How Can Mental Health Experts Be So Blind?

See this tweet? I hope you can see this tweet. I want you to see that photo. The person in it is representative of their market, young and privileged:

It’s by @Mental_Elf. Their description reads, “Evidence-based #MentalHealth research: summarised by experts.” This is the article it links to: Blended psychotherapy: barriers and facilitators identified by psychotherapists.

One barrier they didn’t mention:

Over 25 million Americans aged 60+ are economically insecure — living at or below 250% of the federal poverty level (FPL) ($29,425 per year for a single person). These older adults struggle with rising housing and health care bills, inadequate nutrition, lack of access to transportation, diminished savings, and job loss.
Economic Security for Seniors Facts, National Council on Aging

The old, the frail, the sick, the disabled, people with limited incomes and inadequate housing and transportation … don’t use apps and “online modules”. They don’t so much access traditional psychotherapy either. I wouldn’t have paid much attention to this except the authors are people in the field, “experts”. How can experts be so blind?

It seems the mental health field suffers the same problem as the nutrition field, both ignore the needs of millions of Americans who desperately need their focus but who are invisible.

No, It’s Not Self-Neglect. It’s Social Neglect.

I found this article disturbing:

Elder Abuse: Sometimes It’s Self-Inflicted, New York Times, 2 March 2018

No, it’s not self-neglect. It’s social neglect. This commenter summed it up:

“Let’s face the real issue: we don’t have the social safety net that most other civilized countries provides to its people. We are often a cruel society. And when confronted with the evidence, we blame the victim to clear our conscience and check the phone for messages.”

Even though most of this article placed the onus for neglect on the individual, that is, individuals are at fault for abusing themselves (?!), it also said:

Neglect was more common among those with poor health and cognitive impairment. African-Americans and those with lower income and education had far higher rates of self-neglect.

The problem is caused by a society that does not provide affordable, quality healthcare, housing, and education – in an equitable fashion – that does not ensure a living wage, parental and eldercare leave, unemployment insurance, and a livable social security. It’s so easy to blame the individual. It’s harder to blame the institutions we put into place (or don’t) to prevent this from happening. You have to care.

Boxed Beans

My new favorite food:


  • They are fresher tasting than canned beans.
  • There is no BPA in the lining, although I don’t know how safe the polyethylene lining is.
  • I like the smaller size (13.4 ounces vs. 15 or 16 ounces for a can).
  • They don’t require an opener. (There is a tearable perforation along the top, but I’ll admit I do use scissors sometimes. Still easier than a can opener.)
  • The beans are softer.
  • They cost $1.49 per box which I don’t think is extravagant.
  • There are no other ingredients except beans. Beans, that’s it.
  • Some of the recipes on the sides of the boxes are actually worth making, like the chili below.

This recipe is on the side of the kidney bean box.

Chili made with one box of kidney beans and one box of black beans. The photo doesn’t do it justice, it’s very good! Since the beans are softer, they break apart while cooking and create a nice creamy background. Kidney beans more so than black beans, which makes the combo better than either alone.

Another Study Finds A Low-Fat Vegan Diet Improves Markers Of Diabetes

#T2D is Type 2 Diabetes

In overweight adults with no history of diabetes, a low-fat, plant-based vegan diet can reduce visceral fat and significantly improve both pancreatic beta-cell function and insulin resistance, potentially decreasing the risk of type 2 diabetes.

The 16-week randomized controlled trial in 73 adults showed that participants who ate a diet of vegetables, grains, legumes, and fruits significantly improved their overall metabolic condition.

Previous studies have shown that the prevalence of diabetes is 46% to 74% lower in people who eat a plant-based diet compared with meat lovers in the general population.

A vegan diet has also been shown to improve glycemic control in type 2 diabetes better than calorie-restricted, low-carbohydrate diets.

The vegan diet provided 75% of caloric energy from carbohydrates, 15% from protein, and 10% from fats (20–30 grams/day). There was no calorie restriction in the vegan diet. [This is very low in fat, difficult to do if added oils are used.]

The vegan diet elicited marked increases in meal-stimulated insulin secretion and beta-cell glucose sensitivity, along with decreased fasting insulin resistance and decreased fasting and postprandial plasma glucose concentrations.

There was also improvement in plasma lipid concentrations in response to a low-fat vegan diet, which is consistent with previous studies.

I want to point out that this diet doesn’t just exclude all animal foods, it also excludes all added fats and oils. No sauteing in oil, no oil in dressings.

The evidence for this diet has been around for over a decade:

A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes, Diabetes Care, 2006

Thank you, Virginia!

Eating More Protein Is Not the Answer To Preventing Sarcopenia (Age-Related Muscle Loss)

People think that because diabetes is a disease marked by high levels of blood sugar, eating sugar is a problem. On the surface it makes sense. But that’s not how it works. A healthy person can eat as much sugar, as much carbohydrate, as they want and as long as their cells take it up, they won’t have high blood sugar. The problem occurs when cells resist taking up glucose from the bloodstream. (Which has several causes which I’ve discussed over the years.)

I’m noticing a similar mindset with sarcopenia, a disease marked by loss of muscle mass as we age. People think that because muscles contain protein, eating more protein can preserve muscle. On the surface it makes sense. But that’s not how it works. In fact, it can backfire and cause even greater loss of muscle. (Because a high-protein diet contributes to acidosis. See below.*)

Here’s something I wrote a few years ago:
Up To A Third Of Adults Over 50 Have Some Degree Of Muscle Loss (Sarcopenia), More Protein Doesn’t Seem To Help

Getting more protein may not prevent the loss of muscle mass or strength as we age.

The following study looked at 9 placebo-controlled studies (the gold standard of scientific investigation), and found no benefit from protein:

Clinical Effectiveness Of Protein And Amino Acid Supplementation On Building Muscle Mass In Elderly People: A Meta-Analysis, PLOS ONE, 30 September 2014

Conclusions: These results indicate that amino acid/protein supplements did not increase lean body mass gain and muscle strength significantly more than placebo in a diverse elderly population.

This next one was an exhaustive review of 37 studies from January 2000 to October 2013 that addressed the prevalence of sarcopenia and the effect of nutrition and exercise.

Prevalence Of And Interventions For Sarcopenia In Ageing Adults: A Systematic Review. Report Of The International Sarcopenia Initiative (EWGSOP and IWGS), Age and Aging, 21 September 2014

In a nut shell:

  • Up to a third (33%) of adults over 50 (living in the community, not in a care setting where, as you’d expect, the prevalence is higher) have some degree of muscle loss or reduced muscle function.
  • “Protein supplements have not shown consistent benefits on muscle mass and function.”
  • “Exercise interventions, especially those based on resistance training, may have a role in improving muscle strength and physical performance (moderate quality evidence), but not muscle mass.”

Not only can eating too much protein contribute to muscle loss, it also stresses the kidney. As we saw, excess protein increases calcium losses, and increases risks for kidney stones and renal disease.

Related: High-Fat Diets Contribute To Age-Related Muscle Loss (Sarcopenia)

* How eating too much protein can backfire:1,2

While consuming an adequate amount of protein is important for older adults, consuming too much protein can result in a low-level, diet-induced metabolic acidosis, or abnormally increased acidity in the body. The typical American diet—which is high in animal proteins and cereal grains, and low in fruits and vegetables—can cause a low-grade metabolic acidosis that contributes to the decline in muscle and bone mass found in aging adults.

1 Life Extension, Preventing Sarcopenia, January 2007
2 Diet, Evolution And Aging – The Pathophysiologic Effects Of The Post-Agricultural Inversion Of The Potassium-To-Sodium And Base-To-Chloride Ratios In The Human Diet, European Journal of Nutrition, October, 2001

Nutrition Advice Is Becoming Increasingly Contemptuous

I just finished reading this article in The Atlantic about how the ranks of the poor are growing, especially among older adults. It said, “In America in 2016, nearly half of all single homeless adults were aged 50 and older, compared to 11 percent in 1990.”

I’m contrasting that with this article in the New York Times that advised eating “high-quality foods,” “grass-fed and pasture-raised animal foods,” “cooked at home.” How can you say this isn’t elitist? Who are they talking to? It’s not just the cost of the food but also the time and labor to prepare it, the skill, transportation and food access, an equipped kitchen, working with disabilities. There are so many barriers to this kind of advice.

I’m not arguing that eating fresh, whole, “high-quality” foods prepared and eaten at home with your family isn’t good. I’m saying it’s the kind of advice that millions of Americans can’t adhere to. Now what? What is the advice for low-income, elderly, sick and disabled people? People who lack adequate housing, healthcare, transportation? The advice should be better quality packaged, processed, and prepared food but no one wants to go there. The New York Times article went so far as to tell people not to eat processed food, the same food that Congress is preparing to put into a box and distribute to Americans: