Understanding and Responding to Self-Harm – by Dr. Allan House
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Whether it’s yourself, or (statistically much more likely) a loved one, it’s common to be faced with the deeply unpleasant reality of self-harm. This is a case where most definitely, “forewarned is forearmed”.
Dr. House covers not just the “what” and “why” of self-harm, but also the differences between suicidal and non-suicidal self-harm, as well as the impulsive and the planned.
Stylistically, the book is well-written, well-edited, and well-formatted. All this makes for easy reading and efficient learning.
Much of the book is, of course, given over to how to help in cases of self-harm. More specifically: how to approach things with both seriousness and compassion, and how to help in a way that doesn’t create undue pressure.
Because, as Dr. House explains and illustrates, a lot of well-meaning people end up causing more harm, by their botched attempts to help.
This book looks to avoid such tragedies.
Bottom line: if you’d rather know these things now, instead of wishing you’d known later, then this book is the one-stop guide it claims to be.
Click here to check out Understanding and Responding to Self-Harm, and be prepared!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, so:
Take care!
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Menopause, & When Not To Let Your Guard Down
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This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.
She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?
Untreated menopause is more serious than most people think
Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:
What Menopause Does To The Heart
…and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:
Alzheimer’s Sex Differences May Not Be What They Appear
Treated menopause is safer than many people think
The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.
The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).
It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.
In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).
However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.
You can read more about HRT and breast cancer risk (increases and decreases) here:
…and about the same with regard to HMT, here:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Lifestyle matters, and continues to matter
Menopause often receives the following attention from people:
- Perimenopause: “Is this menopause?”
- Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
- Postmenopause: “Yay, that’s behind me now, back to the new normal”
The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.
This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.
So, you can’t let your guard down!
Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.
Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.
See also: Resistance Is Useful! (Especially As We Get Older)
And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!
Want to know more from Dr. Shepherd?
You might like this book of hers that we reviewed not long back:
Generation M – by Dr. Jessica Shepherd
Take care!
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How To Stay A Step Ahead Of Peripheral Artery Disease
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Far less well-known than Coronary Artery Disease, it can still result in loss of life and limb (not in that order). Fortunately, there are ways to be on your guard:
What it is
Peripheral Artery Disease (PAD) is the same thing as Coronary Artery Disease (CAD), just, in the periphery—which by definition means “outside of the heart and brain”, but in practice, it starts with the extremities. And of the extremities, it tends to start with the feet and legs, for the simple reason that if someone’s circulation is sluggish, then because of gravity, that’s where’s going to get blocked first.
In both CAD and PAD, the usual root cause is atherosclerosis, that is to say, the build-up of fatty material inside the arteries, usually commensurate to LDL (“bad”) cholesterol, especially in men (high LDL is still a predictor of cardiovascular disease in women though, just more modestly so, at least pre-menopause or in cases of treated menopause whereby HRT has returned hormones to pre-menopause levels).
See also: Demystifying Cholesterol
And for that about sex differences: His & Hers: The Hidden Complexities of Statins and Cardiovascular Disease (CVD)
Why it is
This one’s straightforward, as it’s the same things as any kind of cardiovascular disease: high blood pressure, high cholesterol, older age, obesity, smoking, drinking, diabetes, and genetic factors (so, a risk factor is: family history of heart disease).
However, while those are the main causes and/or risk factors, it absolutely can still strike other people, so it’s as well to be watch out for…
What to look out for
Many people first notice signs and symptoms that turn out to be PAD when they experience pain or numbness in the foot or feet, and/or a discoloration of the feet (especially toes), and slow wound healing.
At that stage, chances are you will need to go urgently to a specialist, and surgery is a likely necessity. With a little luck, it’ll be a minimally-invasive surgery to unblock an artery; failing that, an amputation will be in order.
At that stage, under 50% will be alive 5 years from diagnosis:
You probably want to avoid those. Good news is, you can, by catching it earlier!
What to look out for before that
The most common test for PAD is one you can do at home, but enlisting a nurse to do it for you will help ensure accurate readings. It’s called the Ankle-Brachial Index (ABI) test, and it involves comparing the blood pressure in your ankle with the blood pressure in your arm, and expressing them as a ratio.
Here’s how to do it (instructions and a video demonstration if you want it):
Do Try This At Home: ABI Test For Clogged Arteries
If you need a blood pressure monitor, by the way, here’s an example product on Amazon.
- A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
- Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
- High ABI scores (above 1.4) may indicate artery hardening
Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy.
For this reason, this test can be used to raise the alarm, but not to give the “all clear”.
There are other tests that clinicians can do for you, but you can’t do at home unless you have an MRI machine, a CT scanner, an x-ray machine, a doppler-and-ultrasound machine, etc. We’ll not go into those in detail here, but ask your doctor about them if you’re concerned.
What to do about it
In the mid-to-late stages of the disease, the options are medication and surgery, respectively, but your doctor will advise about those in that eventuality.
In the early stages of the disease, the first-line recommend treatment is exercise, of which, especially walking:
Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment
Given that this more often happens when someone hasn’t been walking so much, it can be a walk-rest-walk approach at first (a treadmill on a low setting can be very useful for this):
See also: Exercise Comparison Head-to-Head: Treadmill vs Road
Take care!
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Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
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The Vegan Instant Pot Cookbook – by Nisha Vora
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We all know that we should “eat the rainbow” (and that no, Skittles do not count)… So why do we often find ourselves falling into the same familiar habits and well-worn comfort foods?
Nisha Vora, of “Rainbow Plant Life“, is here to make things a lot easier—brightening up our plates is her mission!
In this Instant Pot-authorized, beautifully illustrated cookbook, Vora offers us 90 recipes to do just that. And because it’s an Instant Pot cookbook, they’re all super easy.
What if you don’t have an Instant Pot? Well, don’t tell Instant Pot we said this, but another pressure cooker brand will work too. And if you don’t have any pressure cooker, the recipes are modifiable for regular pots and pans. The recipes also lend themselves well to slow-cooker cooking, for that matter!
Where Vora really excels though is in making mostly-one-pot dishes beautiful and tasty.
The recipes, by the way, are drawn from cuisines from all around the world, and cover:
- summer and winter dishes
- breakfasts, sides, mains, desserts
- the healthy and the decadent (and sometimes both!)
As for the presentation of each recipe, we get at least one full-page photo of the finished dish and sometimes extras of the steps. We get a little intro, the usual information about ingredients etc, and a no-fuss step-by-step method. It’s very easy to use.
If you have allergies or other dietary considerations, this book is pretty mindful of those, making substitutions minimal and easy.
Bottom line: this comprehensive book will seriously brighten up the colors of your cooking!
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Testosterone, Tourette’s, and Tickly Throats
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝Could you do a series on mens health? Testosterone boosters. Libido? What works what doesnt? Also could you discuss prostate health and what supplements, meds, foods or protocols work to relieve symptoms of bph❞
We could indeed! We’ll be sure to write more, but while you’re waiting, you might like to read our main feature from a while back:
Too Much Or Too Little Testosterone?
…as it does include a lot about the use of a supplement that helps against Benign Prostatic Hyperplasia, with performance comparable to the most common drug prescribed for such.
And since (like that drug) it’s a 5α-reductase inhibitor (meaning it works by blocking the conversion of testosterone to DHT), this means it helps against prostate problems (and also, incidentally, male pattern hair loss) without reducing overall testosterone levels. In fact, because less testosterone will be converted to DHT, you’ll actually (all other things being equal) end up with slightly higher free testosterone levels.
❝My BMI is fine, but my waist is too big. What do I do about that? I am 5′ 5″ tall and 128 pounds and 72 years old.❞
It’s hard to say without knowing about your lifestyle (and hormones, for that matter)! But, extra weight around the middle in particular is often correlated with high levels of cortisol, so you might find this of benefit:
Lower Your Cortisol! (Here’s Why & How)
❝Is there anything special that might help someone with Tourette’s syndrome?❞
There are of course a lot of different manifestations of Tourette’s syndrome, and some people’s tics may be far more problematic to themselves and/or others, while some may be quite mild and just something to work around.
It’s an interesting topic for sure, so we’ll perhaps do a main feature (probably also covering the related-and-sometimes-overlapping OCD umbrella rather than making it hyperspecific to Tourette’s), but meanwhile, you might consider some of these options:
- Deep Brain Stimulation (DBS)
- Medications/ Pharmacology
- Comprehensive Behavioral Intervention for Tics (CBIT)
- Speech Therapies
❝Natural solutions for osteoarthritis. Eg. Rosehip tea, dandelion root tea. Any others??? What foods should I absolutely leave alone?❞
We’ll do a main feature on arthritis (in both its main forms) someday soon, but meanwhile, we recommend eating for good bone/joint health and against inflammation. To that end, you might like these main features we did on those topics:
- We Are Such Stuff As Fish Are Made Of (collagen for bone and joint health)
- The Bare-Bones Truth About Osteoporosis (eating for bone health generally)
- Keep Inflammation At Bay (dietary tips for minimizing inflammation—also, our all-time most popular article to date!)
Of these, probably the last one is the most critical, and also will have the speediest effects if implemented.
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Learn to Age Gracefully
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