The Worry Trick – by Dr. David Carbonell
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Worry is a time-sink that rarely does us any good, and often does us harm. Many books have been written on how to fight anxiety… That’s not what this book’s about.
Dr. David Carbonell, in contrast, encourages the reader to stop trying to avoid/resist anxiety, and instead, lean into it in a way that detoothes it.
He offers various ways of doing this, from scheduling time to worry, to substituting “what if…” with “let’s pretend…”, and guides the reader through exercises to bring about a sort of worry-desensitization.
The style throughout is very much pop-psychology and is very readable.
If the book has a weak point, it’s that it tends to focus on worrying less about unlikely outcomes, rather than tackling worry that occurs relating to outcomes that are likely, or even known in advance. However, some of the techniques will work for such also! That’s when Dr. Carbonell draws from Acceptance and Commitment Therapy (ACT).
Bottom line: if you would like to lose less time and energy to worrying, then this is a fine book for you.
Click here to check out The Worry Trick, and repurpose your energy reserves!
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Hormones & Health, Beyond The Obvious
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Wholesome Health
This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.
What does she want us to know?
Beyond “bikini zone health”
Dr. Gottfried urges us to pay attention to our whole health, in context.
“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.
And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.
That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:
- The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
- The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one
Nor are brains exempt from his…
The female brain (kinda)
While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…
The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.
See for example:
Alzheimer’s Sex Differences May Not Be What They Appear
Dr. Gottfried urges us to take the above seriously!
Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.
She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:
Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)
The other very relevant hormone
…that Dr. Gottfried wants us to pay attention to is insulin.
Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.
In other words: to fight neurodegeneration, keep your blood sugars healthy.
This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:
The Surprising Link Between Type 2 Diabetes & Alzheimer’s
Want more from Dr. Gottfried?
You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:
Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD
…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.
Enjoy!
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Q&A with the 10almonds Team
Q: Very interested in this article on CBD oil in the states. hope you do another one in the future with more studies done on people and more information on what’s new as far as CBD oil goes
A: We’re glad you enjoyed it! We’ll be sure to revisit CBD in the future—partly because it was a very popular article, and partly because, as noted, there is a lot going on there, research-wise!
And yes, we prefer human studies rather than mouse/rat studies where possible, too, and try to include those where we find them. In some cases, non-human animal studies allow us to know things that we can’t know from human studies… because a research institution’s ethics board will greenlight things for mice that it’d never* greenlight for humans.
Especially: things that for non-human animals are considered “introduction of external stressors” while the same things done to humans would be unequivocally called “torture”.
Animal testing in general is of course a moral quagmire, precisely because of the suffering it causes for animals, while the research results (hopefully) can be brought to bear to reduce to suffering of humans. We’re a health and productivity newsletter, not a philosophical publication, but all this to say: we’re mindful of such too.
And yes, we agree, when studies are available on humans, they’re always going to be better than the same study done on mice and rats.
As a topical aside, did you know there’s a monument to laboratory mice and all they’ve (however unintentionally) done for us?
❝The quirky statue depicts an anthropomorphic mouse as an elderly woman, complete with glasses balanced atop its nose. Emerging from two knitting needles in its hands is the recognizable double-helix of a strand of DNA.❞
~ Smithsonian Magazine
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‘It’s okay to poo at work’: new health campaign highlights a common source of anxiety
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For most people, the daily or near-daily ritual of having a bowel motion is not something we give a great deal of thought to. But for some people, the need to do a “number two” in a public toilet or at work can be beset with significant stress and anxiety.
In recognition of the discomfort people may feel around passing a bowel motion at work, the Queensland Department of Health recently launched a social media campaign with the message “It’s okay to poo at work”.
The campaign has gained significant traction on Instagram and Facebook. It has been praised by health and marketing experts for its humorous handling of a taboo topic.
A colourful Instagram post is accompanied by a caption warning of the health risks of “holding it in”, including haemorrhoids and other gastrointestinal problems. The caption also notes:
If you find it extremely difficult to poo around other people, you might have parcopresis.
What is parcopresis?
Parcopresis, sometimes called “shy bowel”, occurs when people experience a difficulty or inability to poo in public toilets due to fear of perceived scrutiny by others.
People with parcopresis may find it difficult to go to the toilet in public places such as shopping centres, restaurants, at work or at school, or even at home when friends or family are around.
They may fear being judged by others about unpleasant smells or sounds when they have a bowel motion, or how long they take to go, for example.
Living with a gastrointestinal condition (at least four in ten Australians do) may contribute to parcopresis due to anxiety about the need to use a toilet frequently, and perceived judgment from others when doing so. Other factors, such as past negative experiences or accessibility challenges, may also play a role.
For sufferers, anxiety can present in the form of a faster heart rate, rapid breathing, sweating, muscle tension, blushing, nausea, trembling, or a combination of these symptoms. They may experience ongoing worry about situations where they may need to use a public toilet.
Living with parcopresis can affect multiple domains of life and quality of life overall. For example, sufferers may have difficulties relating to employment, relationships and social life. They might avoid travelling or attending certain events because of their symptoms.
How common is parcopresis?
We don’t really know how common parcopresis is, partly due to the difficulty of evaluating this behaviour. It’s not necessarily easy or appropriate to follow people around to track whether they use or avoid public toilets (and their reasons if they do). Also, observing individual bathroom activities may alter the person’s behaviour.
I conducted a study to try to better understand how common parcopresis is. The study involved 714 university students. I asked participants to respond to a series of vignettes, or scenarios.
In each vignette participants were advised they were at a local shopping centre and they needed to have a bowel motion. In the vignettes, the bathrooms (which had been recently cleaned) had configurations of either two or three toilet stalls. Each vignette differed by the configuration of stalls available.
The rate of avoidance was just over 14% overall. But participants were more likely to avoid using the toilet when the other stalls were occupied.
Around 10% avoided going when all toilets were available. This rose to around 25% when only the middle of three toilets was available. Men were significantly less likely to avoid going than women across all vignettes.
For those who avoided the toilet, many either said they would go home to poo, use an available disabled toilet, or come back when the bathroom was empty.
Parcopresis at work
In occupational settings, the rates of anxiety about using shared bathrooms may well be higher for a few reasons.
For example, people may feel more self-conscious about their bodily functions being heard or noticed by colleagues, compared to strangers in a public toilet.
People may also experience guilt, shame and fear about being judged by colleagues or supervisors if they need to make extended or frequent visits to the bathroom. This may particularly apply to people with a gastrointestinal condition.
Reducing restroom anxiety
Using a public toilet can understandably cause some anxiety or be unpleasant. But for a small minority of people it can be a real problem, causing severe distress and affecting their ability to engage in activities of daily living.
If doing a poo in a toilet at work or another public setting causes you anxiety, be kind to yourself. A number of strategies might help:
- identify and challenge negative thoughts about using public toilets and remind yourself that using the bathroom is normal, and that most people are not paying attention to others in the toilets
- try to manage stress through relaxation techniques such as deep breathing and progressive muscle relaxation, which involves tensing and relaxing different muscles around the body
- engaging in gradual exposure can be helpful, which means visiting public toilets at different times and locations, so you can develop greater confidence in using them
- use grounding or distraction techniques while going to the toilet. These might include listening to music, watching something on your phone, or focusing on your breathing.
If you feel parcopresis is having a significant impact on your life, talk to your GP or a psychologist who can help identify appropriate approaches to treatment. This might include cognitive behavioural therapy.
Simon Robert Knowles, Associate Professor and Clinical Psychologist, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why is toddler milk so popular? Follow the money
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Toddler milk is popular and becoming more so. Just over a third of Australian toddlers drink it. Parents spend hundreds of millions of dollars on it globally. Around the world, toddler milk makes up nearly half of total formula milk sales, with a 200% growth since 2005. Growth is expected to continue.
We’re concerned about the growing popularity of toddler milk – about its nutritional content, cost, how it’s marketed, and about the impact on the health and feeding of young children. Some of us voiced our concerns on the ABC’s 7.30 program recently.
But what’s in toddler milk? How does it compare to cow’s milk? How did it become so popular?
What is toddler milk? Is it healthy?
Toddler milk is marketed as appropriate for children aged one to three years. This ultra-processed food contains:
- skim milk powder (cow, soy or goat)
- vegetable oil
- sugars (including added sugars)
- emulsifiers (to help bind the ingredients and improve the texture)
added vitamins and minerals.
Toddler milk is usually lower in calcium and protein, and higher in sugar and calories than regular cow’s milk. Depending on the brand, a serve of toddler milk can contain as much sugar as a soft drink.
Even though toddler milks have added vitamins and minerals, these are found in and better absorbed from regular foods and breastmilk. Toddlers do not need the level of nutrients found in these products if they are eating a varied diet.
Global health authorities, including the World Health Organization (WHO), and Australia’s National Health and Medical Research Council, do not recommend toddler milk for healthy toddlers.
Some children with specific metabolic or dietary medical problems might need tailored alternatives to cow’s milk. However, these products generally are not toddler milks and would be a specific product prescribed by a health-care provider.
Toddler milk is also up to four to five times more expensive than regular cow’s milk. “Premium” toddler milk (the same product, with higher levels of vitamins and minerals) is more expensive.
With the cost-of-living crisis, this means families might choose to go without other essentials to afford toddler milk.
How toddler milk was invented
Toddler milk was created so infant formula companies could get around rules preventing them from advertising their infant formula.
When manufacturers claim benefits of their toddler milk, many parents assume these claimed benefits apply to infant formula (known as cross-promotion). In other words, marketing toddler milks also boosts interest in their infant formula.
Manufacturers also create brand loyalty and recognition by making the labels of their toddler milk look similar to their infant formula. For parents who used infant formula, toddler milk is positioned as the next stage in feeding.
How toddler milk became so popular
Toddler milk is heavily marketed. Parents are told toddler milk is healthy and provides extra nutrition. Marketing tells parents it will benefit their child’s growth and development, their brain function and their immune system.
Toddler milk is also presented as a solution to fussy eating, which is common in toddlers.
However, regularly drinking toddler milk could increase the risk of fussiness as it reduces opportunities for toddlers to try new foods. It’s also sweet, needs no chewing, and essentially displaces energy and nutrients that whole foods provide.
Growing concern
The WHO, along with public health academics, has been raising concerns about the marketing of toddler milk for years.
In Australia, moves to curb how toddler milk is promoted have gone nowhere. Toddler milk is in a category of foods that are allowed to be fortified (to have vitamins and minerals added), with no marketing restrictions. The Australian Competition & Consumer Commission also has concerns about the rise of toddler milk marketing. Despite this, there is no change in how it’s regulated.
This is in contrast to voluntary marketing restrictions in Australia for infant formula.
What needs to happen?
There is enough evidence to show the marketing of commercial milk formula, including toddler milk, influences parents and undermines child health.
So governments need to act to protect parents from this marketing, and to put child health over profits.
Public health authorities and advocates, including us, are calling for the restriction of marketing (not selling) of all formula products for infants and toddlers from birth through to age three years.
Ideally, this would be mandatory, government-enforced marketing restrictions as opposed to industry self-regulation in place currently for infant formulas.
We musn’t blame parents
Toddlers are eating more processed foods (including toddler milk) than ever because time-poor parents are seeking a convenient option to ensure their child is getting adequate nutrition.
Formula manufacturers have used this information, and created a demand for an unnecessary product.
Parents want to do the best for their toddlers, but they need to know the marketing behind toddler milks is misleading.
Toddler milk is an unnecessary, unhealthy, expensive product. Toddlers just need whole foods and breastmilk, and/or cow’s milk or a non-dairy, milk alternative.
If parents are worried about their child’s eating, they should see a health-care professional.
Anthea Rhodes, a paediatrician from Royal Children’s Hospital Melbourne and a lecturer at the University of Melbourne, co-authored this article.
Jennifer McCann, Lecturer Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University; Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University, and Naomi Hull, PhD candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?
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It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities.
Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in fight or flight situations.
But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the common cold, flu and COVID.
Stress makes it harder to fight off viruses
When the immune system starts to break down, a virus that would normally have been under control starts to flourish.
Once you begin to feel sick, the stress response rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to fight.
In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of studies where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their nose.
These participants were then quarantined in a hotel and monitored closely to determine who became ill.
One of the most important factors predicting who got sick was prolonged psychological stress.
Cortisol suppresses immunity
“Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for weeks or months.
When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and cortisol.
In a typical stress response, cortisol levels quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an immediate threat.
But in the longer term, chronic stress can be harmful. A Harvard University study from 2022 showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They classified this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness.
Those suffering distress had close to a 50% greater risk of long COVID compared to other participants. Cortisol has been shown to be high in the most severe cases of COVID.
Stress causes inflammation
Inflammation is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right levels.
The immune cells also store a memory of that threat to respond faster and more effectively the next time.
Initially, circulating immune cells detect and flock to the site of infection. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the threat.
During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny nose.
What about chronic stress?
Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate stressor.
The immune system becomes desensitised and unresponsive to this cortisol suppression, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins).
Immune cells become exhausted and start to malfunction. The body loses the ability to turn down the inflammatory response.
Over time, the immune system changes the way it responds by reprogramming to a “low surveillance mode”. The immune system misses early opportunities to destroy threats, and the process of recovery can take longer.
So how can you manage your stress?
We can actively strengthen our immunity and natural defences by managing our stress levels. Rather than letting stress build up, try to address it early and frequently by:
1) Getting enough sleep
Getting enough sleep reduces cortisol levels and inflammation. During sleep, the immune system releases cytokines, which help fight infections and inflammation.
2) Taking regular exercise
Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes toxins. Physical activity also lowers stress hormone levels through the release of positive brain signals.
3) Eating a healthy diet
Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress levels. Staying hydrated helps the body to flush out toxins.
4) Socialising and practising meditation or mindfulness
These activities increase endorphins and serotonin, which improve mood and have anti-inflammatory effects. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce cortisol levels.
Sathana Dushyanthen, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Great Cholesterol Myth, Revised and Expanded – by Dr. Jonny Bowden and Dr. Stephen Sinatra
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The topic of cholesterol, and saturated fat for that matter, is a complex and often controversial one. How does this book treat it?
With strong opinions, is how—but backed by good science. The authors, a nutritionist and a cardiologist, pull no punches about outdated and/or cherry-picked science, and instead make the case for looking at what, statistically speaking, appear to be the real strongest risk factors.
So, are they advocating for Dave Asprey-style butter-guzzling, or “the carnivore diet”? No, no they are not. Those things remain unhealthy, even if they give some short-term gains (of energy levels, weight loss, etc).
They do advocate, however, for enjoying saturated fats in moderation, and instead of certain polyunsaturated seed oils that do far worse. They also advocate strongly for avoiding sugar, stress, and (for different reasons) statins (in most people’s cases).
They also demystify in clear terms, and often with diagrams and infographics, the various kinds of fats and their components, broken down in far more detail than any other pop-science source this reviewer has seen.
Bottom line: if you want to take a scientific approach to heart health, this book can help you to focus on what will actually make the biggest difference.
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