
Yoga for Better Sleep – by Mark Stephens
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The book has, as you might expect:
- postural exercises
- breathing exercises
- meditation exercises
Instructions given in all of the above categories are clear and easy to follow, and there are photographic illustrations too where appropriate.
What sets it apart from many books of this kind is that it also has chapters dedicated to various specific circumstances; the many actual reasons people seriously struggle to sleep; not just “screentime too late”, but for example deprepression, sleep apnea, hyperarousal, or even just aging.
As well as the comprehensive exercises, there are also many tips, tricks, hacks, and workarounds—it’s a practical guidebook with practical advice.
While the book is about yogic practices, the author also does tackle this holistically, acknowledging that there are many factors going on, and that yogic practices should be one more string to our sleep-improving bow—as we continue with other general good advice for good sleep too, have medical tests if it seems appropriate, that kind of thing. Basically, to have one’s assorted approaches work together with synergistic effect.
Bottom line: this book will quite possibly put you to sleep! But only in the best possible way.
Click here to check out Yoga for Better Sleep, and get those valuable Zs in, healthily!
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What happens in my brain when I get a migraine? And what medications can I use to treat it?
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Migraine is many things, but one thing it’s not is “just a headache”.
“Migraine” comes from the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.
Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.
Migraine is a disease with a huge personal and societal impact. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.
Francisco Gonzelez/Unsplash What’s happening in my brain?
The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:
The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.
The hypothalamus is shown here in red. Blamb/Shutterstock Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.
In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.
Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy.
What can you do about the acute attack?
A useful way to conceive of migraine treatment is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.
Aspirin
For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.
Triptans
For moderate to severe attacks, the mainstay of treatment is a class of medications called “triptans”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.
Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.
The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).
As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.
Triptans should be used cautiously in patients with heart disease. CDC/Unsplash Gepants
Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.
Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.
They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.
Ditans
Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.
However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a cost of approximately A$300 for eight wafers.
What about preventing migraines?
The first step is to see if lifestyle changes can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.
Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month benefit the most from starting preventives.
Some people will take medicines to prevent migraines. Tbel Abuseridze/Unsplash Almost all migraine preventives have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:
- tablets that lower blood pressure (candesartan, metoprolol, propranolol)
- antidepressants (amitriptyline, venlafaxine)
- anticonvulsants (sodium valproate, topiramate).
Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.
For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.
It is rare for noticeable benefits to be seen immediately, but with time these drugs typically reduce migraine frequency by 50% or more.
‘Nothing works for me!’
In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications block the action of CGRP.
The most common PBS-listed anti-CGRP medications are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.
These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also effective and PBS-listed for chronic migraine) which must be administered by a trained specialist.
Up to half of adolescents and one-third of young adults are needle-phobic. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.
Data over the past five years suggest anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.
Nonetheless, these are used only after a number of cheaper and more readily available first-line treatments (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.
Mark Slee, Associate Professor, Clinical Academic Neurologist, Flinders University and Anthony Khoo, Lecturer, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When supplies resume, should governments subsidise drugs like Ozempic for weight loss? We asked 5 experts
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
You’ve no doubt heard of Ozempic but have you heard of Wegovy? They’re both brand names of the drug semaglutide, which is currently in short supply worldwide.
Ozempic is a lower dose of semaglutide, and is approved and used to treat diabetes in Australia. Wegovovy is approved to treat obesity but is not yet available in Australia. Shortages of both drugs are expected to last throughout 2024.
Both drugs are expensive. But Ozempic is listed on Australia’s Pharmaceutical Benefits Schedule (PBS), so people with diabetes can get a three-week supply for A$31.60 ($7.70 for concession card holders) rather than the full price ($133.80).
Wegovy isn’t listed on the PBS to treat obesity, meaning when it becomes available, users will need to pay the full price. But should the government subsidise it?
Wegovy’s manufacturer will need to make the case for it to be added to the PBS to an independent advisory committee. The company will need to show Wegovy is a safe, clinically effective and cost-effective treatment for obesity compared to existing alternatives.
In the meantime, we asked five experts: when supplies resume, should governments subsidise drugs like Ozempic for weight loss?
Four out of five said yes
This is the last article in The Conversation’s Ozempic series. Read the other articles here.
Disclosure statements: Clare Collins is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from the National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC), the Medical Research Future Fund (MRFF), the Hunter Medical Research Institute, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, the Western Australian Department of Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk (for weight management resources and an obesity advisory group), Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update, the Heart Foundation evidence reviews on meat and dietary patterns and current co-chair of the Guidelines Development Advisory Committee for Clinical Practice Guidelines for Treatment of Obesity; Emma Beckett has received funding for research or consulting from Mars Foods, Nutrition Research Australia, NHMRC, ARC, AMP Foundation, Kellogg and the University of Newcastle. She works for FOODiQ Global and is a fat woman. She is/has been a member of committees/working groups related to nutrition or food, including for the Australian Academy of Science, the NHMRC and the Nutrition Society of Australia; Jonathan Karnon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment; Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd (a medical device company) and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design and testing; Priya Sumithran has received grant funding from external organisations, including the NHMRC and MRFF. She is in the leadership group of the Obesity Collective and co-authored manuscripts with a medical writer provided by Novo Nordisk and Eli Lilly.
Fron Jackson-Webb, Deputy Editor and Senior Health Editor, The Conversation
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Quinoa vs Couscous – Which is Healthier?
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Our Verdict
When comparing quinoa to couscous, we picked the quinoa.
Why?
Firstly, quinoa is the least processed by far. Couscous, even if wholewheat, has by necessity been processed to make what is more or less the same general “stuff” as pasta. Now, the degree to which something has or has not been processed is a common indicator of healthiness, but not necessarily declarative. There are some processed foods that are healthy (e.g. many fermented products) and there are some unprocessed plant or animal products that can kill you (e.g. red meat’s health risks, or the wrong mushrooms). But in this case—quinoa vs couscous—it’s all borne out pretty much as expected.
For the purposes of the following comparisons, we’ll be looking at uncooked/dry weights.
In terms of macros, quinoa has a little more protein, slightly lower carbs, and several times the fiber. The amino acids making up quinoa’s protein are also much more varied.
In the category of vitamins, quinoa has more of vitamins A, B1, B2, B6, and B9, while couscous boasts a little more of vitamins B3 and B5. Given the respective margins of difference, as well as the total vitamins contained, this category is an easy win for quinoa.
When it comes to minerals, this one’s not even more clear. Quinoa has a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Couscous, meanwhile has more of just one mineral: sodium. So, maybe not one you want more of.
All in all, today’s is an easy pick: quinoa!
Want to learn more?
You might like to read:
- Carbohydrate Mythbusting: Should You Go Light Or Heavy On Carbs?
- What’s The Real Deal With The Paleo Diet?
- Gluten Mythbusting: What’s The Truth? ← we didn’t mention it above, but couscous is by default gluten-free, and couscous, being made of wheat, is by default not gluten-free, which may be another reason for some to choose quinoa
Take care!
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What Are “Adaptogens” Anyway? (And Other Questions Answered)
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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
❝I tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞
(this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)
How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.
Did anyone else have this problem? Let us know! (You can reply to this email, or use the handy feedback widget at the bototm)
❝I may have missed it, but how much black pepper provides benefits?❞
So, for any new subscribers joining us today, this is about two recent main features:
As for a daily dosage of black pepper, it varies depending on the benefit you’re looking for, but:
- 5–20mg of piperine is the dosage range used in most scientific studies we looked at
- 10mg is a very common dosage found in many popular supplements
- That’s the mass of piperine though, so if taking it as actual black pepper rather than as an extract, ½ teaspoon is considered sufficient to enjoy benefits.
❝I loved the health benefits of pepper. I do not like pepper. Where can I get it as a supplement?❞
You can simply buy whole black peppercorns and take a few with water as though they were tablets. Your stomach acid will do the rest. Black pepper is also good for digestion, so taking it with a meal is best.
You can buy piperine (black pepper extract) by itself as a supplement in powder form, but if you don’t like black pepper, you will probably not like this powder either. We couldn’t find it readily in capsule form.
You can buy piperine (black pepper extract) as an adjunct to other supplements, with perhaps the most common/popular being turmeric capsules that also contain 10mg (or more) piperine per capsule. Shop around if you like, but here’s one that has 15mg piperine* per capsule, for example.
*They call it “Bioperine®” but that is literally just piperine. Same goes if you see “Absorbagen™”, it’s still just piperine.
❝What do you mean when you say that something is adaptogenic?❞
Simple version: it means it helps the body adapt to stress, by adjusting the body’s natural responses. Thus, adaptogenic supplements can be contrasted with tranquilizing drugs that mask stress by brute force, for example.
Technical version: adaptogenic activity refers to improving physiological stress resilience, such as by moderating and modulating hypothalamic–pituitary–adrenal axis signaling, and/or by regulating levels of endogenic compounds involved in the cellular stress response.
Read more (technical version):
Read more (simple version):
European Medicines Agency’s Reflection Paper On The Adaptogenic Concept
Enjoy!
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Are Supplements Worth Taking?
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.
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 😎
❝There seems to be a lot of suggestions to take supplements for every thing, from your head to your toes. I know it’s up to the individual but what are the facts or stats to support taking them versus not?❞
Short answer:
- supplementary vitamins and minerals are probably neither needed nor beneficial for most (more on this later) people, with the exception of vitamin D which most people over a certain age need unless they are white and getting a lot of sun.
- other kinds of supplement can be very beneficial or useless, depending on what they are, of course, and also your own personal physiology.
With regard to vitamins and minerals, in most cases they should be covered by a healthy balanced diet, and the bioavailability is usually better from food anyway (bearing in mind, we say vitamin such-and-such, or name an elemental mineral, but there are usually multiple, often many, forms of each—and supplements will usually use whatever is cheapest to produce and most chemically stable).
However! It is also quite common for food to be grown in whatever way is cheapest and produces the greatest visible yield, rather than for micronutrient coverage.
This goes for most if not all plants, and it goes extra for animals (because of the greater costs and inefficiencies involved in rearing animals).
We wrote about this a while back in a mythbusting edition of 10almonds, covering:
- Food is less nutritious now than it used to be: True or False?
- Supplements aren’t absorbed properly and thus are a waste of money: True or False?
- We can get everything we need from our diet: True or False?
You can read the answers and explanations, and see the science that we presented, here:
Do We Need Supplements, And Do They Work?
You may be wondering: what was that about “most (more on this later) people”?
Sometimes someone will have a nutrient deficiency that can’t be easily remedied with diet. Often this occurs when their body:
- has trouble absorbing that nutrient, or
- does something inconvenient with it that makes a lot of it unusable when it gets it.
…which is why calcium, iron, vitamin B12, and vitamin D are quite common supplements to get prescribed by doctors after a certain age.
Still, it’s best to try getting things from one’s diet first all of all, of course.
Things we can’t (reasonably) get from food
This is another category entirely. There are many supplements that are convenient forms of things readily found in a lot of food, such as vitamins and minerals, or phytochemicals like quercetin, fisetin, and lycopene (to name just a few of very many).
Then there are things not readily found in food, or at least, not in food that’s readily available in supermarkets.
For example, if you go to your local supermarket and ask where the mimosa is, they’ll try to sell you a cocktail mix instead of the roots, bark, or leaves of a tropical tree. It is also unlikely they’ll stock lion’s mane mushroom, or reishi.
If perchance you do get the chance to acquire fresh lion’s mane mushroom, by the way, give it a try! It’s delicious shallow-fried in a little olive oil with black pepper and garlic.
In short, this last category, the things most of us can’t reasonably get from food without going far out of our way, are the kind of thing whereby supplements actually can be helpful.
And yet, still, not every supplement has evidence to support the claims made by its sellers, so it’s good to do your research beforehand. We do that on Mondays, with our “Research Review Monday” editions, of which you can find in our searchable research review archive ← we also review some drugs that can’t be classified as supplements, but mostly, it’s supplements.
Take care!
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Blood-Sugar Balancing Beetroot Cutlets
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These beetroot cutlets are meaty and proteinous and fibrous and even have a healthy collection of fats, making these much better for your heart and blood than an animal-based equivalent.
You will need
- 1 can kidney beans, drained and rinsed (or 1 cup same, cooked, drained, and rinsed)
- ½ cup chopped roasted or steamed beetroot, blotted dry
- ½ cup chopped walnuts (if allergic, substitute with ¼ cup pumpkin seeds)
- ½ cup cooked (ideally: mixed) grains of your choice (if you need gluten-free, there are plenty of gluten-free grains and pseudocereals)
- ¼ cup finely chopped onion
- ¼ bulb garlic, minced or crushed
- 2 tbsp nutritional yeast
- 2 tbsp ground flaxseeds
- 2 tbsp ground chia seeds
- 2 tsp tomato purée
- 1 tsp black pepper
- ½ tsp white miso paste
- ½ tsp smoked paprika
- ½ tsp cayenne pepper
- ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Combine the beetroot, beans, walnuts, grains, and onion in a food processor, and process until a coarse even mixture.
2) Add the remaining ingredients and process to mix thoroughly.
3) Transfer the mixture to a clean work surface and divide into six balls. If the structural integrity is not good (i.e. too soft), add a little more of any or all of these ingredients: chopped walnuts, ground flax, ground chia, nutritional yeast.
4) Press the balls firmly into cutlets, and refrigerate for at least 1 hour, but longer is even better if you have the time. Alternatively, if you’d like to freeze them for later use, then this is the point at which to do that.
5) Preheat the oven to 375℉ / 190℃.
6) Roast the cutlets on a baking tray lined with baking paper, for about 30 minutes, turning over carefully with a spatula halfway through. They should be firm when done; if they’re not, give them a little longer.
7) Serve hot, for example on a bed of greens and with a drizzle of aged balsamic vinegar.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Beetroot’s Many Benefits
- Our Top 5 Spices: How Much Is Enough For Benefits?
- What Omega-3 Fatty Acids Really Do For Us
- Three Daily Servings of Beans?
- If You’re Not Taking Chia, You’re Missing Out
Take care!
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