#something about similar ages versus the disparity of experience

[ratatatastic]

there has to be something personally funny about every single finn finding the scoresheet tonight (which is insane btw) but lundy only posts about mackie getting his 6th goal instead

[paperpatchnotes]

City of Ghosts Session Report 1

System: Worlds Without Number

I've recently begun a campaign in the WWN system, using my own setting but liberally stealing from the WWN setting as I enjoy the concepts presented there.

Previously I have run Alien one shots, hefty D&D 5e campaigns, and have been fortunate to play a pf2e campaign, several Call of Cthulhu one shots, a Star Wars (FFG) campaign, a Vampire campaign, and a MOTW campaign. At this point the only thing missing from my experience is something more OSR adjacent so I was actually very excited to dive into this.

My 5e group is what I would call a "hardcore" gaming group. They are good at number crunching, dedicated to the system they're playing (only players I play with who will read the rulebooks unprompted "for fun"), and have strong thoughts and opinions on things like the difficulty and frequency of encounters and magic/martial balance.

We're also young. A lot of the people I run into in the gaming space are older. The oldest of us is still under thirty. We came up on 5e - something oft forgotten by angry Redditors is the reason a lot of us have only ever played 5e isn't because we're stupid but simply we were the prime age for that to be our main game. the timing of it hitting the mainstream and us being old enough to have both the free time and energy to buy and read books and run campaigns go hand in hand. I've noticed in my other groups there's a similar bias towards whatever system welcomed them into the TTRPG space (shout out to my friend whose first game was Werewolf).

So given that, as pretty serious gamers and 5e players, we all think the DM tools are trash, consistently challenging combat is hard to craft, and the caster/martial disparity is annoying to work around (and the magic item system and crafting is hopelessly broken) - for our next game we wanted to try one of the D&D replacements.

Having played pf2e (the favorite suggestion of many) our thoughts were this: it's too much. An overcorrection. While much was also done to reduce the way modifiers stack, there is a general consensus it would be very difficult to play without a VTT and we simply didn't "vibe" with it.

The common desire we have is deadly or challenging combat and a better balance between martials and casters. Working crafting systems are a bonus.

While we have been eyeballing Shadow of the Weird Wizard as an alternative to Shadows of the Demon Lord and a potential option, I have long been using WWN as a worldbuilding tool in my 5e games and pitched trying it out instead. We are two sessions (and a session 0) into a small scale campaign.

Disclaimer: This is a city based campaign instead of a hexcrawl exploration. I love a city game and am of the opinion a lot of principles of exploration apply, but it may color my opinions.

The most frustrating thing so far has been the lack of organization in the rules, hampered further by no online codex.

I had a discussion with a friend about this. No one has ever claimed that 5e was the pinnacle of organization, so I do wonder if this is just a familiarity gap, but I struggle to find rules and information. What I do find is scattered, requires multiple re-reads, or strong interpretation.

People constantly bemoan confusing rulings in 5e and the onus put on the DM but it certainly doesn’t seem like WWN, at least, changes that at all. It’s not really a knock against the system either. As I understand it WWN and its sister games are made by a one man army so editing, parsability, etc, is probably quite different. It’s probably also very different for someone already familiar with the OSR scene to parse versus myself coming up on 5e. 

The main thing though that I find frustrating that is a genuine talent of the 5e writing and design team even if other games do it better, is the lack of “rhyme”. I bet there’s a better word for it, but when design decisions across the game rhyme, it makes it easier to fill in gaps or make rulings on the spot. Things like Proficiency Bonus per Day, subclasses at level 3, AOEs coming in a general subset of sizes and shapes. You don’t want total homogeny but some idea of the general rhyme scheme of game makes it easier to navigate. WWN has some of this...but it also often doesn’t. Trying to rule of the spot can be so tricky, and often I think rules have been left unwritten because of a desire to “rule it as you would real life”. But in real life I can’t see the future or read minds so it gets a little tough to adjucate situations. It doesn’t help my players are incredibly clever.

The other thing that’s definitely become noticeable is that I think, in general, I prefer more niche protection in the form of exclusive mid power abilities scattered across classes than a few very powerful ones. This is still cooking, I may change my mind, but I find myself missing what felt like mechanical diversity in 5e - which is not something 5e often gets praised for.

I’m going to keep eyes on it though. I will probably include more narrative details in future as we go but for now this campaign is mostly to evaluate the system :) 

[tsgwashingtondc]

Dr. Sepehri has toured over 20 of the area’s most reputable preschools, Montessori’s and early learning centers. Here are a few tips to keep in mind as you tour schools for your toddler:

• Location: Location, Location, Location! Location of the school of choice should be one of the most important considerations. Depending on how your child does in the car, a long drive to your child’s school may be a meltdown in the making. The closer to home or work the easier transitions will be. 

• Educational Approaches: Many preschools ascribe to a particular pedagogy: Reggio, Montessori, Waldorf, Emergent, or faith-based curriculums, just to name a few. It is important that families understand the unique components of these different approaches and to determine if they are a good fit for their child’s unique needs and personality. Here is a brief summary of some of the most popular approaches to early childhood education available in the Greater Washington DC Area:

• Montessori: The Montessori method views the learning of a child as self-driven and yet teacher-guided. Montessori schools allow for child ownership and independence by fostering self-help skills and by learning from other classmates. Montessori is a mixed-age classroom where children are also taught to be role models and helpers of the younger children in their cohort. Montessori schools often have self-corrective lines of toys that provide positive feedback as a child plays (such as wooden blocks or puzzles that will only function when assembled correctly). 

• Reggio-Inspired: A Reggio-inspired approach to early education is premised on children learning through language and their environment with teachers acting as guides to the learning process. Children are encouraged to learn about the world around them through investigation, social collaboration, and experimentation as a means of fulfilling the innate curiosity that children carry with them. The Reggio-inspired approach documents a child’s growth and development through photographs of a child engaged in play, artwork collected through the months, and projects that have been completed through the year. 

• Waldorf: The Waldorf method of early education is premised on bolstering a child’s learning by focusing on the mind, whole body, and soul. Classrooms are often based on repetition and routine, music, life skills, and are also very nature-centric. Classrooms are mixed-age cohorts again and can often be seen gardening, baking, or playing instruments together.

• Emergent: Emergent curriculums are often play-based methods of early education that allow teachers to follow the lead of children’s interests. Based on the particular ideas/concepts that excite a classroom of younger learners, the teacher will formulate play-based activities, experiments, and other enrichment opportunities to allow for a child’s collaboration in the education process. Emergent curriculums are ever changing and no two classrooms are alike as the tone of the classroom is set by the children’s ideas and direction for exploration.  

• Faith-Based: Faith-based programs often interweave religion and it’s particular tenets into one of the established philosophies listed above. They are often set in a church, synagogue, mosque or other place of worship but not always. 

Dr. Ellie Sepehri 

Spring valley pediatrics

Washington dc preschools: 

Choosing the right school for your tot

• Class size: What is the student to teacher ratio and are you comfortable with this?

• Napping: Not all preschools that have children attending full-day sessions allow for naptime. Ask your potential preschools if they allow naptime, and if so, for how long?

• Teacher Training: The training the classroom teachers receive to support your toddler is a very reasonable question to ask. What is their training in early childhood education? Are they certified by the official method that the school ascribes to?

• Flexibility of Hours: Depending on the preschool that you choose, there can be many different options for attendance. For instance, some schools break their school days into AM versus PM sessions and/or offer 2-, 3-, or 5-day per week attendances. Some programs have the option for early drop-off (as early as 7:30am) or late-stay (until 6pm). Flexibility is key to a functional and happy household.

• Lunching: Social skills, grace, and courtesy are often practiced during mealtimes. An important question to ask is whether children lunch together? If so, family style? When? How are food allergies and restrictions handled?

• Family Involvement: Every family’s desire for level of school involvement varies. Lookout for school offerings of family gatherings, grandparent lunches, father breakfasts, gardening clubs, parent readings, etc. if a broader sense of community is something you are seeking. 

• Accommodations/Resources: Children with special needs may need additional resources at their school of attendance. It is imperative to ask what resources (i.e. speech, PT, OT, counseling) may be available for your child at school. Are the teachers trained to recognize when a child may need one of the above services? Is there a designated room or space for a child to receive services at school

• Outdoor Time and Space: Children should be encouraged to be outside, weather permitting, to enjoy the good ol’ outdoors, learn by nature, and let out some energy. How much outdoors time do the children get? Does their play space foster mobility, creativity, and fun?

• Summer Camp: Is your child a creature of habit? Does your work schedule require that your child continue ‘school’ through the summer? Often parents find it a great relief that routines are not disturbed for their youngsters by knowing that their preschool has summer camp with near similar hours to school hours. 

• Accommodations/Resources: Children with special needs may need additional resources at their school of attendance. It is imperative to ask what resources (i.e. speech, PT, OT, counselors) may be available for your child at school. Are the teachers trained to recognize when a child may need one of the above services?

• The Playdate: Many schools after submission of the application invite parents and their child to a playdate at the school. These playdates are a fun and relaxing means for the school team to get to know your child. 

• Most importantly, please follow your gut and know that different schools cater to different children with disparate goals, needs, and learning styles. Different models and schools for early education are not necessarily better than the other, but just that, different. Have fun exploring the options available and feel free to consult Dr. Sepehri for her input into the many local programs she has visited! 

[vandykecarolpdrf7]

Beyond Diabetes: Health Benefits of Vinegar

Several of the most popular condiments have something surprising in common. Ketchup, mustard, mayonnaise, salsa, Worcestershire sauce, hot sauce, sriracha, and most store-bought salad dressings have very different flavor and texture profiles: some are sweet, some are salty and savory; some are watery and thin, others are oily and thick. Despite their diverse flavors and wide range of foundational ingredients, one thing unites these seemingly unrelated items: vinegar.

It’s true: I challenge you to go to a grocery store and take a good look at the condiments. You will see vinegar listed among the ingredients in almost all of them, and that’s not even taking into account the myriad forms of vinegar itself, such as apple cider vinegar, balsamic, red wine, champagne, sherry vinegar, and of course, no proper fish & chips meal would be complete without a generous splash of malt vinegar.

It’s also interesting to note that culinary traditions all around the world include various types of pickled vegetables or condiments. In East Asia, there’s kimchi and pickled ginger. In South America, they enjoy curtido; in Eastern Europe there’s sauerkraut and pickled beets, and proper French charcuterie plates and Italian antipasto trays typically include cornichons or brined olives, respectively.

Vinegar has been part of traditional ethnic cuisines around the world for centuries. And while we can’t assume that an ingredient or culinary technique is beneficial merely because it’s been employed by many disparate groups for a very long time, we ought to at least give that possibility some consideration. If certain culinary and gastronomic approaches have persisted through the ages, there are probably some good reasons why. Modern science is catching up to what the cooks of yesteryear seemed to know instinctively: vinegar has some interesting properties, some of which might be of special interest to people following a ketogenic or low-carb diet to help manage blood sugar.

Vinegar as a Natural Digestive Aid

As I mentioned, cuisines all over the world include some type of vinegar or pickled foods with meals. Is the bright tang vinegar provides the only reason for this, or did those ancient cooks know that vinegar brings something to food besides a pleasant little jolt to the tongue?

It’s not hard to connect the dots between vinegar and better digestion. After all, vinegar is acetic acid (molecular formula CH3COOH). As I discussed in my article on GERD and acid reflux, contrary to popular belief, for many people, indigestion and acid reflux result from too little stomach acid, rather than too much.

Hundreds of years ago, long before anyone had ever heard of HCl (stomach acid), it probably wasn’t difficult to observe that when acidic foods or condiments were consumed, digestion went a little more smoothly. (Especially back in the days before Facebook and smartphones, when there wasn’t a whole lot to do after a big meal except sit around and think about how your stomach was feeling.)

Pickling foods in vinegar is a very effective food preservation technique. Even foods that are naturally fermented will eventually end up pickled. Take wine, for example: grape juice is fermented into alcohol, but if the fermentation continues for a longer period of time, the end result is vinegar. In fact, this is where the word “vinegar” comes from: vin aigre, or “sour wine.” (1)

Vinegar is a Powerful Antimicrobial Agent

Vinegar is used as a food preservative precisely because it’s antimicrobial and deters against the proliferation of harmful bacteria. (2) For this reason, it’s also a go-to ingredient for non-toxic household cleaning applications, including laundry, wiping down countertops, and even cleaning windows. It was also used medicinally in wound care and fighting infections as far back as 2000 years ago. (3)

As an interesting aside, here’s a neat bit of information you can use at your next potluck gathering: surely you’ve heard tales of food poisoning caused by potato salad left out on a hot day, like at a summer picnic. Mayonnaise typically gets the blame for this, but guess what? It’s not the mayonnaise that goes bad; it’s the potatoes! It’s true! Mayonnaise contains enough vinegar to keep the bad bugs from proliferating in it. The potatoes, on the other hand, are a bacterial amusement park.

Vinegar Helps Moderate Blood Sugar

This is the most intriguing aspect of vinegar for people on low carb or ketogenic diets, especially for those eating this way to help manage type 2 diabetes or insulin resistance. A surprising amount of scientific literature confirms that vinegar has some impressive effects when it comes to moderating postprandial (after meal) glucose and insulin levels. Vinegar? For blood sugar regulation? Who would’ve thought?

Vinegar Reduces Postprandial Blood Glucose & Insulin

Here’s the overall gist:

In type-1 diabetics, type-2 diabetics, and healthy, non-diabetic subjects, vinegar reduces postprandial blood glucose and, to a lesser extent, postprandial insulin levels.

Taken collectively, studies examining the effects of vinegar on glucose and insulin have included subjects who use no medication as well as some on exogenous insulin and/or oral glucose control aids; people ages 21-79; and with BMIs ranging from approximately 21-34. (According to the BMI scale, a “normal” weight is a BMI of 18.5-24.9, overweight is classified as a BMI 25-29.9, and a BMI equal to or greater than 30 is considered obese.) (4) So the relevant studies encompass wide ranges of ages, body sizes, and medication status, which is important because it tells us the effects observed weren’t limited to healthy, lean, young people.

Taken as a whole, research indicates that vinegar reduces just about everyone’s blood glucose and insulin, but people with type 2 diabetes generally experience a less pronounced effect. (Meaning, their postprandial blood glucose is lower with vinegar than without it, but the reduction typically isn’t as large as that seen in non-diabetic subjects.) This may be because diabetics have poorer glucose control to begin with, so something that’s known to help will still help, but to a lesser degree than for someone who does not have diabetes.

A splash of vinegar isn’t powerful enough to get anyone off their medication, but considering the devastating effects of chronic hyperglycemia and hyperinsulinemia, it certainly never hurts for a diabetic to have another tool in their arsenal—particularly when it’s something as readily available and inexpensive as vinegar.

A Closer Look at the Science of Vinegar and Blood Sugar Composition of the Meal Containing Vinegar

The effect of vinegar on blood glucose is different depending on the composition of the meal consumed. One study showed that vinegar was more effective in lowering postprandial glucose after a high-glycemic index (GI) meal versus one with a low GI. (5) This is probably because a meal with a lower GI would theoretically have less of an impact on blood glucose in the first place, so there’s less of an effect to be had anyway. The study involved type 2 diabetics (non-insulin dependent using diet or metformin alone for disease management), and demonstrated that 20 grams of wine vinegar (6% acidity) reduced postprandial glucose after a high-glycemic meal but less so after a low-glycemic meal containing the same total amount of carbohydrates and also matched for the same number of calories (isocaloric).

For a quick lesson into how mindboggling nutrition research is sometimes, the “low GI” meal in this study consisted of whole grain bread, lettuce, and low-fat cheese. Yes, bread. And low-fat cheese. Whole grain bread, yes, but still — bread, in a meal that’s supposed to be low glycemic. (I suppose it was, at least compared to the high GI meal, which was instant mashed potatoes and low-fat milk!) Anyway, according to the paper, the two meals contained the same amount of total carbohydrate, but the high glycemic meal had a GI of 86, compared to 38 for the low glycemic meal. (6) (The glycemic loads were 44 and 20, for the high and low meals, respectively. See here for more on the distinction between glycemic index and glycemic load.)

Composition of the Carbohydrates in a Meal Containing Vinegar

Related to the glycemic index of a meal, another factor that may influence the effect of vinegar on postprandial glucose (PPG) is the composition of the carbohydrates. A study looking at the effect of vinegar on PPG divided subjects into four randomized crossover intervention groups in which some subjects consumed a mix of simple and complex carbs while others consumed only simple sugars, in the form of a dextrose solution. (7) Three of the four study arms included healthy adults while the fourth included type 2 diabetics not on insulin. The study used both apple cider and raspberry vinegars, helping to establish that the glucose-moderating effects were not limited to apple cider vinegar, which is the one most commonly used in similar studies. Compared to placebo, 10 grams of vinegar (5% acidity) reduced PPG by 23-28% in healthy non-diabetic subjects consuming the starch and juice. In the diabetic subjects, the vinegar treatment resulted in a 13-17% reduction in PPG compared to placebo: less of a decrease than for the healthy subjects, but still potentially significant given the severe consequences of chronic hyperglycemia.

How did the study authors create a placebo for vinegar? Good question! (I mean, if you think about it, it should be pretty obvious when you’re eating or drinking something that has vinegar in compared to something that doesn’t.) One of the studies that used a placebo added saccharine (an artificial sweetener) to the vinegar to take away the acidic bite, and the placebo was water with added saccharine. (8) Both the vinegar and the placebo also had food coloring added. The intense sweetness of the test drinks in association with the bright red, blue, or green color of the drinks were intended to conceal the presence of vinegar. (We could speculate that the saccharine might have introduced a confounding variable with regard to blood glucose & insulin, but since both the vinegar group and the placebo group ingested the saccharine, we would hope that even if it did have an effect, both groups would be affected equally, essentially neutralizing any difference between the two.)

Ingesting Vinegar May Lead to Reduced Hunger

In most of the studies, postprandial blood glucose reached a lower peak and came back to baseline more quickly with vinegar ingestion than without. One of the studies’ subjects reported an increased degree and duration of satiety after the test meal with vinegar versus the one without. (9)

That’s fancy-speak for saying that when vinegar was included with the test meal (wheat bread providing 50 grams of available carbohydrate), the subjects felt fuller and stayed fuller for longer than when eating a meal without vinegar. I am speculating here, but perhaps the increased satiety is connected to the aforementioned better digestion: If you are digesting and absorbing more of the nutrients in your meal, it makes sense that you’d feel more satisfied and possibly have a longer sustained feeling of satiety than if some of the nutrients were being lost to suboptimal digestive function.

Vinegar Reduces Blood Glucose and Insulin

The studies that measured postprandial glucose and insulin generally showed that both of these were lower in the vinegar groups. This is important, because lower glucose at the expense of higher insulin is not necessarily a desirable thing. (10) (Even in the absence of elevated glucose, chronically high insulin appears to be a major driver of cardiometabolic disease.) (11)

The fact that insulin was shown to be lower after meals containing vinegar suggests that the lower blood glucose is not due to increased insulin, and it may in fact be the reverse: insulin might be lower because glucose is lower. Less of a spike in glucose means less insulin is needed to clear it out of the bloodstream. So we can rule out the likelihood that vinegar lowers blood glucose by raising insulin.

How Does Vinegar Affect Glycemic Impact?

The blood glucose moderating effects of vinegar appear to depend somewhat on the food matrix in which the carbohydrate is presented. If the carbs are in liquid form and don’t even have to be broken down in order to be digested (such as in juice or sugar-sweetened beverages), then vinegar provides virtually no benefit.

A food’s glycemic index and load matter, and researchers also speculate that the amount of fiber and the ratio of amylose to amylopectin could also be a factor. (12)

In other words, vinegar might have more or less benefit, depending on whether the food is, for example, potatoes, bread, parsnips, beets, or beans. It might also have differing effects on the same food depending on the level of processing — such as a whole, intact baked potato versus puréed mashed potatoes that don’t even have to be chewed, or a salad of whole wheat berries as opposed to whole wheat crackers that liquefy in your mouth when you mix them with saliva for a few seconds and also don’t need to be chewed.

Taken as a whole, studies indicate that it’s not the total carb content of a meal, but rather, the degree to which the carbs need to be broken down in the digestive tract, that determines how much of an effect vinegar might have — if any.

Add vinegar to a can of soda, and good luck stopping that skyrocketing blood sugar. But dip a chunk of bread in olive oil and lots of balsamic before a pasta dinner and maybe there’s something to it. And don’t forget that adding vinegar to certain starches that have been cooked and cooled to produce resistant starch, like a potato salad or sushi rice, is another way to reduce the elevations in glucose and insulin. (13, (14)) If you’re following a keto or low carb diet, pasta and potatoes likely aren’t part of your life anymore, but on the rare occasion when you might choose to indulge, adding vinegar to starchier meals may help slightly attenuate the impact on blood glucose and insulin.

There’s debate among the researchers as to the actual mechanism by which vinegar results in lower glucose & insulin.

How Does Vinegar Lower Blood Glucose and Insulin?

There are two main theories:

1. Delayed Gastric Emptying

Vinegar causes food to leave the stomach more slowly, which results in a more gradual (and lower overall) rise in postprandial blood glucose. This has been demonstrated in healthy, non-diabetic subjects as well as subjects with type 1 diabetes. (15, (16)) Slower emptying of the stomach could also account for the aforementioned reported increase in satiety with vinegar ingestion.

In the arm of a study involving ingestion of a dextrose solution, vinegar had no effect on reducing PPG at any time point, which suggests that vinegar lowers glucose in part by delaying gastric emptying and/or slowing down the digestion of starch and other complex carbs, rather than that of simple sugars.

This would explain why a study evaluating the effects of vinegar in the context of an oral glucose tolerance test (OGTT) failed to show any benefits from vinegar. The study involved type 2 diabetics treated with oral glucose lowering medications who did an oral glucose tolerance test. (17) Average age of the subjects was 65, with an average HbA1c of 6.6, and average BMI 29.7. So this was a relatively small study group of middle-aged, overweight, not-too-poorly managed type-2 diabetics. (HbA1c of 6.6 isn’t stellar, but many diabetics have levels much higher.) The protocol had subjects drink a beverage containing 75 grams of glucose, once by itself, and then again on a separate test day taken along with 25 grams of white vinegar (4% acidity). There was basically no difference in the glucose and insulin levels with or without the vinegar. This should come as no surprise, though: they gave diabetics 75 grams of pure glucose in liquid form and 25 grams of vinegar made no difference in their glucose spike? This should shock exactly no one.

2. Inhibition of Intestinal Disaccharidases

If vinegar reduces activity of enzymes in the small intestine that digest carbohydrates, then fewer simple sugars will be absorbed, resulting in a smaller rise in PPG.

Studies on human cell lines in vitro have shown that vinegar decreases the activity of multiple disaccharidases (sucrase, maltase, lactase, and trehalase), which could certainly affect PPG. (18) Vinegar seems to be effective only in the presence of complex carbs, which require more digestion than simple sugars (monosaccharides). This further explains the lack of effect of vinegar when pure liquid glucose is consumed. Researchers noted, “Vinegar did not alter PPG when ingested with monosaccharides, suggesting that the antiglycemic action of vinegar is related to the digestion of carbohydrates.” (19)

However, even in a meal that did contain liquid sugar (in the form of orange juice), when the meal wasn’t just sugar, ingestion of vinegar was shown to help reduce postprandial glucose and insulin in healthy subjects, in type 2 diabetics, and in non-diabetic subjects with insulin resistance. When subjects consumed a test meal consisting of a white bagel, butter, and the juice (87 g total carbs), along with placebo or 20 g apple cider vinegar (in 40 g water with 1 tsp saccharine), compared to placebo, vinegar reduced the postprandial glucose and insulin in all groups. Nevertheless, vinegar or no vinegar, we have plenty of reasons not to consume liquid sugars.

Timing Matters

Another factor with using vinegar as a blood glucose regulating adjunct is timing. According to one study, 2 teaspoons (10 g) of vinegar ingested five hours prior to a carbohydrate containing meal had no notable effect on postprandial glucose compared to placebo, while the same amount of vinegar consumed along with the test meal resulted in a 19% lowering of PPG. (20) Here we have modern scientific evidence supporting the wisdom of traditional cuisines that employ acidic or vinegar-based condiments, especially along with starchier meals, such as pickled ginger or kimchi served with rice, dipping bread in oil and vinegar, or a German potato salad with vinegary mustard. (See here for tasty low-carb potato salad substitutes.)

Reducing the rise in blood glucose and insulin after meals is a good reason to include vinegar in your diet. Beyond that, though, perhaps the best reason is much simpler: it’s delicious!

Carb Content of Vinegar

Most vinegars are very low in carbohydrates. After all, vinegar is acidic, not sweet. Most vinegars, such as plain white distilled, apple cider, red wine, and white wine vinegars, have 0-1 gram of carbohydrate per tablespoon.

The exception is balsamic vinegar, which is significantly sweeter tasting than other vinegars. Regular balsamic vinegar has between 4-6 grams of carbs per tablespoon. However, some of the more highly concentrated high-end balsamics, such as those available in gourmet stores and the olive oil and vinegar boutiques that are popping up everywhere, will have substantially more, especially if they’re thick and syrupy. These vinegars, which are more like glazes, could pack a carb punch as high as 8-11 grams per Tbsp.

Fortunately, with balsamic vinegar, a little goes a long way so you shouldn’t need very much to achieve the desired flavor. If a recipe calls for a tablespoon or two of balsamic vinegar, even the thicker variety, the carb count per serving will still be relatively low.

Can Vinegar Help People on a Keto Diet?

The studies evaluating the effects of vinegar on postprandial blood sugar and insulin typically employ high carbohydrate meals. Since the effects appear to be dependent on reducing the digestion of complex carbs, people on ketogenic diets might not experience results as pronounced as those of people eating higher carb diets.

However, for people who have trouble sticking to keto (not everyone’s perfect!), it’s not a bad idea to incorporate some vinegar into meals that are a bit higher in starch. And for some people, blood glucose can remain stubbornly high even when following a strict keto diet. This would be another situation where vinegar would be worth trying. Testing blood sugar at intervals after meals containing vinegar would let someone know whether the vinegar is helping.

For people who experience the

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[uncle-ak]

How About Flipping The Script?!

Is it just me or is it the highlight of February valentine’s day as it is marketed to be even though it is also Black History Month? Is it just me or is Valentine’s Day marketing geared more towards the woman who is the recipient of gifts meanwhile it takes two to tango? Yes, women go through A LOT in society, at home, in the workplace… just about everywhere. They bear and raise children, primary homemakers, hold the family together, unify the family, in some cases sacrifice work for family and a WHOLE lot more and should be appreciated every day, not just on valentine’s day or during women’s history month or mother’s day. This may sound like ruffling feathers but it isn’t the intended purpose. These questions are based on observation in order to improve understanding not to pass judgment. Yes, it is possible to observe without judging; it's all about the mindset/perspective.

October is breast cancer awareness month. Breast cancer which typically or mostly occurs in women also occurs in men although rare; 1 in 100 according to CDC.gov. Something new I learned for the first time last month; Kegel exercises for men and it’s health benefits! Is there an International Men’s Day? How about Men’s health month? That doesn’t seem to make as much of a wave as the women’s month. In a similar way mother’s day and father’s day. This isn’t so much a comparison but an observation; that is why I said ‘and instead of ‘versus’. Any thoughts on why this is the case? Is it that men's issues aren’t as marketable as women’s issues? Or that men don’t care about being celebrated? Or they don't care about being loved out loud? Or that men aren’t as vocal in self-celebration as women are? Or… can we throw in the “equality” or “equity” word in this case...?

How many of us (both women and men) know which month is men’s health month and which day is international men’s day? I must say I didn’t know about these until 2019 when I came across a flyer on Instagram and I went to google to read about it. Between then and last year whenever I posted in celebration, acknowledgment, and appreciation of men, the comments from men were along the lines of; is there something like that? Do we have a month? We are being celebrated too? Thank you for acknowledging. 

I can’t deny that I have had some unpleasant experiences that make me want to lump ALL men in a group and stick a generalized negative label. But in retrospect, I haven’t come across ALL men and definitely won’t so I learned to refrain from using the phrase “ALL men are… xyz.” There is some good in everyone but somehow, the not-so-good experiences stick out like a sore thumb and overshadow the good experiences even if the good experiences may outnumber the not-so-good ones in some cases.

In acknowledgment of men who are open to having the difficult vulnerable conversations such as on PalmWine Central Podcast, those who create the safe space and facilitate the conversation such as the Stuck in The Middle Podcast Coach Talk. It is not easy to engage in conversations that trigger buried trauma and or evoke emotions especially for men in a society that shun men for showing emotion. Men tend to be told, sometimes at a very young age, that ‘men don’t cry, ‘be strong’, ‘be tough’, and or ‘be a man.’ How this translates as they grow up and play out in adulthood ranges in varying ways. This is in no way justifying negative behaviors in men be it irresponsibility, disrespecting women, domestic abuse, infidelity… and yes women too are perpetrators of such, though not as reported as it is by women for men. 

To be vulnerable doesn’t come easy, it isn’t a typically discussed topic in the African community like the love languages. I have asked people what their thoughts are about vulnerability without them looking it up, most responses tend to have a negative connotation to it or it is seen as a weakness. On the contrary, it requires a lot of strength/bravery to be vulnerable. Recognizing and understanding vulnerability doesn’t come easy to everyone because it could also be triggering for the listener/observer. There are professionals; counselors/therapists who can help facilitate such conversation involving self-expression and self-discovery. A good book on this is The Power of Vulnerability by Brene Brown.

Another thing that is considered a weakness in men is seeking help, addressing mental health challenges or even going for an annual physical. A Wall Street Journal article on Men’s health discusses how cultural and social barriers have led men to see health check-ups as a sign of weakness. June is Men’s Health Month; this might probably be better coming from a fellow brother but as someone who works in health care (rehabilitation), seeing the disparity in health outcomes in men, or their willingness to receive/accept care, here is a humble plea. How about getting an annual health physical screen/check-up and trying out counseling as the basic health management/prevention starter package! Rather than going around with undetected high cholesterol, high blood pressure, or hypertension blocking or blowing out a blood vessel or using alcohol to manage emotions or mental challenges.

Also, how about listening to conversations such as; Masculinity Under Attack, Trauma’s Faced by African Menand more from where that is from if you haven’t/aren’t’t already. How about joining the conversation, having similar conversations among your peers in addition to having sports-related discussions. Sometimes being part of such discussions or just listening to others share their stories can be healing. 

For those who can; here is to celebrating and loving out loud brothers/cousins, nephews, uncles, fathers, male role models, husband, significant other, spouse, partner, friends. Men, this is also about you celebrating yourselves and loving on yourself. 

Father’s Day is this month and so is Men’s Health Month. So here is to own the entire month! Make it count in a healthy way! Oh, by the way, International Men’s day is… 

Happy Father’s Day in advance and Happy Men’s Health Month!

[needyourglowtoglow]

The New York Times includes an article: "How Prejudice Can Harm Your Health" by Dhruv Khullar. Here’s the author note: "Dhruv Khullar, M.D., M.P.P., is a resident physician at Massachusetts General Hospital and Harvard Medical School." Here are some excerpts: [begin excerpts] Long before the Rev. Dr. Martin Luther King declared health inequity the most shocking and inhumane form of injustice, W.E.B. Du Bois wrote that “the Negro death rate and sickness are largely matters of condition and not due to racial traits and tendencies.”  Before Du Bois made his case, James McCune Smith — the nation’s first black doctor — carefully detailed the health consequences of freedom and oppression. These men grasped an insight that modern researchers and policy makers often fail to make explicit: Discrimination, especially when chronic, harms the body and the mind. How we treat one another, and how our institutions treat us, affects how long and how well we live. We tend to think of discrimination as a moral or legal issue, and perhaps, in the case of immigration, an economic one. But it’s also a medical issue with important public health consequences. A growing body of evidence suggests that racial and sexual discrimination is toxic to the cells, organs and minds of those who experience it. Research suggests that discrimination is internalized over a lifetime, and linked to a variety of poor health markers and outcomes: more inflammation and worse sleep; smaller babies and higher infant death rates; a greater risk of cancer, depression and substance use. The cumulative burden of discrimination is linked to higher rates of hypertension and more severe narrowing of important arteries in the heart and neck. Even the telomeres at the end of our chromosomes, which act as a sort of timer for aging cells, can shorten. <snip> In one study, researchers asked black women to complete questionnaires on how often they experienced minor “everyday” discrimination, as well as major instances of unfair treatment in housing, employment or with the police. They then followed the women for six years, and found that those who had reported more frequent discrimination were more likely to develop breast cancer. The more pervasive the reported discrimination, the higher their risk. This remained true even after adjusting for more than a dozen other factors like family history, education level, physical activity and use of hormonal supplements or oral contraceptives. Similar work has found that discrimination is a strong predictor of lower back pain in black patients — but not in white patients, who were less likely to report discrimination and for whom discrimination was unrelated to pain. Those who endure chronic discrimination not only experience more stress, but may also process it differently. To test this theory, researchers used surveys to assess the extent of lifetime discrimination that black and white patients had experienced. They then injected patients with phenylephrine (a chemical similar to adrenaline) and found that black patients had a larger temporary increase in blood pressure than white patients. Those who had experienced more discrimination had the largest rise of all. There may also be something particularly sinister about racial stress: People have a bigger spike in blood pressure when talking about racial stressors (being accused of shoplifting) compared with nonracial stressors (experiencing delays at the airport). These effects start early. By fifth grade, black and Hispanic children are already more than twice as likely as white students to say they’ve experienced discrimination at school. (About 7 percent of white children also reported discrimination, and online bullying is a growing problem for students of all backgrounds.) Children who experience discrimination have higher rates of depression, A.D.H.D. and other behavioral problems. And teenagers who endure more discrimination — racial slurs, physical threats, disrespectful behavior, false accusations — are more likely to have disrupted cortisol levels, elevated blood pressure and higher body mass index years later. Most important, even for students who experience similar levels of discrimination, there is considerable variability in whether or not they go on to develop health problems. Many negative health effects seem to be mitigated — and in some cases eliminated — for those who have robust emotional support from family and friends. And some research even suggests that low levels of adversity can promote resilience. Most studies have focused on the health effects of what researchers call interpersonal discrimination, including harassment, “micro-aggressions” or even just the anticipation of prejudice. But an emerging literature is also exploring the role of structural discrimination — the social and economic policies that systematically put certain groups at a disadvantage. Researchers have tried to calculate structural bias by using racial differences in four domains — political participation, educational achievement, employment and incarceration. Blacks, for example, are 12 times more likely to be imprisoned than whites in Wisconsin, but only twice as likely in Hawaii. In Arkansas, the unemployment rate for blacks is 3.6 times higher than for whites; in Delaware, they’re employed at similar rates. These unequal social conditions foster unequal health outcomes. Blacks in states high in structural discrimination are more likely to have heart attacks than blacks in low-discrimination states, and black women are more likely to give birth to babies too small for their gestational age. (Data is mixed on whether whites in these states do better or worse.) In a revealing study of historical data, researchers found that before the abolition of Jim Crow laws, the black infant death rate was nearly 20 percent higher in Jim Crow states versus non-Jim Crow states. This disparity declined sharply after the Civil Rights Act of 1964, such that the gap had essentially closed a decade later. Still, the caustic effects of segregation persist: Blacks in segregated neighborhoods remain at higher risk for hypertension, chronic disease, violence and exposure to environmental pollutants. Research is also identifying harmful inequities for white Americans along geographic and socioeconomic lines. Whites living in rural areas, compared with those in metropolitan centers, now contend with many of the same structural challenges that worsen health: less education, lower incomes, higher unemployment rates and poorer access to medical care. They increasingly feel that they, too, face significant discrimination. In some counties in the Midwest and South, the death rate for white women in their 40s has doubled since 2000. Other work has found that gays and bisexuals living in states that institute policies restricting their rights — like same-sex marriage bans or lack of workplace protections — are more likely to develop depression, anxiety and substance use disorders. And a recent study suggests that the Deferred Action for Childhood Arrivals program, or DACA, conferred large mental health benefits to eligible Hispanic adults, who were nearly 50 percent less likely to report symptoms of major depression compared with noneligible people at risk of being deported. As important as specific policies may be, the general social and political climate probably has broader and longer-lasting effects. Even if they haven’t experienced bias themselves, members of minority groups may develop a hyperawareness for cues of mistreatment, and this sustained vigilance can lead to chronic stress, mood problems and poorer health outcomes. For example, amid a sharp rise in anti-Arab sentiment after the Sept. 11 attacks, women with Arabic names — but not other women — had an increased risk of preterm birth and low-birth weight babies. <snip> When people are marginalized, even unintentionally, it inflicts a toll. Discrimination raises many moral concerns — but also, it seems, many medical ones.

[newstfionline]

How Prejudice Can Harm Your Health

Dhruv Khullar, NY Times, June 8, 2017

     Long before the Rev. Dr. Martin Luther King declared health inequity the most shocking and inhumane form of injustice, W.E.B. Du Bois wrote that “the Negro death rate and sickness are largely matters of condition and not due to racial traits and tendencies.” Before Du Bois made his case, James McCune Smith--the nation’s first black doctor--carefully detailed the health consequences of freedom and oppression.

     These men grasped an insight that modern researchers and policy makers often fail to make explicit: Discrimination, especially when chronic, harms the body and the mind. How we treat one another, and how our institutions treat us, affects how long and how well we live.

     We tend to think of discrimination as a moral or legal issue, and perhaps, in the case of immigration, an economic one. But it’s also a medical issue with important public health consequences. A growing body of evidence suggests that racial and sexual discrimination is toxic to the cells, organs and minds of those who experience it.

     Research suggests that discrimination is internalized over a lifetime, and linked to a variety of poor health markers and outcomes: more inflammation and worse sleep; smaller babies and higher infant death rates; a greater risk of cancer, depression and substance use. The cumulative burden of discrimination is linked to higher rates of hypertension and more severe narrowing of important arteries in the heart and neck. Even the telomeres at the end of our chromosomes, which act as a sort of timer for aging cells, can shorten.

     Discrimination, of course, is only part of the health equation. Individuals are not doomed to disease because of their circumstances. Health and illness are the result of a complex interplay between genetics, behavior and environmental conditions. But experiencing persistent bias can tip the scale.

     In one study, researchers asked black women to complete questionnaires on how often they experienced minor “everyday” discrimination, as well as major instances of unfair treatment in housing, employment or with the police. They then followed the women for six years, and found that those who had reported more frequent discrimination were more likely to develop breast cancer. The more pervasive the reported discrimination, the higher their risk.

     This remained true even after adjusting for more than a dozen other factors like family history, education level, physical activity and use of hormonal supplements or oral contraceptives. Similar work has found that discrimination is a strong predictor of lower back pain in black patients--but not in white patients, who were less likely to report discrimination and for whom discrimination was unrelated to pain.

     Those who endure chronic discrimination not only experience more stress, but may also process it differently. To test this theory, researchers used surveys to assess the extent of lifetime discrimination that black and white patients had experienced. They then injected patients with phenylephrine (a chemical similar to adrenaline) and found that black patients had a larger temporary increase in blood pressure than white patients. Those who had experienced more discrimination had the largest rise of all.

     There may also be something particularly sinister about racial stress: People have a bigger spike in blood pressure when talking about racial stressors (being accused of shoplifting) compared with nonracial stressors (experiencing delays at the airport).

     These effects start early. By fifth grade, black and Hispanic children are already more than twice as likely as white students to say they’ve experienced discrimination at school. (About 7 percent of white children also reported discrimination, and online bullying is a growing problem for students of all backgrounds.)

     Children who experience discrimination have higher rates of depression, A.D.H.D. and other behavioral problems. And teenagers who endure more discrimination--racial slurs, physical threats, disrespectful behavior, false accusations--are more likely to have disrupted cortisol levels, elevated blood pressure and higher body mass index years later.

     Most important, even for students who experience similar levels of discrimination, there is considerable variability in whether or not they go on to develop health problems. Many negative health effects seem to be mitigated--and in some cases eliminated--for those who have robust emotional support from family and friends. And some research even suggests that low levels of adversity can promote resilience.

     Most studies have focused on the health effects of what researchers call interpersonal discrimination, including harassment, “micro-aggressions” or even just the anticipation of prejudice. But an emerging literature is also exploring the role of structural discrimination--the social and economic policies that systematically put certain groups at a disadvantage.

     Researchers have tried to calculate structural bias by using racial differences in four domains--political participation, educational achievement, employment and incarceration. Blacks, for example, are 12 times more likely to be imprisoned than whites in Wisconsin, but only twice as likely in Hawaii. In Arkansas, the unemployment rate for blacks is 3.6 times higher than for whites; in Delaware, they’re employed at similar rates.

     These unequal social conditions foster unequal health outcomes. Blacks in states high in structural discrimination are more likely to have heart attacks than blacks in low-discrimination states, and black women are more likely to give birth to babies too small for their gestational age. (Data is mixed on whether whites in these states do better or worse.)

     In a revealing study of historical data, researchers found that before the abolition of Jim Crow laws, the black infant death rate was nearly 20 percent higher in Jim Crow states versus non-Jim Crow states. This disparity declined sharply after the Civil Rights Act of 1964, such that the gap had essentially closed a decade later. Still, the caustic effects of segregation persist: Blacks in segregated neighborhoods remain at higher risk for hypertension, chronic disease, violence and exposure to environmental pollutants.

     Research is also identifying harmful inequities for white Americans along geographic and socioeconomic lines. Whites living in rural areas, compared with those in metropolitan centers, now contend with many of the same structural challenges that worsen health: less education, lower incomes, higher unemployment rates and poorer access to medical care. They increasingly feel that they, too, face significant discrimination. In some counties in the Midwest and South, the death rate for white women in their 40s has doubled since 2000.

     When people are marginalized, even unintentionally, it inflicts a toll. Discrimination raises many moral concerns--but also, it seems, many medical ones.