The Spectrum of Hope – by Dr. Gayatri Devi
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We’ve written before about Dr. Devi’s work (See: “Alzheimer’s: The Bad News And The Good“) but she has plenty more to say than we could fit in an article.
The book is written for patients, family/carers, and clinicians—without getting deep into the science, which it is assumed clinicians will know. the general style of the book is pop-science, and it’s more about addressing the misconceptions around Alzheimer’s, rather than focusing on neurological features such as beta amyloid plaques and tau proteins and the like.
Dr. Devi explains a lot about the experience of Alzheimer’s—what to expect, or rather, what to know about in advance. Because, as she explains, there are a lot of different manifestations of Alzheimer’s that are all lumped under the same umbrella.
This means that a person could have negligible memory but perfect language and reasoning skills, or the other way around, or some other combination of symptoms showing up or not.
Which means that any plan for managing one’s Alzheimer’s needs to be adaptable and personalized, which is something Dr. Devi talks us through, too.
Bottom line: if you are a loved one has Alzheimer’s, or you just like to be prepared, this is a great book to prepare anybody for just that.
Click here to check out The Spectrum of Hope, and hold onto that hope!
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Are Supplements Worth Taking?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝There seems to be a lot of suggestions to take supplements for every thing, from your head to your toes. I know it’s up to the individual but what are the facts or stats to support taking them versus not?❞
Short answer:
- supplementary vitamins and minerals are probably neither needed nor beneficial for most (more on this later) people, with the exception of vitamin D which most people over a certain age need unless they are white and getting a lot of sun.
- other kinds of supplement can be very beneficial or useless, depending on what they are, of course, and also your own personal physiology.
With regard to vitamins and minerals, in most cases they should be covered by a healthy balanced diet, and the bioavailability is usually better from food anyway (bearing in mind, we say vitamin such-and-such, or name an elemental mineral, but there are usually multiple, often many, forms of each—and supplements will usually use whatever is cheapest to produce and most chemically stable).
However! It is also quite common for food to be grown in whatever way is cheapest and produces the greatest visible yield, rather than for micronutrient coverage.
This goes for most if not all plants, and it goes extra for animals (because of the greater costs and inefficiencies involved in rearing animals).
We wrote about this a while back in a mythbusting edition of 10almonds, covering:
- Food is less nutritious now than it used to be: True or False?
- Supplements aren’t absorbed properly and thus are a waste of money: True or False?
- We can get everything we need from our diet: True or False?
You can read the answers and explanations, and see the science that we presented, here:
Do We Need Supplements, And Do They Work?
You may be wondering: what was that about “most (more on this later) people”?
Sometimes someone will have a nutrient deficiency that can’t be easily remedied with diet. Often this occurs when their body:
- has trouble absorbing that nutrient, or
- does something inconvenient with it that makes a lot of it unusable when it gets it.
…which is why calcium, iron, vitamin B12, and vitamin D are quite common supplements to get prescribed by doctors after a certain age.
Still, it’s best to try getting things from one’s diet first all of all, of course.
Things we can’t (reasonably) get from food
This is another category entirely. There are many supplements that are convenient forms of things readily found in a lot of food, such as vitamins and minerals, or phytochemicals like quercetin, fisetin, and lycopene (to name just a few of very many).
Then there are things not readily found in food, or at least, not in food that’s readily available in supermarkets.
For example, if you go to your local supermarket and ask where the mimosa is, they’ll try to sell you a cocktail mix instead of the roots, bark, or leaves of a tropical tree. It is also unlikely they’ll stock lion’s mane mushroom, or reishi.
If perchance you do get the chance to acquire fresh lion’s mane mushroom, by the way, give it a try! It’s delicious shallow-fried in a little olive oil with black pepper and garlic.
In short, this last category, the things most of us can’t reasonably get from food without going far out of our way, are the kind of thing whereby supplements actually can be helpful.
And yet, still, not every supplement has evidence to support the claims made by its sellers, so it’s good to do your research beforehand. We do that on Mondays, with our “Research Review Monday” editions, of which you can find in our searchable research review archive ← we also review some drugs that can’t be classified as supplements, but mostly, it’s supplements.
Take care!
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Popcorn vs Peanuts – Which is Healthier
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Our Verdict
When comparing air-popped popcorn to peanuts (without an allergy), we picked the peanuts.
Why?
Peanuts, if we were to list popular nuts in order of healthfulness, would not be near the top of the list. Many other nuts have more nutrients and fewer/lesser drawbacks.
But the comparison to popcorn shines a different light on it:
Popcorn has very few nutrients. It’s mostly carbs and fiber; it’s just not a lot of carbs because the manner of its consumption makes it a very light snack (literally). You can eat a bowlful and it was perhaps 30g. It has some small amounts of some minerals, but nothing that you could rely on it for. It’s mostly fresh air wrapped in fiber.
Peanuts, in contrast, are a much denser snack. High in calories yes, but also high in protein, their fats are mostly healthy, and they have not only a fair stock of vitamins and minerals, but also a respectable complement of beneficial phytochemicals: mostly assorted antioxidant polyphenols, but also oleic acid (as in olives, good for healthy triglyceride levels).
Another thing worth a mention is their cholesterol-reducing phytosterols (these reduce the absorption of dietary cholesterol, “good” and “bad”, so this is good for most people, bad for some, depending on the state of your cholesterol and what you ate near in time to eating the nuts)
Peanuts do have their clear downsides too: its phytic acid content can reduce the bioavailability of iron and zinc taken at the same time.
In summary: while popcorn’s greatest claim to dietary beneficence is its fiber content and that it’s close to being a “zero snack”, peanuts (eaten in moderation, say, the same 30g as the popcorn) have a lot to contribute to our daily nutritional requirements.
We do suggest enjoying other nuts though!
Read more: Why You Should Diversify Your Nuts!
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How To Recognize Perfectly Hidden Depression
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Dr. Margaret Rutherford shares her insights from 30 years of professional experience:
There’s only one way to know
In this video, Dr. Rutherford discusses several (presumably pseudonymized) cases of people who came to her therapy office seeming to have their lives very much together when they very much didn’t, including the woman who came in with symptoms of mild anxiety, and then tried to kill herself, and the man who was outwardly an overachiever while consumed with feelings of guilt and shame.
She discusses how even the most skilled mental health professionals will tend to miss hidden depression, as they focus on visible symptoms from the DSM criteria, which may not reflect the patient’s reality, especially for those hiding their struggles.
So, the crux becomes: why do people hide their struggles? One does not go to the emergency room with a broken limb and then say to the doctor “I’m fine thank you; how are you?” so why do people do that when it comes to mental health issues?
The reality is that the shame of revealing feelings like shame itself, fear, and self-loathing keeps people silent, and in particular, research (Schneiderman et al.) shows that emotional pain plays a central role in suicide, and (per Blatt et al.) perfectionism can drastically alter the presentation of depression, making it even harder to diagnose through standard criteria than it already was.
As for what can be done about it? Dr. Rutherford advocates for a cultural shift where talking about emotional pain, including suicidal thoughts, is seen as normal and not shameful. That people need to feel safe expressing these feelings, to prevent tragic outcomes. Instead of judging or dismissing someone with suicidal thoughts, she encourages a compassionate and accepting approach to open up dialogue and understanding.
In short, that everyone can contribute to a culture that views transparency and vulnerability as strengths, helping reduce the stigma around mental health struggles.
And that’s the only way we’ll ever be able to recognize perfectly hidden depression—if people no longer feel that they have to hide it.
For more on all of this, here’s Dr. Rutherford herself:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- The Mental Health First Aid (That You’ll Hopefully Never Need) ← This is about managing depression, in yourself or others
- How To Stay Alive (When You Really Don’t Want To) ← This is about managing suicidality, in yourself or others
Take care!
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The Subtle Art of Not Giving a F*ck – by Mark Manson
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You may wonder from the title: is this book arguing that we should all be callous heartless monsters? And no, it is not.
Instead, author Mark Manson advocates for cynicism, but less in the manner of Scrooge, and more in the manner of Diogenes:
- That life will involve struggle, so we might as well at least choose our struggles.
- That we will make mistakes, so we might as well accept them as learning experiences.
- That we will love and we will lose, so we might as well do it right while we can.
In short, the book is less about not caring… And more about caring about the right things only.
So, what are “the right things”? Manson bids us decide for ourselves, but certainly has ideas and pointers, with regard to what may or may not be healthy values to pursue.
The style throughout is casual and almost conversational, without being overly padded. It makes for very easy reading.
If the book has a weak point, it’s that when it briefly makes a suprisingly prescriptive turn into recommending we take up Buddhism, it may feel a bit like our friend who wants us to join in the latest MLM scheme. But, he’s soon back on track.
Bottom line: if you ever find yourself stressed with living up to unwanted expectations—your own, other people’s, and society’s—this book can really help streamline things.
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Managing Jealousy
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Jealousy is often thought of as a young people’s affliction, but it can affect us at any age—whether we are the one being jealous, or perhaps a partner.
And, the “green-eyed monster” can really ruin a lot of things; relationships, friendships, general happiness, physical health even (per stress and anxiety and bad sleep), and more.
The thing is, jealousy looks like one thing, but is actually mostly another.
Jealousy is a Scooby-Doo villain
That is to say: we can unmask it and see what much less threatening thing is underneath. Which is usually nothing more nor less than: insecurities
- Insecurity about losing one’s partner
- Insecurity about not being good enough
- Insecurity about looking bad socially
…etc. The latter, by the way, is usually the case when one’s partner is socially considered to be giving cause for jealousy, but the primary concern is not actually relational loss or any kind of infidelity, but rather, looking like one cannot keep one’s partner’s full attention romantically/sexually. This drives a lot of people to act on jealousy for the sake of appearances, in situations where they might otherwise, if they didn’t feel like they’d be adversely judged for it, be considerably more chill.
Thus, while monogamy certainly has its fine merits, there can also be a kind of “toxic monogamy” at hand, where a relationship becomes unhealthy because one partner is just trying to live up to social expectations of keeping the other partner in check.
This, by the way, is something that people in polyamorous and/or open relationships typically handle quite neatly, even if a lot of the following still applies. But today, we’re making the statistically safe assumption of a monogamous relationship, and talking about that!
How to deal with the social aspect
If you sit down with your partner and work out in advance the acceptable parameters of your relationship, you’ll be ahead of most people already. For example…
- What counts as cheating? Is it all and any sex acts with all and any people? If not, where’s the line?
- What about kissing? What about touching other body parts? If there are boundaries that are important to you, talk about them. Nothing is “too obvious” because it’s astonishing how many times it will happen that later someone says (in good faith or not), “but I thought…”
- What about being seen in various states of undress? Or seeing other people in various states of undress?
- Is meaningless flirting between friends ok, and if so, how do we draw the line with regard to what is meaningless? And how are we defining flirting, for that matter? Talk about it and ensure you are both on the same page.
- If a third party is possibly making moves on one of us under the guise of “just being friendly”, where and how do we draw the line between friendliness and romantic/sexual advances? What’s the difference between a lunch date with a friend and a romantic meal out for two, and how can we define the difference in a way that doesn’t rely on subjective “well I didn’t think it was romantic”?
If all this seems like a lot of work, please bear in mind, it’s a lot more fun to cover this cheerfully as a fun couple exercise in advance, than it is to argue about it after the fact!
See also: Boundary-Setting Beyond “No”
How to deal with the more intrinsic insecurities
For example, when jealousy is a sign of a partner fearing not being good enough, not measuring up, or perhaps even losing their partner.
The key here might not shock you: communication
Specifically, reassurance. But critically, the correct reassurance!
A partner who is jealous will often seek the wrong reassurance, for example wanting to read their partner’s messages on their phone, or things like that. And while a natural desire when experiencing jealousy, it’s not actually helpful. Because while incriminating messages could confirm infidelity, it’s impossible to prove a negative, and if nothing incriminating is found, the jealous partner can just go on fearing the worst regardless. After all, their partner could have a burner phone somewhere, or a hidden app for cheating, or something else like that. So, no reassurance can ever be given/gained by such requests (which can also become unpleasantly controlling, which hopefully nobody wants).
A quick note on “if you have nothing to fear, you have nothing to hide”: rhetorically that works, but practically it doesn’t.
Writer’s example: when my late partner and I formalized our relationship, we discussed boundaries, and I expressed “so far as I am concerned, I have no secrets from you, except secrets that are not mine to share. For example, if someone has confided in me and asked that I not share it, I won’t. Aside from that, you have access-all-areas in my life; me being yours has its privileges” and this policy itself would already pre-empt any desire to read my messages.
Now indeed, I had nothing to hide. I am by character devoted to a fault. But my friends may well sometimes have things they don’t want me to share, which made that a necessary boundary to highlight (which my partner, an absolute angel by the way and not prone to unhealthy manifestations of jealousy in any case, understood completely).
So, it is best if the partner of a jealous person can explain the above principles as necessary, and offer the correct reassurance instead. Which could be any number of things, but for example:
- I am yours, and nobody else has a chance
- I fully intend to stay with you for life
- You are the best partner I have ever had
- Being with you makes my life so much better
…etc. Note that none of these are “you don’t have to worry about so-and-so”, or “I am not cheating on you”, etc, because it’s about yours and your partner’s relationship. If they ask for reassurances with regard to other people or activities, by all means state them as appropriate, but try to keep the focus on you two.
And if your partner (or you, if it’s you who’s jealous) can express the insecurity in the format…
“I’m afraid of _____ because _____”
…then the “because” will allow for much more specific reassurance. We all have insecurities, we all have reasons we might fear not being good enough for our partner, or losing their affection, and the best thing we can do is choose to trust our partners at least enough to discuss those fears openly with each other.
See also: Save Time With Better Communication ← this can avoid a lot of time-consuming arguments
What about if the insecurity is based in something demonstrably correct?
By this we mean, something like a prior history of cheating, or other reasons for trust issues. In such a case, the jealous partner may well have a reason for their jealousy that isn’t based on a personal insecurity.
In our previous article about boundaries, we talked about relationships (romantic or otherwise) having a “price of entry”. In this case, you each have a “price of entry”:
- The “price of entry” to being with the person who has previously cheated (or similar), is being able to accept that.
- And for the person who cheated (or similar), very likely their partner will have the “price of entry” of “don’t do that again, and also meanwhile accept in good grace that I might be jittery about it”.
And, if the betrayal of trust was something that happened between the current partners in the current relationship, most likely that was also traumatic for the person whose trust was betrayed. Many people in that situation find that trust can indeed be rebuilt, but slowly, and the pain itself may also need treatment (such as therapy and/or couples therapy specifically).
See also: Relationships: When To Stick It Out & When To Call It Quits ← this covers both sides
And finally, to finish on a happy note:
Only One Kind Of Relationship Promotes Longevity This Much!
Take care!
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Clean Needles Save Lives. In Some States, They Might Not Be Legal.
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Kim Botteicher hardly thinks of herself as a criminal.
On the main floor of a former Catholic church in Bolivar, Pennsylvania, Botteicher runs a flower shop and cafe.
In the former church’s basement, she also operates a nonprofit organization focused on helping people caught up in the drug epidemic get back on their feet.
The nonprofit, FAVOR ~ Western PA, sits in a rural pocket of the Allegheny Mountains east of Pittsburgh. Her organization’s home county of Westmoreland has seen roughly 100 or more drug overdose deaths each year for the past several years, the majority involving fentanyl.
Thousands more residents in the region have been touched by the scourge of addiction, which is where Botteicher comes in.
She helps people find housing, jobs, and health care, and works with families by running support groups and explaining that substance use disorder is a disease, not a moral failing.
But she has also talked publicly about how she has made sterile syringes available to people who use drugs.
“When that person comes in the door,” she said, “if they are covered with abscesses because they have been using needles that are dirty, or they’ve been sharing needles — maybe they’ve got hep C — we see that as, ‘OK, this is our first step.’”
Studies have identified public health benefits associated with syringe exchange services. The Centers for Disease Control and Prevention says these programs reduce HIV and hepatitis C infections, and that new users of the programs are more likely to enter drug treatment and more likely to stop using drugs than nonparticipants.
This harm-reduction strategy is supported by leading health groups, such as the American Medical Association, the World Health Organization, and the International AIDS Society.
But providing clean syringes could put Botteicher in legal danger. Under Pennsylvania law, it’s a misdemeanor to distribute drug paraphernalia. The state’s definition includes hypodermic syringes, needles, and other objects used for injecting banned drugs. Pennsylvania is one of 12 states that do not implicitly or explicitly authorize syringe services programs through statute or regulation, according to a 2023 analysis. A few of those states, but not Pennsylvania, either don’t have a state drug paraphernalia law or don’t include syringes in it.
Those working on the front lines of the opioid epidemic, like Botteicher, say a reexamination of Pennsylvania’s law is long overdue.
There’s an urgency to the issue as well: Billions of dollars have begun flowing into Pennsylvania and other states from legal settlements with companies over their role in the opioid epidemic, and syringe services are among the eligible interventions that could be supported by that money.
The opioid settlements reached between drug companies and distributors and a coalition of state attorneys general included a list of recommendations for spending the money. Expanding syringe services is listed as one of the core strategies.
But in Pennsylvania, where 5,158 people died from a drug overdose in 2022, the state’s drug paraphernalia law stands in the way.
Concerns over Botteicher’s work with syringe services recently led Westmoreland County officials to cancel an allocation of $150,000 in opioid settlement funds they had previously approved for her organization. County Commissioner Douglas Chew defended the decision by saying the county “is very risk averse.”
Botteicher said her organization had planned to use the money to hire additional recovery specialists, not on syringes. Supporters of syringe services point to the cancellation of funding as evidence of the need to change state law, especially given the recommendations of settlement documents.
“It’s just a huge inconsistency,” said Zoe Soslow, who leads overdose prevention work in Pennsylvania for the public health organization Vital Strategies. “It’s causing a lot of confusion.”
Though sterile syringes can be purchased from pharmacies without a prescription, handing out free ones to make drug use safer is generally considered illegal — or at least in a legal gray area — in most of the state. In Pennsylvania’s two largest cities, Philadelphia and Pittsburgh, officials have used local health powers to provide legal protection to people who operate syringe services programs.
Even so, in Philadelphia, Mayor Cherelle Parker, who took office in January, has made it clear she opposes using opioid settlement money, or any city funds, to pay for the distribution of clean needles, The Philadelphia Inquirer has reported. Parker’s position signals a major shift in that city’s approach to the opioid epidemic.
On the other side of the state, opioid settlement funds have had a big effect for Prevention Point Pittsburgh, a harm reduction organization. Allegheny County reported spending or committing $325,000 in settlement money as of the end of last year to support the organization’s work with sterile syringes and other supplies for safer drug use.
“It was absolutely incredible to not have to fundraise every single dollar for the supplies that go out,” said Prevention Point’s executive director, Aaron Arnold. “It takes a lot of energy. It pulls away from actual delivery of services when you’re constantly having to find out, ‘Do we have enough money to even purchase the supplies that we want to distribute?’”
In parts of Pennsylvania that lack these legal protections, people sometimes operate underground syringe programs.
The Pennsylvania law banning drug paraphernalia was never intended to apply to syringe services, according to Scott Burris, director of the Center for Public Health Law Research at Temple University. But there have not been court cases in Pennsylvania to clarify the issue, and the failure of the legislature to act creates a chilling effect, he said.
Carla Sofronski, executive director of the Pennsylvania Harm Reduction Network, said she was not aware of anyone having faced criminal charges for operating syringe services in the state, but she noted the threat hangs over people who do and that they are taking a “great risk.”
In 2016, the CDC flagged three Pennsylvania counties — Cambria, Crawford, and Luzerne — among 220 counties nationwide in an assessment of communities potentially vulnerable to the rapid spread of HIV and to new or continuing high rates of hepatitis C infections among people who inject drugs.
Kate Favata, a resident of Luzerne County, said she started using heroin in her late teens and wouldn’t be alive today if it weren’t for the support and community she found at a syringe services program in Philadelphia.
“It kind of just made me feel like I was in a safe space. And I don’t really know if there was like a come-to-God moment or come-to-Jesus moment,” she said. “I just wanted better.”
Favata is now in long-term recovery and works for a medication-assisted treatment program.
At clinics in Cambria and Somerset Counties, Highlands Health provides free or low-cost medical care. Despite the legal risk, the organization has operated a syringe program for several years, while also testing patients for infectious diseases, distributing overdose reversal medication, and offering recovery options.
Rosalie Danchanko, Highlands Health’s executive director, said she hopes opioid settlement money can eventually support her organization.
“Why shouldn’t that wealth be spread around for all organizations that are working with people affected by the opioid problem?” she asked.
In February, legislation to legalize syringe services in Pennsylvania was approved by a committee and has moved forward. The administration of Gov. Josh Shapiro, a Democrat, supports the legislation. But it faces an uncertain future in the full legislature, in which Democrats have a narrow majority in the House and Republicans control the Senate.
One of the bill’s lead sponsors, state Rep. Jim Struzzi, hasn’t always supported syringe services. But the Republican from western Pennsylvania said that since his brother died from a drug overdose in 2014, he has come to better understand the nature of addiction.
In the committee vote, nearly all of Struzzi’s Republican colleagues opposed the bill. State Rep. Paul Schemel said authorizing the “very instrumentality of abuse” crossed a line for him and “would be enabling an evil.”
After the vote, Struzzi said he wanted to build more bipartisan support. He noted that some of his own skepticism about the programs eased only after he visited Prevention Point Pittsburgh and saw how workers do more than just hand out syringes. These types of programs connect people to resources — overdose reversal medication, wound care, substance use treatment — that can save lives and lead to recovery.
“A lot of these people are … desperate. They’re alone. They’re afraid. And these programs bring them into someone who cares,” Struzzi said. “And that, to me, is a step in the right direction.”
At her nonprofit in western Pennsylvania, Botteicher is hoping lawmakers take action.
“If it’s something that’s going to help someone, then why is it illegal?” she said. “It just doesn’t make any sense to me.”
This story was co-reported by WESA Public Radio and Spotlight PA, an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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