s or even 110s, and discuss any medication concerns with the medical team.
- Watch for symptoms of low blood pressure: be alert for symptoms like dizziness or weakness, which could indicate dangerously low blood pressure.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Insider’s Guide To Making Hospital As Comfortable As Possible
Take care!
Don’t Forget…
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Learn to Age Gracefully
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