To Medicate or Not? That is the Question! – by Dr. Asha Bohannon

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Medications are, of course, a necessity of life (literally!) for many, especially as we get older. Nevertheless, overmedication is also a big problem that can cause a lot of harm too, and guess what, it comes with the exact same “especially as we get older” tag too.

So, what does Dr. Bohannon (a doctor of pharmacy, diabetes educator, and personal trainer too) recommend?

Simply put: she recommends starting with a comprehensive health history assessment and analysing one’s medication/supplement profile, before getting lab work done, tweaking all the things that can be tweaked along the way, and—of course—not neglecting lifestyle medicine either.

The book is prefaced and ended with pep talks that probably a person who has already bought the book does not need, but they don’t detract from the practical content either. Nevertheless, it feels a little odd that it takes until chapter 4 to reach “step 1” of her 7-step method!

The style throughout is conversational and energetic, but not overly padded with hype; it’s just a very casual style. Nevertheless, she brings to bear her professional knowledge and understanding as a doctor of pharmacy, to include her insights into the industry that one might not observe from outside of it.

Bottom line: if you’d like to do your own personal meds review and want to “know enough to ask the right questions” before bringing it up with your doctor, this book is a fine choice for that.

Click here to check out To Medicate Or Not, and make informed choices!

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  • The Plant-Based Athlete – by Matt Frazier and Robert Cheeke
  • Coca-Cola vs Diet Coke – Which is Healthier?
    Diet Coke wins over Coca-Cola due to lower sugar content and aspartame sweetener, but both have health risks. Best to avoid both.

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  • Science of Pilates – by Tracy Ward

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    We’ve reviewed other books in this series, “Science of Yoga” and “Science of HIIT” (they’re great too; check them out!). What does this one add to the mix?

    Pilates is a top-tier “combination exercise” insofar as it checks a lot of boxes, e.g:

    • Strength—especially core strength, but also limbs
    • Mobility—range of motion and resultant reduction in injury risk
    • Stability—impossible without the above two things, but Pilates trains this too
    • Fitness—many dynamic Pilates exercises can be performed as cardio and/or HIIT.

    The author, a physiotherapist, explains (as the title promises!) the science of Pilates, with:

    • the beautifully clear diagrams we’ve come to expect of this series,
    • equally clear explanations, with a great balance of simplicity of terms and depth where necessary, and
    • plenty of citations for the claims made, linking to lots of the best up-to-date science.

    Bottom line: if you are in a position to make a little time for Pilates (if you don’t already), then there is nobody who would not benefit from reading this book.

    Click here to check out Science of Pilates, and keep your body well!

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  • Jamaican Coconut Rice

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    This is a great dish that can be enjoyed hot or cold, as a main or as a side. It has carbs, proteins, healthy fats, fiber, as well as an array of healthy phytochemicals. Not to mention, a great taste!

    You will need

    • 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same) (traditional recipe calls for pudding rice, but we’re going with the healthier option here)
    • 2 cans (each 12 z / 400g) coconut milk
    • 2 cups (or 2 cans, of which the drained weight is comparable to a cup each) cooked black beans. If you cook them yourself, this is better, as you will be able to cook them more al dente than you can get from a can, and this firmness is desirable. But canned is fine if that’s what’s available.
    • 1 large red onion, finely chopped
    • ½ cup low-sodium vegetable stock (ideally you made this yourself from vegetable offcuts you saved in the freezer for this purpose, but failing that, low-sodium stock cubes can be bought at any large supermarket)
    • 2 serrano chilis, finely chopped
    • 1 Scotch bonnet chili, without doing anything to it
    • 1 tbsp black pepper, coarse ground
    • 1 tbsp chia seeds
    • 1 tbsp coconut oil
    • Garnish: parsley, chopped

    Note: we have erred on the side of low-heat when it comes to the chilis. If you know that you and (if applicable) everyone else eating would enjoy more heat, add more heat. If not, let extra heat be added at the table via your hot sauce of choice. Sounds heretical, but it ensures everyone gets the right amount! It’s easy to add heat than to take it out, after all.

    However: if you do end up with too much heat in this or any other dish, adding acid will usually help to neutralize that. In the case of this dish, we’d recommend lime juice as a complementary flavor.

    Method

    (we suggest you read everything at least once before doing anything)

    1) In a big sauté pan, add the coconut oil, melt it if not already melted, and add the chopped onion and the chopped chilis, at a temperature sufficient to sizzle. Keep them all moving. Once the coconut oil is absorbed into the onion (this will happen before the onion is fully cooked), add the vegetable stock, followed by the coconut milk; mix it all gently to create a smooth consistency.

    2) Add the rice, chia seeds, and black pepper; mix it all gently but thoroughly; turn the temperature to a simmer, and add the Scotch bonnet chili, without cutting it at all.

    3) Cover and keep on low for about 20–30 minutes until the rice is looking done. Check on it periodically to make sure it’s not running out of liquid, but resist the urge to stir it; it shouldn’t be burning but paradoxically, once you start stirring you can’t stop or it will definitely burn.

    4) Take out the Scotch bonnet chili, and discard*. Add the black beans.

    *its job was to add flavor without adding the high-level heat of that particular chili. If you’re a regular heat-fiend, feel free to experiment with using sliced Scotch bonnet chilis instead of serrano chilis; just be aware that there’s a big difference in heat. Only do this if you really like heat. Using it the way we described in the main recipe is what’s traditional in the Caribbean, by the way.

    5) Now you can (and in fact must) stir, to mix in the black beans and bring them back to temperature within the dish. Be aware that once you start stirring, you need to keep stirring until you’re ready to take it off the heat.

    6) Serve, adding the parsley garnish.

    (this example went light on the beans; our recipe includes more for a heartier dish)

    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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  • Viral science-backed Sleepy Girl Mocktail.

    Turns out the viral ‘Sleepy Girl Mocktail’ is backed by science. Should you try it?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many of us wish we could get a better night’s sleep. Wouldn’t it be great if it was as easy as a mocktail before bed?

    That’s what the latest viral trend might have us believe. The “Sleepy Girl Mocktail” is a mix of tart cherry juice, powdered magnesium supplement and soda water. TikTok videos featuring the concoction have garnered hundreds of thousands of views. But, what does the science say? Do these ingredients actually help us sleep?

    Tart cherry juice

    There is research to show including tart cherry juice in your diet improves overall sleep. Clinical trials show tart cherry juice increases sleep quality and quantity, as well as a lessening insomnia symptoms (compared to a placebo). This could be due to the presence of melatonin, a sleep-promoting hormone, in cherries.

    Tart cherry varieties such as Jerte Valley or Montmorency have the highest concentration of melatonin (approximately 0.135 micrograms of melatonin per 100g of cherry juice). Over the counter melatonin supplements can range from 0.5 milligram to over 100 milligrams, with research suggesting those beginning to take melatonin start with a dose of 0.5–2 milligrams to see an improvement in sleep.

    Melatonin naturally occurs in our bodies. Our body clock promotes the release of melatonin in the evening to help us sleep, specifically in the two hours before our natural bedtime.

    If we want to increase our melatonin intake with external sources, such as cherries, then we should be timing our intake with our natural increase in melatonin. Supplementing melatonin too close to bed will mean we may not get the sleep-promoting benefits in time to get off to sleep easily. Taking melatonin too late may even harm our long-term sleep health by sending the message to our body clock to delay the release of melatonin until later in the evening.

    Magnesium – but how much?

    Magnesium also works to promote melatonin, and magnesium supplements have been shown to improve sleep outcomes.

    However, results vary depending on the amount of magnesium people take. And we don’t yet have the answers on the best dose of magnesium for sleep benefits.

    We do know magnesium plays a vital role in energy production and bone development, making it an important daily nutrient for our diets. Foods rich in magnesium include wheat cereal or bread, almonds, cashews, pumpkin seeds, spinach, artichokes, green beans, soy milk and dark chocolate.

    Bubbly water

    Soda water serves as the base of the drink, rather than a pathway to better sleep. And bubbly water may make the mix more palatable. It is important to keep in mind that drinking fluids close to bedtime can be disruptive to our sleep as it might lead to waking during the night to urinate.

    Healthy sleep recommendations include avoiding water intake in the two hours before bed. Having carbonated beverages too close to bed can also trigger digestive symptoms such as bloating, gassiness and reflux during the night.

    Bottoms up?

    Overall, there is evidence to support trying out the Sleepy Girl Mocktail to see if it improves sleep, however there are some key things to remember:

    • timing: to get the benefits of this drink, avoid having it too close to bed. Aim to have it two hours before your usual bedtime and avoid fluids after this time

    • consistency: no drink is going to be an immediate cure for poor sleep. However, this recipe could help promote sleep if used strategically (at the right time) and consistently as part of a balanced diet. It may also introduce a calming evening routine that helps your brain relax and signals it’s time for bed

    • maximum magnesium: be mindful of the amount of magnesium you are consuming. While there are many health benefits to magnesium, the recommended daily maximum amounts are 420mg for adult males and 320mg for adult females. Exceeding the maximum can lead to low blood pressure, respiratory distress, stomach problems, muscle weakness and mood problems
    • sugar: in some of the TikTok recipes sugar (as flavoured sodas, syrups or lollies) is added to the drink. While this may help hide the taste of the tart cherry juice, the consumption of sugar too close to bed may make it more difficult to get to sleep. And sugar in the evening raises blood sugar levels at a time when our body is not primed to be processing sugar. Long term, this can increase our risk of diabetes

    • sleep environment: follow good sleep hygiene practices including keeping a consistent bedtime and wake time, a wind-down routine before bed, avoiding electronic device use like phones or laptops in bed, and avoiding bright light in the evening. Bright light works to suppress our melatonin levels in the evening and make us more alert.

    What about other drinks?

    Other common evening beverages include herbal tisanes or teas, hot chocolate, or warm milk.

    Milk can be especially beneficial for sleep, as it contains the amino acid tryptophan, which can promote melatonin production. Again, it is important to also consider the timing of these drinks and to avoid any caffeine in tea and too much chocolate too close to bedtime, as this can make us more alert rather than sleepy.

    Getting enough sleep is crucial to our health and wellbeing. If you have tried multiple strategies to improve your sleep and things are not getting better, it may be time to seek professional advice, such as from a GP.

    The Conversation

    Charlotte Gupta, Postdoctoral research fellow, CQUniversity Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Related Posts

  • The Plant-Based Athlete – by Matt Frazier and Robert Cheeke
  • Fermenting Everything – by Andy Hamilton

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is not justanother pickling book! This is, instead, what it says on the front cover, “fermenting everything”.

    Ok, maybe not literally everything, but every kind of thing that can reasonably be fermented, and it’s probably a lot more things than you might think.

    From habanero chutney to lacto-lemonade, aioli to kombucha, Ukrainian fermented tomatoes to kvass. We could go on, but we’d soon run out of space. You get the idea. If it’s a fermented product (food, drink, condiment) and you’ve heard of it, there’s probably a recipe in here.

    All in all, this is a great way to get in your gut-healthy daily dose of fermented products!

    He does also talk safety, and troubleshooting too. And so long as you have a collection of big jars and a fairly normally-furnished kitchen, you shouldn’t need any more special equipment than that, unless you decide to you your fermentation skills for making beer (which does need some extra equipment, and he offers advice on that—our advice as a health science publication is “don’t drink beer”, though).

    Bottom line: with this in hand, you can create a lot of amazing foods/drinks/condiments that are not only delicious, but also great for gut health.

    Click here to check out Fermenting Everything, and widen your culinary horizons!

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  • PS, We Love You

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    PS, we love you. With good reason!

    There are nearly 20,000 studies on PS listed on PubMed alone, and its established benefits include:

    We’ll explore some of these studies and give an overview of how PS does what it does. Just like the (otherwise unrelated) l-theanine we talked about a couple of weeks ago, it does do a lot of things.

    Speaking of unpronounceable wonder-drugs, do you remember paracetamoxyfrusebendroneomycin? If you haven’t heard of it before, you’re in for a treat, and if you have, well, have a dose on us:

    Show it to a friend who might need it, and pass on the cheer!

    Now, back to more serious things

    PS = Cow Brain?!

    Let’s first address a concern. You may have heard something along the lines of “hey, isn’t PS made from cow brain, and isn’t that Very Bad™ for humans, mad cow disease and all?”. The short answer is:

    Firstly: ingesting cow brain tissue is indeed generally considered Very Bad™ for humans, on account of the potential for transmission of Bovine Spongiform Encephalopathy (BSE) resulting in its human equivalent, Creutzfeldt–Jakob Disease (CJD), whose unpleasantries are beyond the scope of this newsletter.

    Secondly (and more pleasantly): whilst PS can be derived from bovine brain tissue, most PS supplements these days derive from soy—or sometimes sunflower lecithin. Check labels if unsure.

    Using PS to Improve Other Treatments

    In the human body, the question of tolerance brings us a paradox (not the tolerance paradox, important as that may also be): we must build and maintain a strong immune system capable of quickly adapting to new things, and then when we need medicines (or even supplements), we need our body to not build tolerance of them, for them to continue having an effect.

    So, we’re going to look at a very hot-off-the-press study (Feb 2023), that found PS to “mediate oral tolerance”, which means that it helps things (medications, supplements etc.) that we take orally and want to keep working, keep working.

    In the scientists’ own words (we love scientists’ own words because they haven’t been distorted by the popular press)…

    ❝This immunotherapy has been shown to prevent/reduce immune response against life-saving protein-based therapies, food allergens, autoantigens, and the antigenic viral capsid peptide commonly used in gene therapy, suggesting a broad spectrum of potential clinical applications. Given the good safety profile of PS together with the ease of administration, oral tolerance achieved with PS-based nanoparticles has a very promising therapeutic impact.❞

    Nguyen et al, Feb 2023

    In other words, to parse those two very long sentences into two shorter bullet points:

    • It allows a lot of important treatments to continue working—treatments that the body would otherwise counteract
    • It is very safe—and won’t harm the normal function of your immune system at large

    This is also very consistent with one of the benefits we mentioned up top—PS helps avoid rejection of implants, something that can be a huge difference to health-related quality of life (HRQoL), never mind sometimes life itself!

    What is PS Anyways, and How Does It Work?

    Phosphatidylserine is a phospholipid, a kind of lipid, found in cell membranes. More importantly:

    It’s a signalling agent, mainly for apoptosis, which in lay terms means: it tells cells when it’s time to die.

    Cellular death sounds like a bad thing, but prompt and efficient cellular apoptosis (death) and resultant prompt and efficient autophagy (recycling) reduce the risk of your body making mistakes when creating new cells from old cells.

    Think about photocopying:

    • Situation A: You have a document, and you want to copy it. If you copy it before it gets messed up, your copy will look almost, if not exactly, like the original. It’ll be super easy to read.
    • Situation B: You have a document, and you want to copy it, but you delay doing so for so long that the original is all scuffed and creased and has a coffee stain on it. These unwanted changes will get copied onto the new document, and any copy made of that copy will keep the problems too. It gets worse and worse each time.

    So, using this over-simplifier analogy, the speed of ‘copying’ is a major factor in cellular aging. The sooner cells are copied, before something gets damaged, the better the copy will be.

    So you really, really want to have enough PS (our bodies make it too, by the way) to signal promptly to a cell when its time is up.

    You do not want cells soldiering on until they’re the biological equivalent of that crumpled up, coffee-stained sheet of paper.

    Little wonder, then, that PS’ most commonly-sought benefit when it comes to supplementation is to help avoid age-related neurodegeneration (most notably, memory loss)!

    Keeping the cells young means keeping the brain young!

    PS’s role as a signalling agent doesn’t end there—it also has a lot to say to a wide variety of the body’s immunological cells, helping them know what needs to happen to what. Some things should be immediately eaten and recycled; other things need more extreme measures applied to them first, and yet other things need to be ignored, and so forth.

    You can read more about that in Elsevier’s publication if you’re curious 🙂

    Wow, what a ride today’s newsletter has been! We started at paracetamoxyfrusebendroneomycin, and got down to the nitty gritty with a bunch of hopefully digestible science!

    We love feedback, so please let us know if we’re striking the balance right, and/or if you’d like to see more or less of something—there’s a feedback widget at the bottom of this email!

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  • The Sucralose News: Scaremongering Or Serious?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s the news on sucralose?

    These past days the press has been abuzz with frightening tales:

    How true and/or serious is this?

    Firstly, let’s manage expectations. Pineapple juice also breaks down DNA, but is not generally considered a health risk. So let’s keep that in mind, while we look into the science.

    Is sucralose as scary as pineapple juice, or is it something actually dangerous?

    The new study (that sparked off these headlines)

    The much-referenced study is publicly available to read in full—here it is:

    Toxicological and pharmacokinetic properties of sucralose-6-acetate and its parent sucralose: in vitro screening assays

    You may notice that this doesn’t have quite the snappy punchiness of some of the headlines, but let’s break this down, if you’ll pardon the turn of phrase:

    • Toxicological: pertaining to whether or not it has toxic qualities
    • Pharmacokinetic: the science of asking, of chemicals in bodies, “where did it come from; where did it go; what could it do there; what can we know?”
    • Sucralose-6-acetate: an impurity that can be found in sucralose. For perspective, the study found that the sucralose in Splenda contained “up to” 0.67% sucralose-6-acetate.
    • Sucralose: a modified form of sucrose, that makes it hundreds of times sweeter, and non-caloric because the body cannot break it down so it’s treated as a dietary fiber and just passes through
    • In vitro: things are happening in petri dishes, not in animals (human or otherwise), which would be called “in vivo”
    • Screening assays: “we set up a very closed-parameters chemical test, to see what happens when we add this to this” ⇽ oversimplification, but this is the basic format of a screening assay

    Great, now we understand the title, but what about the study?

    Researchers looked primarily at the effects of sucralose-6-acetate and sucralose (together and separately) on epithelial cells (these are very simple cells that are easy to study; conveniently, they are also most of what makes up our intestinal walls). For this, they used a fancy way of replicating human intestinal walls, that’s actually quite fascinating but beyond the scope of today’s newsletter. Suffice it to say: it’s quite good, and/but has its limitations too. They also looked at some in vivo rat studies.

    What they found was…

    Based on samples from the rat feces (somehow this didn’t make it into the headlines), it appears that sucralose may be acetylated in the intestines. What that means is that we, if we are like the rats (definitely not a given, but a reasonable hypothesis), might convert up to 10% of sucralose into sucralose-6-acetate inside us. Iff we do, the next part of the findings become more serious.

    Based on the in vitro simulations, both sucralose and sucralose-6-acetate reduced intestinal barrier integrity at least a little, but sucralose-6-acetate was the kicker when it came to most of the effects—at least, so we (reasonably!) suppose.

    Basically, there’s a lot of supposition going on here but the suppositions are reasonable. That’s how science works; there’s usually little we can know for sure from a single study; it’s when more studies roll in that we start to get a more complete picture.

    What was sucralose-6-acetate found to do? It increased the expression of genes associated with inflammation, oxidative stress, and cancer (granted those three things generally go together). So that’s a “this probably has this end result” supposition.

    More concretely, and which most of the headlines latched onto, it was found (in vitro) to induce cytogenic damage, specifically, of the clastogenic variety (produces DNA strand breaks—so this is different than pineapple’s bromelain and DNA-helicase’s relatively harmless unzipping of genes).

    The dose makes the poison

    So, how much is too much and is that 0.67% something to worry about?

    • Remembering the rat study, it may be more like 10% once our intestines have done their thing. Iff we’re like rats.
    • But, even if it’s only 0.67%, this will still be above the “threshold of toxicological concern for genotoxicity”, of 0.15µg/person/day.
    • On the other hand, the fact that these were in vitro studies is a serious limitation.
    • Sometimes something is very dangerous in vitro, because it’s being put directly onto cells, whereas in vivo we may have mechanisms for dealing with that.

    We won’t know for sure until we get in vivo studies in human subjects, and that may not happen any time soon, if ever, depending on the technical limitations and ethical considerations that sometimes preclude doing certain studies in humans.

    Bottom line:

    • The headlines are written to be scary, but aren’t wrong; their claims are fundamentally true
    • What that means for us as actual humans may not be the same, however; we don’t know yet
    • For now, it is probably reasonable to avoid sucralose just in case

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