
The Gym For Your Mental Health
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Getting The Most Out Of Therapy
If you’ve never had therapy, what image do you have of it? Perhaps you imagine a bearded and bespectacled man in a suit, impassively making notes on a clipboard. Perhaps you imagine an empathetic woman, with tissues and camomile tea on standby.
The reality is: the experience of therapy can vary, a lot.
In its results, too! Sometimes we may try therapy and think “well that was a waste of time and money”. Sometimes we may try therapy and it’ll change our life.
So… Is there any way to make it less of a lottery?
First: knowledge is power
And while the therapist-client relationship certainly shouldn’t be a power struggle, you do want to be empowered.
So, read about different styles of therapy, and also, read some how-to guides for self-therapy. We’ve recommended some before in previous editions of 10almonds; you can check those books out here:
- How to Be Your Own Therapist: Boost your mood and reduce your anxiety in 10 minutes a day – by Owen O’Kane
- You Are the One You’ve Been Waiting For: Applying Internal Family Systems to Intimate Relationships – by Dr. Richard Schwartz
- DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy – by Sheri van Dijk
- How to Do the Work: Recognize Your Patterns, Heal from Your Past, and Create Your Self – by Dr. Nicole LaPera
This will serve two purposes:
- You’ll know what to expect out of a therapist
- You can more efficiently “get to work” in therapy
It also, of course, could help you already, without even going to therapy!
Second: begin with the end in mind
A person who does not know what they want to get out of therapy, will likely not get much out of therapy. Or rather, their first task will be to figure that out. So, figure it out in advance, if you can.
Maybe you have a problem that has a specific name, for example poor self-esteem, anxiety, stress, depression, trauma, neuroticism, phobia, etc.
This isn’t Alcoholics Anonymous, and in this case you don’t want a lifetime of “Hello, my name is ______ and I have ______”, if you can help it.
So, what do you want?
- Maybe you want to be able to go to social events without feeling anxious
- Maybe you want your relationship(s) to be more secure and fulfilling
- Maybe you want to no longer have nightmares about that traumatic thing
- Maybe you want to be able to greet each day’s tasks with confidence and without overwhelm
…etc.
A good therapist will help you to set such goals (if you haven’t already), and attain them.
If you’re going the self-therapy route, then this is your job now!
It will probably start with the question: imagine that everything currently troubling you is now healed.
What would that look like, to you?
Third: get a good match for you
Unless you are going entirely the self-therapy route (which can work for some), you will want a therapist who’s a good match for you.
It may take a degree of “suck it and see” trial runs before you find the right one, but that takes time and money, so you’ll want to streamline the process as much as you can. If you do this well, you may be able to find a good therapist for you first time.
For this, personal recommendations (such as from friends) may help more than exmaining academic and institutional affiliations.
Yes, you want a well-qualified therapist who is a member in good standing of a respectable regulated body… but whether your therapist is easy for you to “get on with” will matter at least as much as whether their approach is psychodynamic, or 4th wave CBT, or IFS, or whatever seems popular in your time and place.
Bear in mind:
- Some therapists are specialized in helping with some kinds of things and not others. It will obviously help if the therapist you choose is specialized in the thing you are seeking help for.
- Some therapists may be able to relate to you better (or not), based on simple factors of who they are. To this end, while your therapist certainly doesn’t have to be a mirror image of you, factors like age, gender, race, etc can be relevant and may be worth considering, depending on what you are seeking help with, and what factors impact that thing.
Prefer keeping things to yourself?
Therapy isn’t for everyone, but having a good relationship with oneself definitely is. You might want to invest in one of the books whose reviews we linked above, and you might also get value from previous Psychology Sunday articles, which you can find in our archive (every seventh edition here has a Psychology Sunday main feature):
Click Here To Check Out The 10almonds Archive
To borrow the catchphrase of Dr. Kirk Honda (a therapist and therapy educator with decades of experience):
❝Take care of yourself, because you deserve it; you really, really do.❞
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How Old Is Too Old For HRT?
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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 😎
❝I think you guys do a great job. Wondering if I can suggest a topic? Older women who were not offered hormone replacement therepy because of a long term study that was misread. Now, we need science to tell us if we are too old to benefit from begininng to take HRT. Not sure how old your readers are on average but it would be a great topic for older woman. Thanks❞
Thank you for the kind words, and the topic suggestion!
About the menopause and older age thereafter
We’ve talked a bit before about the menopause, for example:
What You Should Have Been Told About The Menopause Beforehand
And we’ve even discussed the unfortunate social phenomenon of post-menopausal women thinking “well, that’s over and done with now, time to forget about that”, because spoiler, it will never be over and done with—your body is always changing every day, and will continue to do so until you no longer have a body to change.
This means, therefore, that since changes are going to happen no matter what, the onus is on us to make the changes as positive (rather than negative) as possible:
Menopause, & When Not To Let Your Guard Down
About cancer risk
It sounds like you know this one, but for any who were unaware: indeed, there was an incredibly overblown and misrepresented study, and even that was about older forms of HRT (being conjugated equine estrogens, instead of bioidentical estradiol):
As for those who have previously had breast cancer or similar, there is also:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Is it too late?
Fortunately, there is a quick and easy test to know whether you are too old to benefit:
First, find your pulse, by touching the first two fingers of one hand, against the wrist of the other. If you’re unfamiliar with where to find the pulse at the wrist, here’s a quick explainer.
Or if you prefer a video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Did you find it?
Good; in that case, it’s not too late!
Scientists have tackled this question, looking at women of various ages, and finding that when comparing age groups taking HRT, disease risk changes do not generally vary much by age i.e., someone at 80 gets the same relative benefit from HRT as someone at 50, with no extra risks from the HRT. For example, if taking HRT at 50 reduces a risk by n% compared to an otherwise similar 50-year-old not on HRT, then doing so at 80 reduces the same risk by approximately the same percentage, compared to an otherwise similar 80-year-old not on HRT.
There are a couple of exceptions, such as in the case of already having advanced atherosclerotic lesions (in which specific case HRT could increase inflammation; not something it usually does), or in the case of using conjugated equine estrogens instead of modern bioidentical estradiol (as we talked about before).
Thus, for the most part, HRT is considered safe and effective regardless of age:
How old is too old for hormone therapy?
👆 that’s from 2015 though, so how about a new study, from 2024?
❝Compared with never use or discontinuation of menopausal hormone therapy after age 65 years, the use of estrogen monotherapy beyond age 65 years was associated with significant risk reductions in mortality (19% or adjusted hazards ratio, 0.81; 95% CI, 0.79-0.82), breast cancer (16%), lung cancer (13%), colorectal cancer (12%), congestive heart failure (CHF) (5%), venous thromboembolism (3%), atrial fibrillation (4%), acute myocardial infarction (11%), and dementia (2%).❞
❝Among senior Medicare women, the implications of menopausal hormone therapy use beyond age 65 years vary by types, routes, and strengths. In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with estradiol rather than conjugated estrogen.❞
Read in full: Use of menopausal hormone therapy beyond age 65 years and its effects on women’s health outcomes by types, routes, and doses
As for more immediately-enjoyable benefits (improved mood, healthier skin, better sexual function, etc), yes, those also are benefits that people enjoy at least into their eighth decade:
See: Use of hormone therapy in Swedish women aged 80 years or older
What about…
Statistically speaking, most people who take HRT have a great time with it and consider it life-changing in a good way. However, nothing is perfect; sometimes going on HRT can have a shaky start, and for those people, there may be some things that need addressing. So for that, check out:
HRT Side Effects & Troubleshooting
And also, while estrogen monotherapy is very common, it is absolutely worthwhile to consider also taking progesterone alongside it:
Progesterone Menopausal HRT: When, Why, And How To Benefit
Enjoy!
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SMOL Bowl With Sautéed Greens
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Whole grains are good, and gluten is bad for some people. Today’s dish has four whole grains, and no gluten (assuming no cross-contamination, so look for the gluten-free label if that’s important to you). Breafast? Brunch? Lunch? Supper, even? This is good at any time of day, packed with nutrients and full of flavor!
You will need (per person)
- 1 cup mixed cooked grains of equal parts sorghum, millet, oats, lentils (SMOL)—these can be cooked in bulk in advance and frozen in portions, as it’s often good to used mixed grains, and these four are a great combination for many purposes.
- ½ cup low sodium vegetable stock (ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough for this purpose, but failing that, low-sodium stock cubes can be bought at most large supermarkets).
- ½ cup finely chopped red onion
- 6 oz cavolo nero, finely chopped
- 1 small carrot, finely chopped
- 3 cloves garlic, finely chopped
- 1 tbsp nutritional yeast
- 1 tsp black pepper, coarse ground
- 1 tsp white miso paste
- To serve: 1 lemon wedge
Method
(we suggest you read everything at least once before doing anything)
1) Add the stock to a sauté pan over a medium heat, and add the onion, garlic, and carrot. Stir frequently for about 7 minutes.
2) Add the cavolo nero and miso paste, stirring for another 4 minutes. If there is any liquid remaining, drain it off now.
3) Warm the SMOL mixture (microwave is fine) and spoon it into a bowl, topping with the nutritional yeast and black pepper. Finally, add the hot cavolo nero mixture.
4) Serve with the lemon wedge on the side, to add a dash of lemon at will.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
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Stop Cancer 20 Years Ago
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Get Abreast And Keep Abreast
This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.
What does she want us to know?
Start now
If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.
What this means for those of us without breast cancer (or a history therof) is: start now
Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.
Start what, you ask? Taking away its roots. And how?
Inflammation as the root of cancer
To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.
Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:
“and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”
So, fight inflammation now, and have a reduced risk of a lot of other woes later.
See: How to Prevent (or Reduce) Inflammation
Don’t settle for “normal”
People are told, correctly but not always helpfully, such things as:
- It’s normal to have less energy at your age
- It’s normal to have a weaker immune system at your age
- It’s normal to be at a higher risk of diabetes, heart disease, etc
…and many more. And these things are true! But that doesn’t mean we have to settle for them.
We can be all the way over on the healthy end of the distribution curve. We can do that!
(so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)
If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.
So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:
See: Focusing On Health In Our Sixties
Fast to live
Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.
This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.
See: Intermittent Fasting: We Sort The Science From The Hype
While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.
It’s never too late
All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”
The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.
Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.
Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:
- Knowing stuff
- Doing stuff
So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.
Want to know more?
We recently reviewed her book, and heartily recommend it:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Enjoy!
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Nutritional Profiles to Recipes
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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
❝I like the recipes. Most don’t seem to include nutritional profile. would lilke to see that. Macro/micro world…. Thank you❞
We’re glad you’re enjoying them! There are a couple of reasons why we don’t, but the reasons can be aggregated into one (admittedly rare) concept: honesty
To even try to give you these figures, we’d first need to use the metric system (or at least, a strictly mass-based system) which would likely not go well with our largely American readership, because “half a bulb of garlic, or more if you like”, and “1 cucumber” or “1 cup chopped carrot” could easily way half or twice as much, depending on the sizes of the vegetables or the chopping involved, and in the case of chopped vegetables measured by the cup, even the shape of the cup (because of geometry and the spaces left; it’s like Tetris in there). We can say “4 cups low-sodium broth” but we can’t say how much sodium is in your broth. And so on.
And that’s without getting into the flexibility we offer with substitutions, often at a rate of several per recipe.
We’d also need to strictly regulate your portion sizes for you, because we (with few exceptions, such as when they are a given number of burger patties, or a dessert-in-a-glass, etc) give you a recipe for a meal and leave it to you how you divide it and whether there’s leftovers.
Same goes for things like “Extra virgin olive oil for frying”; a recipe could say to use “2 tbsp” but let’s face it, you’re going to use what you need to use, and that’s going to change based on the size of your pan, how quickly it’s absorbed into the specific ingredients that you got, which will change depending on how fresh they are, and things like that.
By the time we’ve factored in your different kitchen equipment, how big your vegetables are, the many factors effecting how much oil you need, substitutions per recipe per making something dairy-free, or gluten-free, or nut-free, etc, how big your portion size is (we all know that “serves 4” is meaningless in reality)… Even an estimated average would be wildly misleading.
So, in a sea of recipes saying “500 kcal per serving” from the same authors who say you can caramelize onions in 4–5 minutes “or until caramelized” and then use the 4–5 minutes figure for calculating the overall recipe time… We prefer to stay honest.
PS: for any wondering, caramelizing onions takes closer to 45 minutes than 4–5 minutes, and again will depend on many factors, including the onions, how finely you chopped them, the size and surface of your pan, the fat you’re using, whether you add sugar, what kind, how much you stir them, the mood of your hob,
and the phase of the moon. Under very favorable circumstances, it could conceivably be rushed in 20 minutes or so, but it could also take 60. Slow-cooking them (i.e. in a crock pot) over 3–4 hours is a surprisingly viable “cheat” option, by the way. It’ll take longer, obviously, but provided you plan in advance, they’ll be ready when you need them, and perfectly done (the same claim cannot be made if you budgeted 4–5 minutes because you trusted a wicked and deceitful author who wants to poop your party).Take care!
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Vegetarian & Vegan Diets: Good Or Bad For Brain Health?
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It’s well-established that most people should eat more plants, and generally speaking, less meat. But what about abstaining from meat completely? And what about abstaining from all animal products?
For a more general overview (rather than specifically brain health), check out: Do We Need Animal Products To Be Healthy?
Now, about brains…
Before Homo sapiens was a thing, our precursors such as Homo habilis developed language (thus: greatly enhanced collaborative teamwork) and cooking, resulting in Homo ergaster (who came approximately next in line, give or take taxonomical quibbles) having twice the cranial capacity, generally attributed to being able to acquire and—where appropriate—cook calorie-dense food, which included meat, and also tubers that can’t be safely eaten raw. It’s estimated (based on forensic examination of tooth wear, mineralization, microdeposits of various kinds, etc) that our consumption of animal products in that era was around 10% of our diet (fluctuating by region, of course), but it likely was an important one.
By the time we got to Homo erectus, our skulls (including our cranial cavities, and thus it is presumed, our brains) were actually larger than in Homo sapiens. You may be wondering about Homo neanderthalensis; our cousins (or in some cases, ancestors—but that is beyond the scope of today’s article) also had larger cranial cavities than us, and certainly enjoyed comparatively advanced culture, arts, religion, etc.
Fast-forward to the present day. Nothing is going to meaningfully change our skull size, as individuals. Brain size? Well, keep hydrated or it’ll shrink. Don’t overhydrate or it’ll swell. Neuroplasticity means we can increase (or lose) volume in specific areas of the brain, according to what we do most of. For example, if you were to scan this writer’s brain, you’d probably find overdevelopment in the various areas pertaining to language and memory, as that’s been “my thing” for as long as I can remember (which is a long way). See also: An Underrated Tool Against Alzheimer’s
The impact of diet in the modern day
Unlike our distant ancestors, if we want a high-calorie snack we can buy some nuts from the supermarket, and if anything, this can be a problem (as many people’s go-to high-calorie snack may be a lot less healthy than that), and in turn cause problems for the brain, because too many pizzas, cheeseburgers, tater tots, and so forth cause chronic inflammation, and thus, neuroinflammation.
See also: 6 Worst Foods That Cause Dementia
So much for “calories for the brain”. Yes, the brain definitely needs calories (it expends a very large portion of our daily calorie intake), but you can have too much of a good thing.
In any case, the brain needs more than just calories!
For example, you may remember the “6 Pillars Of Nutritional Psychiatry”, which are:
- Be whole; eat whole
- Eat the rainbow
- The greener, the better
- Tap into your body intelligence
- Consistency & balance are key
- Avoid anxiety-triggering foods
For more on all of those, see Dr. Uma Naidoo’s 6 Pillars Of Nutritional Psychiatry ← She’s a Harvard-trained psychiatrist, professional chef graduating with her culinary school’s most coveted award, and a trained nutritionist. Between those three qualifications, she knows her stuff when it comes to the niche that is nutritional psychiatry.
When it comes to any potential nutritional deficiencies of a vegetarian or vegan diet, it’s a matter of planning.
Properly planned vegetarian diets are rich in essential nutrients like carbohydrates, fiber, magnesium, potassium, folate, vitamins C and E, and an abundance of phytochemicals, which support brain health (and overall health too, but today is about brain health).
However, if not well-planned, they can indeed lack certain nutrients such as vitamin B12, iron, and omega-3 fatty acids, which are critical for brain function.
In essence, there’s a difference between a “whole foods plant-based diet” and junk food that just happens to be vegetarian or vegan.
Vitamin B12 is usually supplemented by vegans, but it can also be enjoyed from nutritional yeast used in cooking (it adds a cheesy flavor to dishes for which that’d be appropriate).
Iron is a fascinating beast, because while everyone thinks of red meat (which is indeed rich in iron), not only are there good plant-based sources of iron, but there are important considerations when it comes to bioavailability differences between heme and non-heme iron. In few words, heme iron (from blood etc) is more bioavailable by 1.8x, but all iron, including non-heme iron (from beans, greens, etc) can have its bioavailability multiplied by 5x just by having it with vitamin C:
Avoiding Anemia (More Than Just “Get More Iron”)
Omega-3 fatty acids, for vegetarians that mostly means eggs. See: Eggs: All Things In Moderation?
For vegans, we must look to nuts and seeds, for the most part. Or supplement—many omega 3 supplements are vegan, made from algae, or seaweed (that in turn is composed partially or entirely of algae):
So really, it comes down to “make sure you still get these things”, and once you’re used to it, it’s easy.
For those who prefer to keep some meat in their diet
Our summary in our top-linked article (Do We Need Animal Products To Be Healthy?) concluded:
- Most of us can live healthily and happily on just plants if we so choose.
- Some people cannot, and will require varying kinds (and quantities) of animal products.
- As for red and/or processed meats, we’re not the boss of you, but from a health perspective, the science is clear: unless you have a circumstance that really necessitates it, just don’t.
- Same goes for pork, which isn’t red and may not be processed, but metabolically it’s associated with the same problems.
- The jury is out on poultry, but it strongly appears to be optional, healthwise, without making much of a difference either way
- Fish is roundly considered healthful in moderation. Enjoy it if you want, don’t if you don’t.
And the paper from which we’ve largely been working from today included such comments as:
❝ Evidence suggests that vegan and vegetarian diets, when well planned, can be rich in phytonutrients and antioxidants, which have been associated with lower levels of inflammatory markers, such as C-reactive protein (CRP) and interleukin-6 (IL-6). These findings indicate a potential role in reducing systemic inflammation and oxidative stress, both of which are linked to neurodegenerative diseases.
However, deficiencies in critical nutrients such as vitamin B12, DHA, EPA, and iron have been consistently associated with an increased risk of cognitive decline, mood disturbances, and neurodegenerative disorders.
While plant-based diets provide anti-inflammatory and antioxidant benefits, their neurological implications depend on nutrient adequacy. Proper planning, supplementation, and food preparation techniques are essential to mitigate risks and enhance cognitive health.❞
Source: Impact of Vegan and Vegetarian Diets on Neurological Health: A Critical Review ← you can see that they also cover the same nutrients that we do
One final note, not discussed above
We often say “what’s good for your heart is good for your brain”, because the former feeds the latter (with oxygen and nutrients) and assists in cleanup (of detritus that otherwise brings about cognitive decline).
So with that in mind…
What Matters Most For Your Heart? ← hint: it’s fiber. So whether you eat animal products or not, please do eat plenty of plants!
Take care!
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Why do I poo in the morning? A gut expert explains
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No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.
But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?
To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.
Here’s what the science says.
H_Ko/Shutterstock So morning poos are real?
In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.
The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.
About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.
But why the morning?
There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.
For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.
There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.
Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.
One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.
Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.
Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.
How important are morning poos?
Large international surveys show the vast majority of people will poo between three times a day and three times a week.
This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.
So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.
Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.
Can you train yourself to be regular?
Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.
A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.
A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.
We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.
Fibre from fruits and vegetables also helps make bowel motions more regular.
Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.
Monitoring your bowel habits
Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.
If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.
But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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