Vaginal Probiotics: What Does The Science Say?
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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 😎
❝Is there any merit to vaginal probiotics?❞
What a fun question! First let’s break it down, as this could mean two different things:
- Probiotics, which you consume, using your mouth, which are marketed as benefiting vaginal health
- Probiotics taken as a vaginal pessary/suppository, to act directly there
The former has limited evidence for it, but generally speaking, improving one’s gut health improves all other areas of health, so it’s not surprising if it helps this too.
See for example:
Some notes:
- candidal vaginitis means a yeast infection causing vaginal inflammation
- bacterial vaginosis means a vaginal bacterial imbalance (generally also featuring vaginal inflammation, though it can be asymptomatic)
In the latter case, the “imbalance” in question is usually a shortage of Lactobacillus sp. (that is to say, the diverse species of the Lactobacillus genus) resulting in an overgrowth of other kinds of bacteria, which in turn results in changing the vaginal microbiome to make it warmer and more acidic than it should be.
While a healthy vagina shouldn’t smell of roses, it shouldn’t smell fishy either; if it does, that’s a sign of bacterial vaginosis.
What it’s supposed to be like: slightly bitter, slightly salty, distinctly umami, along with a cocktail of personal pheromones (and if menstruating or otherwise* vaginally bleeding, then of course add: iron/”metallic”). The pheromones will also reflect any hormonal changes, but should never make anything smell bad, just different.
*e.g. due to PCOS, fibroids, etc. Note that in the case of PCOS, it may also smell a little different (if it does, then usually: a little more musky), due to often different hormone levels. Again: it still shouldn’t smell bad, though, just different.
In the above-linked study, taking more live Lactobacillus acidophilus (in yogurt, eating it, with their mouths) improved levels of L. acidophilus in the vagina. While the study authors concluded “this ingestion of yogurt may have reduced episodes of bacterial vaginosis”, which is rather a weak claim, it can be argued that it merely improving the levels of L. acidophilus in the vagina was already a win.
That was a small (n=42, and only 7 followed through to completion) and old (1996) study, and it bears mentioning that most of the studies into this seem to be small and old, but conclude similarly with weakly positive statements.
However, it does make a difference what kind of Lactobacillus is used, for example in this next study…
- L. fermentum RC-14 worked well (90% success rate)
- L. rhamnosus GR-1 worked somewhat (40% success rate)
- L. rhamnosus GG did not work (0% success rate)
So, diversity is key, and getting a wide range of Lactobacillus sp. seems to be a safe bet.
Short version: enjoying probiotics as part of your diet probably improves vaginal health, just like it improves pretty much everything else.
See also: Make Friends With Your Gut (You Can Thank Us Later)
You would think that this would mean that taking probiotics as a vaginal pessary/suppository would be even better, but the results are weaker, as in this study, which produced temporary improvements in about half the study group, with only 3 out of 28 being free of bacterial vaginosis the next month:
Treatment of bacterial vaginosis with lactobacilli
This study got better results, with a 61% success rate:
Important note
Do note that this last category, involving topical treatments (i.e., manually introducing Lactobacillus sp. to the vagina) were all in cases of pre-existing bacterial vaginosis, not as a prophylactic and/or general health-improving thing.
If your vagina seems happy right now, then do not mess with its happy bacterial balance!
And at all times (regardless of whether it seems happy right now or not): do not douche (it does not need it and will not benefit from it; the vagina is self-cleaning*) as this will wash out many of your Lactobacilli and will do absolutely nothing against any Candida there (C. albicans being a rooted fungus, whereas Lactobacillus is a sausage-shaped bacterium with many tiny appendages but no actual ability to stay put), so Candida will flourish in the Lactobacillus’s absence.
*by the vagina, we are referring to the vaginal canal. The vulva—the outside part consisting of the two pairs of labia, the glans clitoris, and clitoral hood—are not self-cleaning, and should just be washed gently per your normal bath/shower routine; that’s perfectly fine and good.
And definitely don’t put any “cleansing” toiletries inside the vagina (or any toiletries at all, for that matter), even if they are sold and marketed for that purpose; they will not help and they will harm.
Also, due to their neighborliness, messing up the microbiome inside the vagina is a common way to also get Candida inside the urethra:
How To Avoid Urinary Tract Infections (UTIs)
One other option
Finally, unless you have a “very good friend” you have a pressing urge to swap germs with, you might want to leave this one to the scientists, but we share this paper just for interest:
Lastly…
Going back to oral supplementation, if you’d like to try that then check out this for further notes on what, why, how, etc:
How Much Difference Do Probiotic Supplements Make To Health?
Take care!
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Live Life in Crescendo – by Stephen Covey and Cynthia Covey-Haller
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Stephen Covey is of course best known for his “7 Habits of Highly Effective People“, while the dozen books he wrote afterwards, not including this one, did not get the same acclaim.
Not including this one, because this one was published posthumously and, notwithstanding the order of the names on the cover, in all likelihood his daughter wrote most of.
And yet! The very spirit of this book is in defiance of 7 Habits being his “early career” magnum opus. We say “early career”, because he was 57 already when that was published, but it was one of his earlier books.
In this work the authors lay out the case for how “your most important work is always ahead of you“, and that it is perfectly possible to “live life in crescendo“, and keep on giving whatever it is that we want to give to the world.
We also learn, mostly through storytelling, of how people are infinitely more important than things, and that it is there that we should put our investments. And that while adversity may not make us stronger, it just means we may need to change our approach, to continue to be productive in whatever way is meaningful to us.
Bottom line: if ever you wonder how your future could live up to your past (in a good way), this is the book to get you thinking.
Click here to check out Live Life in Crescendo, and figure out what your next great work will be!
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Gluten: What’s The Truth?
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Gluten: What’s The Truth?
We asked you for your health-related view of gluten, and got the above spread of results. To put it simply:
Around 60% of voters voted for “Gluten is bad if you have an allergy/sensitivity; otherwise fine”
The rest of the votes were split fairly evenly between the other three options:
- Gluten is bad for everyone and we should avoid it
- Gluten is bad if (and only if) you have Celiac disease
- Gluten is fine for all, and going gluten-free is a modern fad
First, let’s define some terms so that we’re all on the same page:
What is gluten?
Gluten is a category of protein found in wheat, barley, rye, and triticale. As such, it’s not one single compound, but a little umbrella of similar compounds. However, for the sake of not making this article many times longer, we’re going to refer to “gluten” without further specification.
What is Celiac disease?
Celiac disease is an autoimmune disease. Like many autoimmune diseases, we don’t know for sure how/why it occurs, but a combination of genetic and environmental factors have been strongly implicated, with the latter putatively including overexposure to gluten.
It affects about 1% of the world’s population, and people with Celiac disease will tend to respond adversely to gluten, notably by inflammation of the small intestine and destruction of enterocytes (the cells that line the wall of the small intestine). This in turn causes all sorts of other problems, beyond the scope of today’s main feature, but suffice it to say, it’s not pleasant.
What is an allergy/intolerance/sensitivity?
This may seem basic, but a lot of people conflate allergy/intolerance/sensitivity, so:
- An allergy is when the body mistakes a harmless substance for something harmful, and responds inappropriately. This can be mild (e.g. allergic rhinitis, hayfever) or severe (e.g. peanut allergy), and as such, responses can vary from “sniffly nose” to “anaphylactic shock and death”.
- In the case of a wheat allergy (for example), this is usually somewhere between the two, and can for example cause breathing problems after ingesting wheat or inhaling wheat flour.
- An intolerance is when the body fails to correctly process something it should be able to process, and just ejects it half-processed instead.
- A common and easily demonstrable example is lactose intolerance. There isn’t a well-defined analog for gluten, but gluten intolerance is nonetheless a well-reported thing.
- A sensitivity is when none of the above apply, but the body nevertheless experiences unpleasant symptoms after exposure to a substance that should normally be safe.
- In the case of gluten, this is referred to as non-Celiac gluten sensitivity
A word on scientific objectivity: at 10almonds we try to report science as objectively as possible. Sometimes people have strong feelings on a topic, especially if it is polarizing.
Sometimes people with a certain condition feel constantly disbelieved and mocked; sometimes people without a certain condition think others are imagining problems for themselves where there are none.
We can’t diagnose anyone or validate either side of that, but what we can do is report the facts as objectively as science can lay them out.
Gluten is fine for all, and going gluten-free is a modern fad: True or False?
Definitely False, Celiac disease is a real autoimmune disease that cannot be faked, and allergies are also a real thing that people can have, and again can be validated in studies. Even intolerances have scientifically measurable symptoms and can be tested against nocebo.
See for example:
- Epidemiology and clinical presentations of Celiac disease
- Severe forms of food allergy that can precipitate allergic emergencies
- Properties of gluten intolerance: gluten structure, evolution, and pathogenicity
However! It may not be a modern fad, so much as a modern genuine increase in incidence.
Widespread varieties of wheat today contain a lot more gluten than wheat of ages past, and many other molecular changes mean there are other compounds in modern grains that never even existed before.
However, the health-related impact of these (novel proteins and carbohydrates) is currently still speculative, and we are not in the business of speculating, so we’ll leave that as a “this hasn’t been studied enough to comment yet but we recognize it could potentially be a thing” factor.
Gluten is bad if (and only if) you have Celiac disease: True or False?
Definitely False; allergies for example are well-evidenced as real; same facts as we discussed/linked just above.
Gluten is bad for everyone and we should avoid it: True or False?
False, tentatively and contingently.
First, as established, there are people with clinically-evidenced Celiac disease, wheat allergy, or similar. Obviously, they should avoid triggering those diseases.
What about the rest of us, and what about those who have non-Celiac gluten sensitivity?
Clinical testing has found that of those reporting non-Celiac gluten sensitivity, nocebo-controlled studies validate that diagnosis in only a minority of cases.
In the following study, for example, only 16% of those reporting symptoms showed them in the trials, and 40% of those also showed a nocebo response (i.e., like placebo, but a bad rather than good effect):
This one, on the other hand, found that positive validations of diagnoses were found to be between 7% and 77%, depending on the trial, with an average of 30%:
Re-challenge Studies in Non-celiac Gluten Sensitivity: A Systematic Review and Meta-Analysis
In other words: non-Celiac gluten sensitivity is a thing, and/but may be over-reported, and/but may be in some part exacerbated by psychosomatic effect.
Note: psychosomatic effect does not mean “imagining it” or “all in your head”. Indeed, the “soma” part of the word “psychosomatic” has to do with its measurable effect on the rest of the body.
For example, while pain can’t be easily objectively measured, other things, like inflammation, definitely can.
As for everyone else? If you’re enjoying your wheat (or similar) products, it’s well-established that they should be wholegrain for the best health impact (fiber, a positive for your health, rather than white flour’s super-fast metabolites padding the liver and causing metabolic problems).
Wheat itself may have other problems, for example FODMAPs, amylase trypsin inhibitors, and wheat germ agglutinins, but that’s “a wheat thing” rather than “a gluten thing”.
That’s beyond the scope of today’s main feature, but you might want to check out today’s featured book!
For a final scientific opinion on this last one, though, here’s what a respected academic journal of gastroenterology has to say:
From coeliac disease to noncoeliac gluten sensitivity; should everyone be gluten-free?
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How To April Fool Yourself Into Having A Nutrient-Dense Diet!
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These nutrient-dense foods pack such a punch you only need a bit added to your meal…
- “Have 5 servings of fruit per day”—popular wisdom in the West
- “Have 7 servings of fruit per day!”—generally held as the norm in Japan
- “Have these 12 things that are mostly fruit & veg & nuts each day”—Dr. Greger’s Daily Dozen
- “Does the pickle that comes with a burger count?”—an indication of how much many people struggle.
For what it’s worth: pickles are a good source of some minerals (and some healthy gut bacteria too), but are generally too high in sodium to be healthy for most people beyond in the most modest moderation.
But! It can be a lot easier, and without sitting down to a salad buffet every day!
Here are some sneaky tips:
(call it our nod to April Fool’s Day, because tricking yourself into eating more healthily is a top-tier prank)
Beyond soups and smoothies
Soups and smoothies are great, because we can take a lot of nutrients that way without actually oing much eating. And if we’ve a want or need to hide something, blending it does a fine job. However, we’re confident you already know how to make soups and smoothies. So…
Sauces are another excellent place to put nutrients—and as a bonus, homemade sauces will mean skipping on the store-bought sauces whose ingredients all-too-often look something like “sugar, water, spirit vinegar, glucose-fructose syrup, modified maize starch, maltodextrin, salt…”
Top things to use as a main base ingredient in sauces:
- Tomato purée—so much lycopene, and great vitamins too! Modest flavour, but obviously only sensible for what you intend to be a tomato-based sauce. Use it to make anything from marinara sauce to ketchup, sweet-and-sour to smoky barbecue.
- Lentils/beans—if unsure, red lentils or haricot beans have a very mild taste, and edamame beans are almost not-there, flavor-wise. But cooked and blended smooth, these are high-protein, iron-rich, flavonoid-heavy, and a good source of fiber too. Can be used as the base of so many savory creamy sauces!
- Corn—that yellow color? It’s all the lutein. Home-made creamed corn goes great as a dipping sauce! Added spices optional.
Vegetables that punch above their weight
Sometimes, you might not want to eat much veg, but a small edible side-dish could be appealing, or even a generous garnish. In those cases, if you choose wisely, you can have a lot of nutrients in a tiny portion. Here are some that have an absurd nutrient-to-size ratio:
Cacao nibs—one for the dessert-lovers here, but can also garnish a frothy coffee, your morning overnight oats, or if we’re honest, can also just be snacked on! And they keep for ages. Botanically technically a fruit, but we’re going to throw it in here. As for health qualities? Where to begin…
They:
- are full of antioxidants and fight inflammation
- boost immune health
- help control blood sugar levels
- improve vascular function and heart health
- and even fight cancer, which is a many-headed beast, but for example:
…which is starting to look like a pattern, isn’t it? It’s good against cancer.
Brussels sprouts—if your knee-jerk reaction here wasn’t one of great appeal, then consider: these are delicious if done right.
Buy them fresh, not frozen (nothing nutritionally wrong with frozen if you like them—we’re just doing the extra-level tastiness here). Wash them and peel them, then cut twice from the top to almost-the-bottom, to quarter them in a way that they still stay in one piece. Rub them (or if you’re going easier on the fats, spray them) with a little olive oil, a tiny touch of lemon juice, and sprinkle a little cracked black pepper. Sautée them. We know people will advise roasting, which is also great, but try the sautée approach, and thank us later.
Four sprouts is already a sufficient daily serving of cruciferous vegetables, and provides so many health benefits, with not just a stack of vitamins and minerals, but also have anti-cancer properties, are great for your heart in multiple ways, and reduce inflammation too. They’re literally one of the healthiest foods out there and you only need a tiny portion to benefit.
Kale—Don’t like the taste/texture? That’s OK, read on… No surprises here, but it’s crammed with vitamins and minerals.
- If you don’t care for the bitter taste, cooking it (such as by steaming it) takes that away.
- If you don’t care for the texture, baking it with a little sprayed-on olive oil changes that completely (and is how “kale chips” are made).
- If you don’t care for either? Do the “kale chips” thing mentioned above, but do it on a lower heat for longer—dry it out, basically. Then either blend it in a food processor, or by hand with a pestle and mortar (it turns to powder very easily, so this won’t be hard work), and you now have a very nutrient-dense powder that tastes of very little. While fries are not a health food, an example here is that you can literally dust fries with it and they won’t taste any different but you got a bunch of vitamins and minerals added from a whole food source.
- If going for the above approach, do it in batch and make yourself a jar of it to keep handy with your seasonings collection!
Bell peppers—Working hard to justify their high prices in the grocery store, these are very high in vitamins, especially rich in carotenoids, including lutein, and as a bonus, they’re also full of antioxidants. So, slice some and throw them at whatever else you’re cooking, and you’ve added a lot of nutrients for negligible effort.
Garlic—once you’ve done the paperwork, garlic not only makes bland meals delicious, but is also a treasure trove of micronutrients. It has a stack of vitamins and minerals, and also contains allicin. If you’ve not heard of that one, it’s the compound in garlic that is so good for blood pressure and heart health. See for example:
- Lipid-lowering effects of time-released garlic
- Garlic extract lowers blood pressure in patients with hypertension
- Garlic extract reduces blood pressure in hypertensives
If an apple a day keeps the doctor away, just imagine what a bulb of garlic can do (come on, we can’t be the only ones who measure garlic by the bulb instead of by the clove, right?)!
But in seriousness: measure garlic with your heart—have lots or a little, per your preference. The whole point here is that even a little of these superfoods can make a huge difference to your health!
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Seed Saving Secrets – by Alice Mirren
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We all know that home-grown is best, and yet many of us are not exactly farmers (this reviewer tries with mixed results—hardy crops survive; others, not so much). While it’s easy to blame the acidic soil, the harsh climate, or not having enough time and money (this reviewer blames all of the above), the fact remains that a skilled gardener can produce a good crop in any conditions.
That’s where this book helps; right from the beginning, from the seeds. Have you ever bought a pack of seeds, excitedly sown them, and then had a germination rate of zero or something close to that (this reviewer has)?
Alice Mirren takes us on a tour of how to save seeds from plants you know are regionally viable (not the product of some vast globalized industry that doesn’t know you live in an ancient bog with a cold south-east wind blowing in from Siberia), and then how to care for and curate them, how to store them for future years, how to keep a self-perpetuating seed bank.
She goes beyond that, though. Regular 10almonds readers might remember about the supercentenarian “Blue Zones”, and how big factors in healthy longevity include community and purpose; Mirren advocates for organizing community seed banks, which will also mean that everyone (including you) has access to much more diverse seeds, and when it comes to the perils of natural selection, diversity means survival. Otherwise, if you have just one seed type, a single blight can wipe out everything pretty much overnight.
Bottom line: if you grow your own food or would like to, this is a “bible of…” level book that you absolutely should have to hand.
Click here to check out Seed Saving Secrets, and see the results in your kitchen and on your plate!
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Fruit & Veg In The Fridge: Pros & Cons
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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
❝What effect does refrigeration have on the nutritional value of fruit and vegetables??❞
It’s difficult to give a single definitive answer, because naturally there are a lot of different fruits and vegetables, and a lot of different climates. The answer may be different for tomatoes in Alaska vs bananas in Arizona!
However, we can still generalize at least somewhat
Refrigeration will generally slow down any degradation process, and in the case of fruit and vegetables, that can mean slowing down their “ripening” too, as applicable.
However…
Refrigeration will also impede helpful bioactivity too, and that includes quite a list of things.
Here’s a good study that’s quite illustrative; we’d summarize the conclusions but the rather long title already does that nicely:
So, this really is a case of “there are pros and cons, but probably more cons on balance”.
In practical terms, a good take-away from this can be twofold:
- don’t keep fruit and veg in the fridge unless the ambient temperature really requires it
- if the ambient temperature does require it, it’s best to get the produce in fresh each day if that’s feasible, to minimize time spent in the fridge
An extra thing not included there: often when it comes to the spoilage of fruit and veg, the problem is that it respires and oxidizes; reducing the temperature does lower the rate of those, but often a far better way is to remove the oxygen. So for example, if you get carried away and chop too many carrot batons for your hummus night, then putting them in a sealed container can go a long way to keeping them fresh.
See also: How Does the Nutritional Value of Fruits and Vegetables Change Over Time?
Enjoy!
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Is white rice bad for me? Can I make it lower GI or healthier?
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Rice is a culinary staple in Australia and around the world.
It might seem like a given that brown rice is healthier than white and official public health resources often recommend brown rice instead of white as a “healthy swap”.
But Australians definitely prefer white rice over brown. So, what’s the difference, and what do we need to know when choosing rice?
Dragne Marius/Unsplash What makes rice white or brown?
Rice “grains” are technically seeds. A complete, whole rice seed is called a “paddy”, which has multiple parts:
- the “hull” is the hard outer layer which protects the seed
- the “bran”, which is a softer protective layer containing the seed coat
- the “germ” or the embryo, which is the part of the seed that would develop into a new plant if was germinated
- the “endosperm”, which makes up most of the seed and is essentially the store of nutrients that feeds the developing plant as a seed grows into a plant.
Rice needs to be processed for humans to eat it.
Along with cleaning and drying, the hard hulls are removed since we can’t digest them. This is how brown rice is made, with the other three parts of the rice remaining intact. This means brown rice is regarded as a “wholegrain”.
White rice, however, is a “refined” grain, as it is further polished to remove the bran and germ, leaving just the endosperm. This is a mechanical and not a chemical process.
What’s the difference, nutritionally?
Keeping the bran and the germ means brown rice has more magnesium, phosphorus, potassium B vitamins (niacin, folate, riboflavin and pyridoxine), iron, zinc and fibre.
The germ and the bran also contain more bioactives (compounds in foods that aren’t essential nutrients but have health benefits), like oryzanols and phenolic compounds which have antioxidant effects.
Brown rice is cleaned and dried and the hard hulls are removed. Sung Min/Shutterstock But that doesn’t mean white rice is just empty calories. It still contains vitamins, minerals and some fibre, and is low in fat and salt, and is naturally gluten-free.
White and brown rice actually have similar amounts of calories (or kilojoules) and total carbohydrates.
There are studies that show eating more white rice is linked to a higher risk of type 2 diabetes. But it is difficult to know if this is down to the rice itself, or other related factors such as socioeconomic variables or other dietary patterns.
What about the glycaemic index?
The higher fibre means brown rice has a lower glycaemic index (GI), meaning it raises blood sugar levels more slowly. But this is highly variable between different rices within the white and brown categories.
The GI system uses low (less than 55), medium (55–70) and high (above 70) categories. Brown rices fall into the low and medium categories. White rices fall in the medium and high.
There are specific low-GI types available for both white and brown types. You can also lower the GI of rice by heating and then cooling it. This process converts some of the “available carbohydrates” into “resistant starch”, which then functions like dietary fibre.
Are there any benefits to white rice?
The taste and textural qualities of white and brown rices differ. White rice tends to have a softer texture and more mild or neutral flavour. Brown rice has a chewier texture and nuttier flavour.
So, while you can technically substitute brown rice into most recipes, the experience will be different. Or other ingredients may need to be added or changed to create the desired texture.
Removing more of the outer layers may also reduce the levels of contaminants such as pesticides.
We don’t just eat rice
You’ll likely have vegetables and protein with your rice. Chay_Tee/Shutterstock Comparing white and brown rice seems like an easy way to boost nutritional value. But just because one food (brown rice) is more nutrient-dense doesn’t make the other food (white rice) “bad”.
Ultimately, it’s not often that we eat just rice, so we don’t need the rice we choose to be the perfect one. Rice is typically the staple base of a more complex dish. So, it’s probably more important to think about what we eat with rice.
Adding vegetables and lean proteins to rice-based dishes can easily add the micronutrients, bioactives and fibre that white rice is comparatively lacking, and this can likely do more to contribute to diet quality than eating brown rice instead.
Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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