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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The Easiest Way To Take Up Journaling
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.
Dear Diary…
It’s well-established that journaling is generally good for mental health. It’s not a magical panacea, as evidenced by The Diaries of Franz Kafka for example (that man was not in good mental health). But for most of us, putting our thoughts and feelings down on paper (or the digital equivalent) is a good step for tidying our mind.
And as it can be said: mental health is also just health.
But…
What to write about?
It’s about self-expression (even if only you will read it), and…
❝Writing about traumatic, stressful or emotional events has been found to result in improvements in both physical and psychological health, in non-clinical and clinical populations.
In the expressive writing paradigm, participants are asked to write about such events for 15–20 minutes on 3–5 occasions.
Those who do so generally have significantly better physical and psychological outcomes compared with those who write about neutral topics.❞
Source: Emotional and physical health benefits of expressive writing
In other words, write about whatever moves you.
Working from prompts
If you read the advice above and thought “but I don’t know what moves me”, then fear not. It’s perfectly respectable to work from prompts, such as:
- What last made you cry?
- What last made you laugh?
- What was a recent meaningful moment with family?
- What is a serious mistake that you made and learned from?
- If you could be remembered for just one thing, what would you want it to be?
In fact, sometimes working from prompts has extra benefits, precisely because it challenges us to examine things we might not otherwise think about.
If a prompt asks “What tends to bring you most joy recently?” and the question stumps you, then a) you now are prompted to look at what you can change to find more joy b) you probably wouldn’t have thought of this question—most depressed people don’t, and if you cannot remember recent joy, then well, we’re not here to diagnose, but let’s just say that’s a symptom.
A quick aside: if you or a loved oneare prone to depressive episodes, here’s a good resource, by the way:
The Mental Health First-Aid That You’ll Hopefully Never Need
And in the event of the mental health worst case scenario:
The six prompts we gave earlier are just ideas that came to this writer’s mind, but they’re (ok, some bias here) very good ones. If you’d like more though, here’s a good resource:
550+ Journal Prompts: The Ultimate List
The Good, The Bad, and The Ugly
While it’s not good to get stuck in ruminative negative thought spirals, it is good to have a safe outlet to express one’s negative thoughts/feelings:
Remember, your journal is (or ideally, should be) a place without censure. If you fear social consequences should your journal be read, then using an app with a good security policy and encryption options can be a good idea for journaling
Finch App is a good free option if it’s not too cutesy for your taste, because in terms of security:
- It can’t leak your data because your data never leaves your phone (unless you manually back up your data and then you choose to put it somewhere unsafe)
- It has an option to require passcode/biometrics etc to open the app
As a bonus, it also has very many optional journaling prompts, and also (optional) behavioral activation prompts, amongst more other offerings that we don’t have room to list here.
Take care!
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High-Protein Plant-Based Diet for Beginners – by Maya Howard with Ariel Warren
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Seasoned vegans (well-seasoned vegans?) will know that getting enough protein from a plant-based diet is really not the challenge that many think it is, but for those just embarking on cutting out the meat, it’s not useful to say “it’s easy!”; it’s useful to show how.
That’s what this book does. And not just by saying “these foods” and leaving people to wonder if they need to eat a pound of tofu each day to get their protein in. Instead, recipes. Enough for a 4-week meal plan, and the idea is that after a month of eating that way, it won’t be nearly so mysterious.
The recipes are very easy to execute, while still having plenty of flavor (which is what happens when one uses a lot of flavorsome main ingredients and then seasons them well too). The ingredients are not obscure, and you should be able to find everything easily in any medium-sized supermarket.
As for the well-roundedness of the diet, we’ll mention that the “with Ariel Warren” in the by-line means that while the book was principally authored by Maya Howard (who is, at time of writing, a nutritionist-in-training), she had input throughout from Ariel Warren (a Registered Dietician Nutritionist) to ensure she didn’t go off-piste anyway and it gets the professional stamp of approval.
Bottom line: if you’d like to cook plant based while still prioritizing protein and you’re not sure how to make that exciting and fun instead of a chore, then this book will show you how to please your taste buds and improve your body composition at the same time.
Click here to check out High-Protein Plant-Based Diet for Beginners, and dig in!
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The End of Food Allergy – by Dr. Kari Nadeau & Sloan Barnett
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We don’t usually mention author credentials beyond their occupation/title. However, in this case it bears acknowledging at least the first line of the author bio:
❝Kari Nadeau, MD, PhD, is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University and is one of the world’s leading experts on food allergy❞
We mention this, because there’s a lot of quack medicine out there [in general, but especially] when it comes to things such as food allergies. So let’s be clear up front that Dr. Nadeau is actually a world-class professional at the top of her field.
This book is, by the way, about true allergies—not intolerances or sensitivities. It does touch on those latter two, but it’s not the main meat of the book.
In particular, most of the research cited is around peanut allergies, though the usual other common allergens are all discussed too.
The authors’ writing style is that of a science educator (Dr. Nadeau’s co-author, Sloan Barnett, is lawyer and health journalist). We get a clear explanation of the science from real-world to clinic and back again, and are left with a strong understanding, not just a conclusion.
The titular “End of Food Allergy” is a bold implicit claim; does the book deliver? Yes, actually.
The book lays out guidelines for safely avoiding food allergies developing in infants, and yes, really, how to reverse them in adults. But…
Big caveat:
The solution for reversing severe food allergies (e.g. “someone nearby touched a peanut three hours ago and now I’m in anaphylactic shock”), drug-assisted oral immunotherapy, takes 6–24 months of weekly several-hour-long clinic visits, relies on having a nearby clinic offering the service, and absolutely 100% cannot be done at home (on pain of probable death).
Bottom line: it’s by no means a magic bullet, but yes, it does deliver.
Click here to check out The End of Food Allergy to learn more!
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Relationships: When To Stick It Out & When To Call It Quits
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Like A Ship Loves An Anchor?
Today’s article may seem a little bit of a downer to start with, but don’t worry, it picks up again too. Simply put, we’ve written before about many of the good parts of relationships, e.g:
Only One Kind Of Relationship Promotes Longevity This Much!
…but what if that’s not what we have?
Note: if you have a very happy, secure, fulfilling, joyous relationship, then, great! Or if you’re single and happy, then, also great! Hopefully you will still find today’s feature of use if you find yourself advising a friend or family member one day. So without further ado, let’s get to it…
You may be familiar with the “sunk cost fallacy”; if not: it’s what happens when a person or group has already invested into a given thing, such that even though the thing is not going at all the way they hoped, they now want to continue trying to make that thing work, lest their previous investment be lost. But the truth is: if it’s not going to work, then the initial investment is already lost, and pouring out extra won’t help—it’ll just lose more.
That “investment” in a given thing could be money, time, energy, or (often the case) a combination of the above.
In the field of romance, the “sunk cost fallacy” keeps a lot of bad relationships going for longer than perhaps they should, and looking back (perhaps after a short adjustment period), the newly-single person says “why did I let that go on?” and vows to not make the same mistake again.
But that prompts the question: how can we know when it’s right to “keep working on it, because relationships do involve work”, as perfectly reasonable relationship advice often goes, and when it’s right to call it quits?
Should I stay or should I go?
Some questions for you (or perhaps a friend you might find yourself advising) to consider:
- What qualities do you consider the most important for a partner to have—and does your partner have them?
- If you described the worst of your relationship to a close friend, would that friend feel bad for you?
- Do you miss your partner when they’re away, or are you glad of the break? When they return, are they still glad to see you?
- If you weren’t already in this relationship, would you seek to enter it now? (This takes away sunk cost and allows a more neutral assessment)
- Do you feel completely safe with your partner (emotionally as well as physically), or must you tread carefully to avoid conflict?
- If your partner decided tomorrow that they didn’t want to be with you anymore and left, would that be just a heartbreak, or an exciting beginning of a new chapter in your life?
- What things would you generally consider dealbreakers in a relationship—and has your partner done any of them?
The last one can be surprising, by the way. We often see or hear of other people’s adverse relationship situations and think “I would never allow…” yet when we are in a relationship and in love, there’s a good chance that we might indeed allow—or rather, excuse, overlook, and forgive.
And, patience and forgiveness certainly aren’t inherently bad traits to have—it’s just good to deploy them consciously, and not merely be a doormat.
Either way, reflect (or advise your friend/family member to reflect, as applicable) on the “score” from the above questions.
- If the score is good, then maybe it really is just a rough patch, and the tools we link at the top and bottom of this article might help.
- If the score is bad, the relationship is bad, and no amount of historic love or miles clocked up together will change that. Sometimes it’s not even anyone’s fault; sometimes a relationship just ran its course, and now it’s time to accept that and turn to a new chapter.
“At my age…”
As we get older, it’s easy for that sunk cost fallacy to loom large. Inertia is heavy, the mutual entanglement of lives is far-reaching, and we might not feel we have the same energy for dating that we did when we were younger.
And there may sometimes be a statistical argument for “sticking it out” at least for a while, depending on where we are in the relationship, per this study (with 165,039 participants aged 20–76), which found:
❝Results on mean levels indicated that relationship satisfaction decreased from age 20 to 40, reached a low point at age 40, then increased until age 65, and plateaued in late adulthood.
As regards the metric of relationship duration, relationship satisfaction decreased during the first 10 years of the relationship, reached a low point at 10 years, increased until 20 years, and then decreased again.❞
Source: Development of Relationship Satisfaction Across the Life Span: A Systematic Review and Meta-Analysis
And yet, when it comes to prospects for a new relationship…
- If our remaining life is growing shorter, then it’s definitely too short to spend in an unhappy relationship
- Maybe we really won’t find romance again… And maybe that’s ok, if w’re comfortable making our peace with that and finding joy in the rest of life (this widowed writer (hi, it’s me) plans to remain single now by preference, and her life is very full of purpose and beauty and joy and yes, even love—for family, friends, etc, plus the memory of my wonderful late beloved)
- Nevertheless, the simple fact is: many people do find what they go on to describe as their best relationship yet, late in life ← this study is with a small sample size, but in this case, even anecdotal evidence seems sufficient to make the claim reasonable; probably you personally know someone who has done so. If they can, so can you, if you so wish.
- Adding on to that last point… Later life relationships can also offer numerous significant advantages unique to such (albeit some different challenges too—but with the right person, those challenges are just a fun thing to tackle together). See for example:
An exploratory investigation into dating among later‐life women
And about those later-life relationships that do work? They look like this:
this one looks like the title says it all, but it really doesn’t, and it’s very much worth at least reading the abstract, if not the entire paper—because it talks a lot about the characteristics that make for happy or unhappy relationships, and the effect that those things have on people. It really is very good, and quite an easy read.
See again: Healthy Relationship, Healthy Life
Take care!
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Hazelnuts vs Almonds – Which is Healthier?
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Our Verdict
When comparing hazelnuts to almonds, we picked the almonds.
Why?
It’s closer than you might think! But we say almonds do come out on top.
In terms of macronutrients, almonds have notably more protein, while hazelnuts have notably more fat (healthy fats, though). Almonds are also higher in both carbs and fiber. Looking at Glycemic Index, hazelnuts’ GI is low and almonds’ GI is zero. We could call the macros category a tie, but ultimately if we need to prioritize any of these things, it’s protein and fiber, so we’ll call this a nominal win for almonds.
When it comes to vitamins, hazelnuts have more of vitamins B1, B5, B6, B9 C, and K. Meanwhile, almonds have more of vitamins B2, B3, E, and choline. So, a moderate win for hazelnuts.
In the category of minerals, almonds retake the lead with more calcium, magnesium, phosphorus, potassium, selenium, and zinc, while hazelnuts boast more copper and manganese. A clear win for almonds.
Adding up the categories, this makes for a marginal win for almonds. Of course, both of these nuts are very healthy (assuming you are not allergic), and best is to enjoy both if possible.
Want to learn more?
You might like to read:
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Can kimchi really help you lose weight? Hold your pickle. The evidence isn’t looking great
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Fermented foods have become popular in recent years, partly due to their perceived health benefits.
For instance, there is some evidence eating or drinking fermented foods can improve blood glucose control in people with diabetes. They can lower blood lipid (fats) levels and blood pressure in people with diabetes or obesity. Fermented foods can also improve diarrhoea symptoms.
But can they help you lose weight, as a recent study suggests? Let’s look at the evidence.
Remind me, what are fermented foods?
Fermented foods are ones prepared when microbes (bacteria and/or yeast) ferment (or digest) food components to form new foods. Examples include yoghurt, cheese, kefir, kombucha, wine, beer, sauerkraut and kimchi.
As a result of fermentation, the food becomes acidic, extending its shelf life (food-spoilage microbes are less likely to grow under these conditions). This makes fermentation one of the earliest forms of food processing.
Fermentation also leads to new nutrients being made. Beneficial microbes (probiotics) digest nutrients and components in the food to produce new bioactive components (postbiotics). These postbiotics are thought to contribute to the health benefits of the fermented foods, alongside the health benefits of the bacteria themselves.
What does the evidence say?
A study published last week has provided some preliminary evidence eating kimchi – the popular Korean fermented food – is associated with a lower risk of obesity in some instances. But there were mixed results.
The South Korean study involved 115,726 men and women aged 40-69 who reported how much kimchi they’d eaten over the previous year. The study was funded by the World Institute of Kimchi, which specialises in researching the country’s national dish.
Eating one to three servings of any type of kimchi a day was associated with a lower risk of obesity in men.
Men who ate more than three serves a day of cabbage kimchi (baechu) were less likely to have obesity and abdominal obesity (excess fat deposits around their middle). And women who ate two to three serves a day of baechu were less likely to have obesity and abdominal obesity.
Eating more radish kimchi (kkakdugi) was associated with less abdominal obesity in both men and women.
However, people who ate five or more serves of any type of kimchi weighed more, had a larger waist sizes and were more likely to be obese.
The study had limitations. The authors acknowledged the questionnaire they used may make it difficult to say exactly how much kimchi people actually ate.
The study also relied on people to report past eating habits. This may make it hard for them to accurately recall what they ate.
This study design can also only tell us if something is linked (kimchi and obesity), not if one thing causes another (if kimchi causes weight loss). So it is important to look at experimental studies where researchers make changes to people’s diets then look at the results.
How about evidence from experimental trials?
There have been several experimental studies looking at how much weight people lose after eating various types of fermented foods. Other studies looked at markers or measures of appetite, but not weight loss.
One study showed the stomach of men who drank 1.4 litres of fermented milk during a meal took longer to empty (compared to those who drank the same quantity of whole milk). This is related to feeling fuller for longer, potentially having less appetite for more food.
Another study showed drinking 200 millilitres of kefir (a small glass) reduced participants’ appetite after the meal, but only when the meal contained quickly-digested foods likely to make blood glucose levels rise rapidly. This study did not measure changes in weight.
Kefir, a fermented milk drink, reduced people’s appetite.
Ildi Papp/ShutterstockAnother study looked at Indonesian young women with obesity. Eating tempeh (a fermented soybean product) led to changes in an appetite hormone. But this did not impact their appetite or whether they felt full. Weight was not measured in this study.
A study in South Korea asked people to eat about 70g a day of chungkookjang (fermented soybean). There were improvements in some measures of obesity, including percentage body fat, lean body mass, waist-to-hip ratio and waist circumference in women. However there were no changes in weight for men or women.
A systematic review of all studies that looked at the impact of fermented foods on satiety (feeling full) showed no effect.
What should I do?
The evidence so far is very weak to support or recommend fermented foods for weight loss. These experimental studies have been short in length, and many did not report weight changes.
To date, most of the studies have used different fermented foods, so it is difficult to generalise across them all.
Nevertheless, fermented foods are still useful as part of a healthy, varied and balanced diet, particularly if you enjoy them. They are rich in healthy bacteria, and nutrients.
Are there downsides?
Some fermented foods, such as kimchi and sauerkraut, have added salt. The latest kimchi study said the average amount of kimchi South Koreans eat provides about 490mg of salt a day. For an Australian, this would represent about 50% of the suggested dietary target for optimal health.
Eating too much salt increases your risk of high blood pressure, heart disease and stroke.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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