Undo It! – by Dr. Dean Ornish & Anne Ornish
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Of course, no lifestyle changes will magically undo Type 1 Diabetes or Cerebral Palsy. But for many chronic diseases, a lot can be done. The question is,how does one book cover them all?
As authors Dr. Dean Ornish and Anne Ornish explain, very many chronic diseases are exacerbated, or outright caused, by the same factors:
- Gene expression
- Inflammation
- Oxidative stress
This goes for chronic disease from heart disease to type 2 diabetes to cancer and many autoimmune diseases.
We cannot change our genes, but we can change our gene expression (the authors explain how). And certainly, we can control inflammation and oxidative stress.
Then first part of the book is given over to dietary considerations. If you’re a regular 10almonds reader, you won’t be too surprised at their recommendations, but you may enjoy the 70 recipes offered.
Attention is also given to exercising in ways optimized to beat chronic disease, and to other lifestyle factors.
Limiting stress is important, but the authors go further when it comes to psychological and sociological factors. Specifically, what matters most to health, when it comes to intimacy and community.
Bottom line: this is a very good guide to a comprehensive lifestyle overhaul, especially if something recently has given you cause to think “oh wow, I should really do more to avoid xyz disease”.
Click here to check out Undo It, and better yet, prevent it in advance!
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Your Brain On (And Off) Estrogen
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This is Dr. Lisa Mosconi. She’s a professor of Neuroscience in Neurology and Radiology, and is one of the 1% most influential scientists of the 21st century. That’s not a random number or an exaggeration; it has to do with citation metrics collated over 20 years:
A standardized citation metrics author database annotated for scientific field
What does she want us to know?
Women’s brains age differently from men’s
This is largely, of course, due to menopause, and as such is a generalization, but it’s a statistically safe generalization, because:
- Most women go through menopause—and most women who don’t, avoid it by dying pre-menopause, so the aging also does not occur in those cases
- Menopause is very rarely treated immediately—not least of all because menopause is diagnosed officially when it has been one year since one’s last period, so there’s almost always a year of “probably” first, and often numerous years, in the case of periods slowing down before stopping
- Menopausal HRT is great, but doesn’t completely negate that menopause occurred—because of the delay in starting HRT, some damage can be done already and can take years to reverse.
Medicated and unmedicated menopause proceed very differently from each other, and this fact has historically caused obfuscation of a lot of research into age-related neurodegeneration.
For example, it is well-established that women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.
Superficially, one might conclude “estrogen is to blame” or maybe “the xx-chromosomal karyotype is to blame”.
The opposite, however, is true with regard to estrogen—estrogen appears to be a protective factor in women’s neurological health, which is why increased neurodegeneration occurs when estrogen levels decline (for example, in menopause).
For a full rundown on this, see:
Alzheimer’s Sex Differences May Not Be What They Appear
It’s not about the extra X
Dr. Mosconi examines this in detail in her book “The XX Brain”. To summarize and oversimplify a little: the XX karyotype by itself makes no difference, or more accurately, the XY karyotype by itself makes no difference (because biologically speaking, female physiological attributes are more “default” than male ones; it is only 12,000ish* years of culture that has flipped the social script on this).
*Why 12,000ish years? It’s because patriarchalism largely began with settled agriculture, for reasons that are fascinating but beyond the scope of this article, which is about health science, not archeology.
The topic of “which is biologically default” is relevant, because the XY karyotype (usually) informs the body “ignore previous instructions about ovaries, and adjust slightly to make them into testes instead”, which in turn (usually) results in a testosterone-driven system instead of an estrogen-driven system. And that is what makes the difference to the brain.
One way we can see that it’s about the hormones not the chromosomes, is in cases of androgen insensitivity syndrome, in which the natal “congratulations, it’s a girl” pronouncement may later be in conflict with the fact it turns out she had XY chromosomes all along, but the androgenic instructions never got delivered successfully, so she popped out with fairly typical female organs. And, relevantly for Dr. Mosconi, a typically female brain that will age in a typically female fashion, because it’s driven by estrogen, regardless of the Y-chromosome.
The good news
The good news from all of this is that while we can’t (with current science, anyway) do much about our chromosomes, we can do plenty about our hormones, and also, the results of changes in same.
Remember, Dr. Mosconi is not an endocrinologist, nor a gynecologist, but a neurologist. As such, she makes the case for how a true interdisciplinary team for treating menopause should not confined to the narrow fields usually associated with “bikini medicine”, but should take into account that a lot of menopause-related changes are neurological in nature.
We recently reviewed another book by Dr. Mosconi:
The Menopause Brain – by Dr. Lisa Mosconi
…and as we noted there, many sources will mention “brain fog” as a symptom of menopause, Dr. Mosconi can (and will) point to a shadowy patch on a brain scan and say “that’s the brain fog, there”.
And so on, for other symptoms that are often dismissed as “all in your head”, as though that’s a perfectly acceptable place for problems to be.
This is critical, because it’s treating real neurological things as the real things they are.
Dr. Mosconi’s advice, beyond HRT
Dr. Mosconi notes that brain health tends to dip during perimenopause but often recovers, showing the brain’s resilience to hormonal shifts. As such, all is not lost if for whatever reason, hormone replacement therapy isn’t a viable option for you.
Estrogen plays a crucial role in brain energy, and women’s declining estrogen levels during menopause increase the need for antioxidants to protect brain health—something not often talked about.
Specifically, Dr. Mosconi tells us, women need more antioxidants and have different metabolic responses to diets compared to men.*
*Yes, even though men usually have negligible estrogen, because their body (and thus brain, being also part of their body) is running on testosterone instead, which is something that will only happen if either you are producing normal male amounts of testosterone (requires normal male testes) or you are taking normal male amounts of testosterone (requires big bottles of testosterone; this isn’t the kind of thing you can get from a low dose of testogel as sometimes prescribed as part of menopausal HRT to perk your metabolism up).
Note: despite women being a slight majority on Earth, and despite an aging population in wealthy nations, meaning “a perimenopausal woman” is thus the statistically average person in, for example, the US, and despite the biological primacy of femaleness… Medicine still mostly looks to men as the “default person”, which in this case can result in seriously low-balled estimates of what antioxidants are needed.
In terms of supplements, therefore, she recommends:
- Antioxidants: key for brain health, especially in women. Rich sources include fruits (especially berries) and vegetables. Then there’s the world’s most-consumed antioxidant, which is…
- Coffee: Italian-style espresso has the highest antioxidant power. Adding a bit of fat (e.g. oat milk) helps release caffeine more slowly, reducing jitters. Taking it alongside l-theanine also “flattens the curve” and thus improves its overall benefits.
- Flavonoids: important for both men and women but particularly essential for women. Found in many fruits and vegetables.
- Chocolate: dark chocolate is an excellent source of antioxidants and flavonoids!
- Turmeric: a natural neuroprotectant with anti-inflammatory properties, best boosted by taking with black pepper, which improves absorption as well as having many great qualities of its own.
- B Vitamins: B6, B9, and B12 are essential for anti-aging and brain health; deficiency in B6 is rare, while deficiency in B9 (folate) and especially B12 is very common later in life.
- Vitamins C & E: important antioxidants, but caution is needed with fat-soluble vitamins to avoid toxicity.
- Omega-3s: important for brain health; can be consumed in the diet, but supplements may be necessary.
- Caution with zinc: zinc can support immunity and endocrine health (and thus, indirectly, brain health) but may be harmful in excess, particularly for brain health.
- Probiotics & Prebiotics: beneficial for gut health, and in Dr. Mosconi’s opinion, hard to get sufficient amounts from diet alone.
For more pointers, you might want to check out the MIND diet, that is to say, the “Mediterranean-DASH Intervention for Neurodegenerative Delay” upgrade to make the Mediterranean diet even brain-healthier than it is by default:
Four Ways To Upgrade The Mediterranean Diet
Want to know more from Dr. Mosconi?
Here’s her TED talk:
Click Here If The Embedded Video Doesn’t Load Automatically!
Enjoy!
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All In Your Head (Which Is Where It’s Supposed To Be)
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Today’s news is all about things above the neck, and mostly in the brain. From beating depression to beating cognitive decline, from mindfulness against pain to dentistry nightmares to avoid:
Transcranial ultrasound stimulation
Transcranial magnetic stimulation is one of those treatments that sounds like it’s out of a 1950s sci-fi novel, and yet, it actually works (it’s very well-evidenced against treatment-resistant depression, amongst other things). However, a weakness of it is that it’s difficult to target precisely, making modulation of most neurological disorders impossible. Using ultrasound instead of a magnetic field allows for much more finesse, with very promising initial results across a range of neurological disorders
Read in full: Transcranial ultrasound stimulation: a new frontier in non-invasive brain therapy
Related: Antidepressants: Personalization Is Key!
This may cause more pain and damage, but at least it’s more expensive too…
While socialized healthcare systems sometimes run into the problem of not wanting to spend money where it actually is needed, private healthcare systems have the opposite problem: there’s a profit incentive to upsell to more expensive treatments. Here’s how that’s played out in dentistry:
Read in full: Dentists are pulling healthy and treatable teeth to profit from implants, experts warn
Related: Tooth Remineralization: How To Heal Your Teeth Naturally
Mindfulness vs placebo, for pain
It can be difficult with some “alternative therapies” to test against placebo, for example “and control group B will merely believe that they are being pierced with needles”, etc. However, in this case, mindfulness meditation was tested as an analgesic vs sham meditation (just deep breathing) and also vs placebo analgesic cream, vs distraction (listening to an audiobook). Mindfulness meditation beat all of the other things:
Read in full: Mindfulness meditation outperforms placebo in reducing pain
Related: No-Frills, Evidence-Based Mindfulness
Getting personal with AI doctors
One of the common reasons that people reject AI doctors is the “lack of a human touch”. However, human and AI doctors may be meeting in the middle nowadays, as humans are pressed to see more patients in less time, and AI is trained to be more personal—not just a friendlier affect, but also, such things as remembering the patient’s previous encounters (again, something with which overworked human doctors sometimes struggle). This makes a big difference to patient satisfaction:
Read in full: Personalization key to patient satisfaction with AI doctors
Related: AI: The Doctor That Never Tires?
Combination brain therapy against cognitive decline
This study found that out of various combinations trialled, the best intervention against cognitive decline was a combination of 1) cognitive remediation (therapeutic interventions designed to improve cognitive functioning, like puzzles and logic problems), and 2) transcranial direct current stimulation (tDCS), a form of non-invasive direct brain stimulation, similar to the magnetic or ultrasound methods we mentioned earlier today. Here’s how it worked:
Read in full: Study reveals effective combination therapy to slow cognitive decline in older adults
Related: How To Reduce Your Alzheimer’s Risk
Take care!
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Carrots vs Parsnips – Which is Healthier?
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Our Verdict
When comparing carrots to parsnips, we picked the parsnips.
Why?
There are arguments for both! But we say parsnips win on overall nutritional density.
In terms of macros, parsnips vary quite a lot from region to another, but broadly speaking, parsnips have more carbs and fiber, and/but the ratios are such that carrots have the lower glycemic index. We’ll call this one a win for carrots.
When it comes to vitamins, carrots have more of vitamins A, B2, B3, B6, and choline, while parsnips have more of vitamins B1, B5, B9, C, E, and K. A small win for parsnips here.
In the category of minerals, carrots are not higher in any minerals, while parsnips are higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. An overwhelming win for parsnips.
While the overall vitamin and mineral content puts parsnips ahead, it’s still worth noting that carrots have highly bioavailable megadoses of vitamin A.
Another thing to note is that the glycemic index recorded for both is when peeled and boiled, whereas both of these root vegetables can be enjoyed raw if you wish, which has a much lower GI.
In short, enjoy either or both, but parsnips are the more nutritionally dense overall.
Want to learn more?
You might like to read:
Glycemic Index vs Glycemic Load vs Insulin Index
Take care!
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What you need to know about endometriosis
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Endometriosis affects one in 10 people with a uterus who are of reproductive age. This condition occurs when tissue similar to the endometrium—the inner lining of the uterus—grows on organs outside of the uterus, causing severe pain that impacts patients’ quality of life.
Read on to learn more about endometriosis: What it is, how it’s diagnosed and treated, where patients can find support, and more.
What is endometriosis, and what areas of the body can it affect?
The endometrium is the tissue that lines the inside of the uterus and sheds during each menstrual cycle. Endometriosis occurs when endometrial-like tissue grows outside of the uterus.
This tissue can typically grow in the pelvic region and may affect the outside of the uterus, fallopian tubes, ovaries, vagina, bladder, intestines, and rectum. It has also been observed outside of the pelvis on the lungs, spleen, liver, and brain.
What are the symptoms?
Symptoms may include pelvic pain and cramping before or during menstrual periods, heavy menstrual bleeding, bleeding or spotting between periods, pain with bowel movements or urination, pain during or after sex or orgasm, fatigue, nausea, bloating, and infertility.
The pain associated with this condition has been linked to depression, anxiety, and eating disorders. A meta-analysis published in 2019 found that more than two-thirds of patients with endometriosis report psychological stress due to their symptoms.
Who is at risk?
Endometriosis most commonly occurs in people with a uterus between the ages of 25 and 40, but it can also affect pre-pubescent and post-menopausal people. In rare cases, it has been documented in cisgender men.
Scientists still don’t know what causes the endometrial-like tissue to grow, but research shows that people with a family history of endometriosis are at a higher risk of developing the condition. Other risk factors include early menstruation, short menstrual cycles, high estrogen, low body mass, and starting menopause at an older age.
There is no known way to prevent endometriosis.
How does endometriosis affect fertility?
Up to 50 percent of people with endometriosis may struggle to get pregnant. Adhesions and scarring on the fallopian tubes and ovaries as well as changes in hormones and egg quality can contribute to infertility.
Additionally, when patients with this condition are able to conceive, they may face an increased risk of pregnancy complications and adverse pregnancy outcomes.
Treating endometriosis, taking fertility medications, and using assistive reproductive technology like in vitro fertilization can improve fertility outcomes.
How is endometriosis diagnosed, and what challenges do patients face when seeking a diagnosis?
A doctor may perform a pelvic exam and request an ultrasound or MRI. These exams and tests help identify cysts or other unusual tissue that may indicate endometriosis.
Endometriosis can only be confirmed through a surgical laparoscopy (although less-invasive diagnostic tests are currently in development). During the procedure, a surgeon makes a small cut in the patient’s abdomen and inserts a thin scope to check for endometrial-like tissue outside of the uterus. The surgeon may take a biopsy, or a small sample, and send it to a lab.
It takes an average of 10 years for patients to be properly diagnosed with endometriosis. A 2023 U.K. study found that stigma around menstrual health, the normalization of menstrual pain, and a lack of medical training about the condition contribute to delayed diagnoses. Patients also report that health care providers dismiss their pain and attribute their symptoms to psychological factors.
Additionally, endometriosis has typically been studied among white, cisgender populations. Data on the prevalence of endometriosis among people of color and transgender people is limited, so patients in those communities face additional barriers to care.
What treatment options are available?
Treatment for endometriosis depends on its severity. Management options include:
- Over-the-counter pain medication to alleviate pelvic pain
- Hormonal birth control to facilitate lighter, less painful periods
- Hormonal medications such as gonadotropin-releasing hormone (GnRH) or danazol, which stop the production of hormones that cause menstruation
- Progestin therapy, which may stop the growth of endometriosis tissue
- Aromatase inhibitors, which reduce estrogen
In some cases, a doctor may perform a laparoscopic surgery to remove endometrial-like tissue.
Depending on the severity of the patient’s symptoms and scar tissue, some doctors may also recommend a hysterectomy, or the removal of the uterus, to alleviate symptoms. Doctors may also recommend removing the patient’s ovaries, inducing early menopause to potentially improve pain.
Where can people living with endometriosis find support?
Given the documented mental health impacts of endometriosis, patients with this condition may benefit from therapy, as well as support from others living with the same symptoms. Some peer support organizations include:
- Endometriosis Coalition Patient Support Group (virtual)
- MyEndometriosisTeam (virtual)
- Endo Black, Inc. (Washington, D.C.)
- endoQueer (virtual)
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Which Plant Milk?
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Plant-based milks—what’s best?
You asked us to look at some popular plant milks and their health properties, and we said we’d do a main feature, so here it is!
We’ll also give a quick nod to environmental considerations at the end too (they might not be quite what you expect!). That said, as a health and productivity newsletter, we’ll be focusing on the health benefits.
While we can give a broad overview, please note that individual brands may vary, especially in two important ways:
- Pro: many (most?) brands of plant milks fortify their products with extra vitamins and minerals, especially vitamin D and calcium.
- Con: some brands also add sugar.
So, by all means use this guide to learn about the different plants’ properties, and/but still do check labels later.
Alternatively, consider making your own!
- Pros: no added sugar + cheaper
- Cons: no added vitamins and minerals + some equipment required
Almond milk
Almond milk is low in carbs and thus good for a carb-controlled diet. It’s also high in vitamin E and a collection of minerals.
Oat milk
Oats are one of the healthiest “staple foods” around, and while drinking oat milk doesn’t convey all the benefits, it does a lot. It also has one of the highest soluble fiber contents of any milk, which is good for reducing LDL (bad) cholesterol levels.
See for example: Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia
Coconut milk
Coconut has a higher fat content than most plant milks, but also contains medium-chain triglycerides (MCTs). These raise HDL (good) cholesterol levels.
Read the study: How well do plant based alternatives fare nutritionally compared to cow’s milk?
Hemp milk
Being made from hemp seeds that contain a lot of protein and healthy fats (including omega-3 and omega-6), hemp milk packs a nutritious punch. It’s carb-free. It’s also THC-free, in case you were wondering, which means no, it does not have psychoactive effects.
Pea milk
It’s very high in protein, and contains an array of vitamins and minerals. It’s not very popular yet, so there isn’t as much research about it. This 2021 study found that it had the nutritional profile the closest to cow’s milk (beating soy by a narrow margin) and praised it as a good alternative for those with a soy allergy.
This is Research Review Monday so we try to stick to pure science, but for your interest… here’s an interesting pop-science article (ostensibly in affiliation with the pea milk brand, Ripple) about the nutritional qualities of their pea milk specifically, which uses particularly nutrient-dense yellow peas, plus some extra vitamin and mineral fortifications:
Read: Ripple Milk: 6 Reasons Why You Should Try Pea Milk
Soy milk
Perhaps the most popular plant milk, and certainly usually the cheapest in stores. It’s high in protein, similar to cow’s milk. In fact, nutritionally, it’s one of the closest to cow’s milk without involving cows as a middleman. (Did you know three quarters of all soy in the world is grown to feed to livestock, not humans? Now you do).
And no, gentlemen-readers, it won’t have any feminizing effects. The human body can’t use the plant estrogens in soy for that. It does give some isoflavone benefits though, which are broadly good for everyone’s health. See for example this research review with 439 sources of its own:
Read: Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature
Quick note on flavor: nut milks have the flavor of the nut they were made from. Coconut milk tastes of coconut. The other milks listed above don’t have much of a flavor—which in many cases may be what you want.
Note on environmental considerations:
A lot of us try to be as socially responsible as reasonably possible in our choices, so this may be an influencing factor. In a nutshell:
- Oats and Soy are generally grown as vast monocrops, and these are bad for the environment
- They are still better for the environment than cow’s milk though, as for example most soy is grown to feed to cows, not humans. So including cows in the process means four times as much monocrop farming, plus adds several other environmental issues that are beyond the scope of this newsletter.
- Almonds are particularly resource-intensive when it comes to water use.
- Still nowhere near as much as cows, though.
- Peas are grown in places that naturally have very high rainfall, so are a good option here. Same generally goes for rice, which didn’t make the cut today. (Nor did hazelnuts, sorry—we can only include so much!)
- Hemp is by far and away the most environmentally friendly, assuming it is grown in a climate naturally conducive to such.
- Making plant milk at home is usually most environmentally friendly, depending on where your ingredients came from.
- Literally any plant milk is much more environmentally friendly than cow’s milk.
See the science for yourself: Reducing food’s environmental impacts through producers and consumers
See also (if you like graphs and charts): Environmental footprints of dairy and plant-based milks
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Vitamin C (Drinkable) vs Vitamin C (Chewable) – Which is Healthier?
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Our Verdict
When comparing vitamin C (drinkable) to vitamin C (chewable), we picked the drinkable.
Why?
First let’s look at what’s more or less the same in each:
- The usable vitamin C content is comparable
- The bioavailability is comparable
- The additives to hold it together are comparable
So what’s the difference?
With the drinkable, you also drink a glass of water
If you’d like to read more about how to get the most out of the vitamins you take, you can do so here:
Are You Wasting Your Vitamins? Maybe, But You Don’t Have To
If you’d like to get some of the drinkable vitamin C, here’s an example product on Amazon
Enjoy!
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