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

❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞

(this was in response to our article about menopausal HRT)

Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:

• Those with HRT were significantly less likely to have knee arthritis than those without
• However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
• While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.

We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.

Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.

The researchers do mention:

❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞

~ Dr. Spector et al.

What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.

With regard to the timing, the researchers do note:

❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.

These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞

~ Ibid.

You can read the study here:

Is hormone replacement therapy protective for hand and knee osteoarthritis in women?: The Chingford Study

On whether it is worth it now…

Again, do speak with an endocrinologist because your situation may vary, but:

• hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
• anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!

(We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)

Meanwhile, take care!

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 😎

❝I need to cook for a family event and the combined dietary restrictions are: vegetarian, no lactose, no gluten, no nuts, including peanuts and coconuts, no discernible carbs, including lentils and chickpeas, no garlic or onions, no cabbage, no soup, and it can’t be remotely spicy. The nut allergy is of course absolute and we are vegetarian, the other things may be slightly negotiable but I’d like a stress-free dinner. Ideas?❞

That is indeed quite restrictive! But a challenge is (almost) always fun.

To answer generally first: one approach is to do buffet-style dining, with many small dishes. While nuts will still need to be absent, because of the nature of nut allergies, the rest can just be skipped on a per-person basis.

But, let’s see what we can do with a one-dish-fits-all approach!

The biggest challenge seems to be getting protein and flavor. Protein options are more limited without meat, lactose, or legumes, and flavor requires some attention without being able to rely on spices.

To give a sample à la carte menu… With these things in mind, we’ve selected three of our recipes from the recipes section of our site, that will require only minor modifications:

1) Invigorating Sabzi Khordan: skip the walnuts and either partition or omit the scallions, and ensure the cheese is lactose-free (most supermarkets stock lactose-free cheeses, nowadays).

With regard to the flatbreads, you can either skip, or use our gluten-free Healthy Homemade Flatbreads recipe, though it does use chickpea flour and quinoa flour, so the “no discernible carbs” person(s) might still want to skip them. If it’s not an issue on the carbs front, then you might also consider, in lieu of one of the more traditional cheeses, using our High-Protein Paneer recipe which, being vegan, is naturally lactose-free. Also, which is not traditional but would work fine, you might want to add cold hard-boiled halved eggs, since the next course will be light on protein:

2) Speedy Easy Ratatouille: skip the red chili and garlic; that’s all for this one!

3) Black Forest Chia Pudding: the glycemic index of this should hopefully be sufficient to placate the “no discernible carbs” person(s), but if it’s not, we probably don’t have a keto-friendlier dessert than this. And obviously, when it comes to the garnish of “a few almonds, and/or berries, and/or cherries and/or cacao nibs”, don’t choose the almonds.

Want to know more?

For any who might be curious:

Gluten: What’s The Truth? ← this also discusses the differences between an allergy/intolerance/sensitivity—it’s more than just a matter of severity!

Take care!