Three Critical Kitchen Prescriptions

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Three Critical Kitchen Prescriptions

This is Dr. Saliha Mahmood-Ahmed. She’s a medical doctor—specifically, a gastroenterologist. She’s also a chef, and winner of the BBC’s MasterChef competition. So, from her gastroenterology day-job and her culinary calling, she has some expert insights to share on eating well!

❝Food and medicine are inextricably linked to one another, and it is an honour to be a doctor who specialises in digestive health and can both cook, and teach others to cook❞

~ Dr. Saliha Mahmood-Ahmed, after winning MasterChef and being asked if she’d quit medicine to be a full-time chef

Dr. Mahmood-Ahmed’s 3 “Kitchen Prescriptions”

They are:

  1. Cook, cook, cook
  2. Feed your gut bugs
  3. Do not diet

Let’s take a look at each of those…

Cook, cook, cook

We’re the only species on Earth that cooks food. An easy knee-jerk response might be to think maybe we shouldn’t, then, but… We’ve been doing it for at least 30,000 years, which is about 1,500 generations, while a mere 100 generations is generally sufficient for small evolutionary changes. So, we’ve evolved this way now.

More importantly in this context: we, ourselves, should cook our own food, at least per household.

Not ready meals; we haven’t evolved for those (yet! Give it another few hundred generations maybe)

Feed your gut bugs

The friendly ones. Enjoy prebiotics, probiotics, and plenty of fiber—and then be mindful of what else you do or don’t eat. Feeding the friendly bacteria while starving the unfriendly ones may seem like a tricky task, but it actually can be quite easily understood and implemented. We did a main feature about this a few weeks ago:

Making Friends With Your Gut (You Can Thank Us Later)

Do not diet

Dr. Mahmood-Ahmed is a strong critic of calorie-counting as a weight-loss strategy:

Rather than focusing on the number of calories consumed, try focusing on introducing enough variety of food into your daily diet, and on fostering good microbial diversity within your gut.

It’s a conceptual shift from restrictive weight loss, to prescriptive adding of things to one’s diet, with fostering diversity of microbiota as a top priority.

This, too, she recommends be undertaken gently, though—making small, piecemeal, but sustainable improvements. Nobody can reasonably incorporate, say, 30 new fruits and vegetables into one’s diet in a week; it’s unrealistic, and more importantly, it’s unsustainable.

Instead, consider just adding one new fruit or vegetable per shopping trip!

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  • Coughing/Wheezing After Dinner?

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    The After-Dinner Activities You Don’t Want

    A quick note first: our usual medical/legal disclaimer applies here, and we are not here to diagnose you or treat you; we are not doctors, let alone your doctors. Do see yours if you have any reason to believe there may be cause for concern.

    Coughing and/or wheezing after eating is more common the younger or older someone is. Lest that seem contradictory: it’s a U-shaped bell-curve.

    It can happen at any age and for any of a number of reasons, but there are patterns to the distribution:

    Mostly affects younger people:

    Allergies, asthma

    Young people are less likely to have a body that’s fully adapted to all foods yet, and asthma can be triggered by certain foods (for example sulfites, a common preservative additive):

    Adverse reactions to the sulphite additives

    Foods/drinks that commonly contain sulfites include soft drinks, wines and beers, and dried fruit

    As for the allergies side of things, you probably know the usual list of allergens to watch out for, e.g: dairy, fish, crustaceans, eggs, soy, wheat, nuts.

    However, that’s far from an exhaustive list, so it’s good to see an allergist if you suspect it may be an allergic reaction.

    Affects young and old people equally:

    Again, there’s a dip in the middle where this doesn’t tend to affect younger adults so much, but for young and old people:

    Dysphagia (difficulty swallowing)

    For children, this can be a case of not having fully got used to eating yet if very small, and when growing, can be a case of “this body is constantly changing and that makes things difficult”.

    For older people, this can can come from a variety of reasons, but common culprits include neurological disorders (including stroke and/or dementia), or a change in saliva quality and quantity—a side-effect of many medications:

    Hyposalivation in Elderly Patients

    (particularly useful in the article above is the table of drugs that are associated with this problem, and the various ways they may affect it)

    Managing this may be different depending on what is causing your dysphagia (as it could be anything from antidepressants to cancer), so this is definitely one to see your doctor about. For some pointers, though:

    NHS Inform | Dysphagia (swallowing problems)

    Affects older people more:

    Gastroesophagal reflux disease (GERD)

    This is a kind of acid reflux, but chronic, and often with a slightly different set of symptoms.

    GERD has no known cure once established, but its symptoms can be managed (or avoided in the first place) by:

    And of course, don’t smoke, and ideally don’t drink alcohol.

    You can read more about this (and the different ways it can go from there), here:

    NICE | Gastro-oesophageal reflux disease

    Note: this above page refers to it as “GORD”, because of the British English spelling of “oesophagus” rather than “esophagus”. It’s the exact same organ and condition, just a different spelling.

    Take care!

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  • Does This New Machine Cure Depression?

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    Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).

    TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:

    Regulatory Clearance and Approval of Therapeutic Protocols of Transcranial Magnetic Stimulation for Psychiatric Disorders

    The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.

    Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:

    Antidepressants: Personalization Is Key!

    Transcranial stimulation… At home?

    Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).

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    What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.

    In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).

    See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies

    And as for the study, here it is:

    Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial

    …which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…

    Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:

    Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode

    This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.

    And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.

    Want something else against depression meanwhile?

    Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:

    The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like

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  • Resveratrol & Healthy Aging

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    Resveratrol & Healthy Aging

    Resveratrol is the compound found in red grapes, and thus in red wine, that have resulted in red wine being sometimes touted as a heart-healthy drink.

    However, at the levels contained in red wine, you’d need to drink 100–1000 glasses of wine per day (depending on the wine) to get the dose of resveratrol that was associated with heart health benefits in mouse studies.

    Which also means: if you are not a mouse, you might need to drink even more than that!

    Further reading: can we drink to good health?

    Resveratrol supplementation

    Happily, resveratrol supplements exist. But what does resveratrol do?

    It lowers blood pressure:

    Effect of resveratrol on blood pressure: a meta-analysis of randomized controlled trials

    It improves blood lipid levels:

    Consumption of resveratrol decreases oxidized LDL and ApoB in patients undergoing primary prevention of cardiovascular disease: a triple-blind, 6-month follow-up, placebo-controlled, randomized trial

    It improves insulin sensitivity:

    Resveratrol retards progression of diabetic nephropathy through modulations of oxidative stress, proinflammatory cytokines, and AMP-activated protein kinase

    It has neuroprotective effects too:

    Resveratrol promotes clearance of Alzheimer’s disease amyloid-beta peptides

    Is it safe?

    For most people, it is generally recognized as safe. However, if you are on blood-thinners or otherwise have a bleeding disorder, you might want to skip it:

    Antiplatelet activity of synthetic and natural resveratrol in red wine

    You also might want to check with your pharmacist/doctor, if you’re on blood pressure meds, anxiety meds, or immunosuppressants, as it can increase the amount of these drugs that will then stay in your system:

    Resveratrol modulates drug- and carcinogen-metabolizing enzymes in a healthy volunteer study

    And as ever, of course, if unsure just check with your pharmacist/doctor, to be on the safe side.

    Where to get it?

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    This news is based on a rodent study, so we don’t know for sure if it’s applicable to humans yet, but there’s no reason to expect that it won’t be.

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    What your gums say about your hormones

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