12 Questions For Better Brain Health

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We usually preface our “Expert Insights” pieces with a nice banner that has a stylish tall cutout that allows us to put a photo of the expert in. Today we’re not doing that, because for today’s camera-shy expert, we could only find one photo, and it’s a small, grainy, square headshot that looks like it was taken some decades ago, and would not fit our template at all. You can see it here, though!

In any case, Dr. Linda Selwa is a neurologist and neurophysiologist with nearly 40 years of professional experience.

The right questions to ask

As a neurologist, she found that one of the problems that results in delayed interventions (and thus, lower efficacy of those interventions) is that people don’t know there’s anything to worry about until a degenerative brain condition has degenerated past a certain point. With that in mind, she bids us ask ourselves the following questions, and discuss them with our primary healthcare providers as appropriate:

  1. Sleep: Are you able to get sufficient sleep to feel rested?
  2. Affect, mood and mental health: Do you have concerns about your mood, anxiety, or stress?
  3. Food, diet and supplements: Do you have concerns about getting enough or healthy enough food, or have any questions about supplements or vitamins?
  4. Exercise: Do you find ways to fit physical exercise into your life?
  5. Supportive social interactions: Do you have regular contact with close friends or family, and do you have enough support from people?
  6. Trauma avoidance: Do you wear seatbelts and helmets, and use car seats for children?
  7. Blood pressure: Have you had problems with high blood pressure at home or at doctor visits, or do you have any concerns about blood pressure treatment or getting a blood pressure cuff at home?
  8. Risks, genetic and metabolic factors: Do you have trouble controlling blood sugar or cholesterol? Is there a neurological disease that runs in your family?
  9. Affordability and adherence: Do you have any trouble with the cost of your medicines?
  10. Infection: Are you up to date on vaccines, and do you have enough information about those vaccines?
  11. Negative exposures: Do you smoke, drink more than one to two drinks per day, or use non-prescription drugs? Do you drink well water, or live in an area with known air or water pollution?
  12. Social and structural determinants of health: Do you have concerns about keeping housing, having transportation, having access to care and medical insurance, or being physically or emotionally safe from harm?

You will note that some of these are well-known (to 10almonds readers, at least!) risk factors for cognitive decline, but others are more about systemic and/or environmental considerations, things that don’t directly pertain to brain health, but can have a big impact on it anyway.

About “concerns”: in the case of those questions that ask “do you have concerns about…?”, and you’re not sure, then yes, you do indeed have concerns.

About “trouble”: as for these kinds of health-related questionnaires in general, if a question asks you “do you have trouble with…?” and your answer is something like “no, because I have a special way of dealing with that problem” then the answer for the purposes of the questionnaire is yes, you do indeed have trouble.

Note that you can “have trouble with” something that you simultaneously “have under control”—just as a person can have no trouble at all with something that they leave very much out of control.

Further explanation on each of the questions

If you’re wondering what is meant by any of these, or what counts, or why the question is even being asked, then we recommend you check out Dr. Selwa et al’s recently-published paper, then all is explained in there, in surprisingly easy-to-read fashion:

Emerging Issues In Neurology: The Neurologist’s Role in Promoting Brain Health

If you scroll past the abstract, introduction, and disclaimers, then you’ll be straight into the tables of information about the above 12 factors.

Want to be even more proactive?

Check out:

How To Reduce Your Alzheimer’s Risk

Take care!

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  • Mango vs Guava – Which is Healthier?

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    Our Verdict

    When comparing mango to guava, we picked the guava.

    Why?

    Looking at macros first, these two fruits are about equal on carbs (nominally mango has more, but it’s by a truly tiny margin), while guava has more than 3x the protein and more than 3x the fiber. A clear win for guava.

    In terms of vitamins, mango has more of vitamins A, E, and K, while guava has more of vitamins B1, B2, B3, B5, B7, B9, and C. Another win for guava.

    In the category of minerals, mango is not higher in any minerals, while guava is higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc.

    In short, enjoy both; both are healthy. But if you’re choosing one, there’s a clear winner here, and it’s guava.

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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  • How Much Difference Do Probiotic Supplements Make, Really?

    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.

    How Much Difference Do Probiotic Supplements Make?

    There are three main things that get talked about with regard to gut health:

    • Prebiotics (fibrous foods)
    • Probiotics (things containing live “good” bacteria)
    • Postbiotics (things to help them thrive)

    Today we’ll be talking about probiotics, but if you’d like a refresher on general gut health, here’s our previous main feature:

    Making Friends With Your Gut (You Can Thank Us Later)

    What bacteria are in probiotics?

    There are many kinds, but the most common by far are Lactobacillus sp. and Bifidobacteria sp.

    Taxonomical note:sp.” just stands for “species”. The first name is the genus, which contains a plurality of (sometimes, many) species.

    Lactobacillus acidophilus, also written L. acidophilus, is a common species of Lactobacillus sp. in probiotics.

    Bifidobacterium bifidum, also written B. bifidum, is a common species of Bifidobacterium sp. in probiotics.

    What difference do they make?

    First, and perhaps counterintuitively, putting more bacteria into your gut has a settling effect on the digestion. In particular, probiotics have been found effective against symptoms of IBS and ulcerative colitis, (but not Crohn’s):

    Probiotics are also helpful against diarrhea, including that caused by infections and/or antibiotics, as well as to reduce antibiotic resistance:

    Probiotics also boost the immune system outside of the gut, too, for example reducing the duration of respiratory infections:

    Multi-Strain Probiotic Reduces the Duration of Acute Upper Respiratory Disease in Older People: A Double-Blind, Randomised, Controlled Clinical Trial

    You may recallthe link between gut health and brain health, thanks in large part to the vagus nerve connecting the two:

    The Brain-Gut Highway: A Two-Way Street

    No surprises, then, that probiotics benefit mental health. See:

    There are so many kinds; which should I get?

    Diversity is good, so more kinds is better. However, if you have specific benefits you’d like to enjoy, you may want to go stronger on particular strains:

    Choosing an appropriate probiotic product for your patient: An evidence-based practical guide

    Where can I get them?

    We don’t sell them, but here’s an example product on Amazon, for your convenience.

    Alternatively, you can check out today’s sponsor, who also sell such; we recommend comparing products and deciding which will be best for you

    Enjoy!

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  • When You Know What You “Should” Do (But Knowing Isn’t The Problem)

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    When knowing what to do isn’t the problem

    Often, we know what we need to do. Sometimes, knowing isn’t the problem!

    The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.

    While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.

    What is Motivational Interviewing?

    ❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞

    Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice

    It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.

    However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.

    Three Phases

    Motivational Interviewing traditionally has three phases:

    1. Exploring and understanding the issue at hand
    2. Guiding and deciding importance and goals
    3. Choosing and setting an action plan

    In self-practice, maybe you can already know and understand what it is that you want/need to change.

    If not, consider asking yourself such questions as:

    • What does a good day look like? What does a bad day look like?
    • If things are not good now, when were they good? What changed?
    • If everything were perfect now, what would that look like? How would you know?

    Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?

    This is a critical process:

    • Give your answers numerically on a scale from 0 to 10
    • Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
    • In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
    • After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.

    Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.

    Some things to ask yourself at this stage of the motivational self-interviewing:

    • What’s a good SMART goal to get you started?
    • What could stop you from achieving your goal?
      • How could you overcome that challenge?
      • What is your backup plan, if you have to scale back your goal for some reason?

    A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.

    The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.

    Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”

    Secret fourth stage

    The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.

    For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.

    When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.

    Want to learn more?

    We only have so much room here, but there are lots of resources out there.

    Here’s a high-quality page that:

    • explains motivational interviewing in more depth than we have room for here
    • offers a lot of free downloadable resource packs and the like

    Check it out: Motivational Interviewing Theory & Resources

    Enjoy!

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  • The Salt Fix – by Dr. James DiNicolantonio

    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.

    This book has a bold premise: high salt consumption is not, as global scientific consensus holds, a serious health risk, but rather, as the title suggests, a health fix.

    Dr. DiNicolantonio, a pharmacist, explains how “our ancestors crawled out of the sea millions of years ago and we still crave that salt”, giving this as a reason why we should consume salt ad libitum, aiming for 8–10g per day, and thereafter a fair portion of the book is given over to discussing how many health conditions are caused/exacerbated by sugar, and that therefore we have demonized the wrong white crystal (scientific consensus is that there are many white crystals that can cause us harm).

    Indeed, sugar can be a big health problem, but reading it at such length felt a lot like when all a politician can talk about is how their political rival is worse.

    A lot of the studies the author cites to support the idea of healthy higher salt consumption rates were on non-human animals, and it’s always a lottery as to whether those results translate to humans or not. Also, many of the studies he’s citing are old and have methodological flaws, while others we could not find when we looked them up.

    One of the sources cited is “my friend Jose tried this and it worked for him”.

    Bottom line: sodium is an essential mineral that we do need to live, but we are not convinced that this book’s ideas have scientific merit. But are they well-argued? Also no.

    Click here to check out The Salt Fix for yourself! It’s a fascinating book.

    (Usually, if we do not approve of a book, we simply do not review it. We like to keep things positive. However, this one came up in Q&A, so it seemed appropriate to share our review. Also, the occasional negative review may reassure you, dear readers, that when we praise a book, we mean it)

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  • What’s Your Personal Life Expectancy?

    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.

    Tick Tock… Goes the Death Clock?

    This fun little test will ask a few questions about you and your lifestyle, and then make a prediction of your personal life expectancy, based on global statistics from the World Health Organisation.

    And then the countdown starts… Literally, it generates a clock for you to see your life-seconds ticking away—this may or may not delight you, but it sure is a curiosity.

    Their “Letters” page has a lot of reactions from people who just got their results (spoiler: people’s perspectives on life vary a lot)

    Who mostly uses this service? According to their stats page, it’s mostly curious under-45s, with gradually less interest in knowing about it from 45 onwards… until the age of 70, when suddenly everyone wants to know about it again!

    So Is It Possible To Pause The Clock On Aging? – Q&A Spotlight Interview

    Life extension is sometimes viewed as the domain of the super-rich, and with less than half of Millennials (and almost none of Gen-Z) having retirement plans, often those of us who aren’t super-rich have more mundane (and immediate!) goals than living to 120.

    And yet…

    Middle class and working class life-extensionists do exist, even if not garnering the same media attention. We think that’s strange—after all, while the whimsies of the super-rich may be entertaining to read about, it’s not nearly as applicable to most people as more relatable stories:

    • The twenty-something who gives up smoking and adds (healthier!) years to their life
    • The thirty-something who adopts a plant-based diet and is less likely to die of heart disease
    • The forty-something who stops drinking, and avoids health conditions and mishaps alike
    • The fifty-something who reconsiders their health plan in light of their changing body
    • The sixty-something who takes up yoga, or chess, or salsa dancing
    • The seventy-something who gets asked what their secret is
    • …and so on

    But these are ideas, textbook examples. What if we make it more personal?

    We interviewed 10 Almonds subscriber and longevity enthusiast Anastasia S., and here’s what she had to say:

    Q: What does life extension mean to you, in your life?

    A: To me, the key is healthy life extension. People often joke “I don’t want to live longer; the last years are the worst!” but they’re missing the point that after a certain age, those difficulties are coming whether they come at 50 or 70 or 90. Personally, I’d rather keep them at bay if I can.

    Q: How do you do that?

    A: Firstly, which won’t be a shock: good diet and exercise. Those two things are possibly the biggest active influences on my longevity. I’m vegan, which I don’t think is outright necessary for good health but done right, it can certainly be good. In this house we eat a lot of whole grains, beans, lentils, vegetables in general, nuts too. As for exercise, I do 30–60 minutes of Pilates daily; it’s nothing fancy and it’s just me in my pajamas at home, but it keeps me strong and fit and supple. I also walk everywhere; I don’t even own a car. Beyond that… I don’t drink or smoke (probably the biggest passive influences on my longevity, i.e., things that aren’t there to make it shorter), and I try to take my sleep seriously, making sure to schedule enough time and prepare properly for it.

    Q: Take your sleep seriously? How so?

    A: Good “sleep hygiene” as some call it—I schedule a little wind-down time before sleep, with no glaring screens or main lights, making a space between my busy day and restful sleep, kicking anything requiring brainpower to the morning, and making a conscious choice not to think more about those things in the meantime. I take care to make my sleeping environment as conducive as possible to good sleep too; I have a good mattress and pillows, I make sure the temperature is cool but cosy. I have a pot of herbal tea on my bedside table—I hydrate a lot.

    Q: Do you take any supplements?

    A: I do! They’re mostly quite general though, just “covering my bases”, so to speak. I take a daily nootropic stack (a collection of supplements specifically for brain health), too. I buy them in bulk, so they don’t cost so much.

    Q: This seems quite a healthy lifestyle! Do you have any vices at all?

    A: I definitely drink more coffee than I probably should! But hey, nobody’s perfect. I do love coffee, though, and as vices go, it’s probably not too bad.

    Q: How’s it all working out for you? Do you feel younger?

    A: I’m 38 and sometimes I feel like a teenager; sometimes I feel like an old lady. But the latter is usually for social reasons, not health-related reasons. I do have streaks of gray in my hair though, and I love that! If people don’t notice my grays, then they often think I’m in my 20s, rather than pushing 40. A little while back, I was stopped in the street by someone wanting to sell me a change of household utilities provider, then she stopped herself mid-sentence and said “Oh but wait, you look a bit too young, never mind”. Most general metrics of health would put me in my 20s.

    Q: That’s interesting that you love your gray hairs, for someone who wants to stay young; is it an exception?

    A: It’s more that I want to minimize the problems that come with age, and not everything’s a problem. Gray hairs are cool; joint pain, not so much. A long life rich with experiences is cool; memory loss, not so much. So, I try to keep healthy, and wear my years as best I can.

    Q: Sounds good to us; good luck with it!

    A: Thank you; I do my best!

    Here at 10 Almonds, we love featuring what our readers are doing to improve their health; if you’re willing to be featured in our newsletter, let us know by replying to this email (where an actual human will read it, we promise!)

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  • Keep Cellulite At Bay

    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 😎

    ❝Does anything actually get rid of cellulite? Nothing seems to❞

    Let’s get the bad news over with in one go:

    Nothing (that the scientific world currently knows of) can get rid of cellulite permanently, nor completely guard against it proactively. Which, given that it affects up to 98% of women to some degree, and often shows up not long after puberty (though it can appear at any time and often increases later in life), any pre-emptive health regime would need to be started as a child in any case.

    As with many things that predominantly affect women, the world of medicine isn’t entirely sure what causes it, let alone how to effectively treat it.

    Obviously hormones are implicated, namely estrogen.

    Obviously adiposity is implicated, because one can’t have dimples in one’s fat if one doesn’t have enough fat to dimple.

    Other hypothesized contributory factors include genetics, poor diet, inactivity, unhealthy lifestyle (in ways not previously mentioned, e.g. use of alcohol, tobacco, etc), accumulated toxins, and pregnancy.

    Here’s an old paper (from 2004); today’s reviews say pretty much the same thing, but we love how succinctly (albeit, somewhat depressingly) this abstract states how little we know and how little we can do:

    Cellulite: a review of its physiology and treatment

    However, all is not lost!

    There are some things that can affect how much cellulite we get, and there are some things that can reduce it, and even some things that can get rid of it completely—albeit temporarily.

    First, a quick refresher on what it actually is, physiologically speaking: cellulite occurs when connective tissue bands pull the skin down in places, where fat tissue has been able to squeeze through. One of the reasons it is hypothesized women get this more than men is because our fat is not merely different in distribution and overall percentage, but also in how the fat cells stack up; we generally have have of a vertical stacking structure going on, while men generally have a more horizontal structure. This means that it can be easier for ours to get moved about differently, causing the connective tissue to pull on the skin unevenly in places.

    With that in mind…

    Prevention is, as we say, probably impossible if your body is running on estrogen. However, those contributory factors we mentioned above? Most of those are modifiable, including these things that it is hypothesized can reduce it:

    Diet: as it seems to be worsened by inflammation (what isn’t?), an anti-inflammatory diet is recommended.

    Exercise: there are three things here: 1) exercises to improve circulation and thus the body’s ability to sort things out by itself 2) HIIT exercise to reduce body fat percentage, if one has a high enough starting body fat percentage for that to be a healthy goal 3) mobility exercises, to ensure our connective tissues are the right amount of mobile.

    Creams and lotions

    These reduce the superficial appearance of cellulite, without actually treating the thing itself. Mostly they are caffeine-based, which when used topically increases blood flow and works as a local diuretic, reducing the water content of the fat cells, diminishing the appearance of the cellulite by making each fat cell physically smaller (while still containing the same amount of fat, and it’ll bounce back in size as soon as the body can restore osmotic balance).

    Medical procedures

    There are too many of these to discuss them all separately, but they all work on the principle of breaking up the tough bands of connective tissue to eliminate the dimpling of cellulite.

    The methods they use vary from ultrasound to cryolipolysis to lasers to “vacuum-assisted precise tissue release”, which involves a suction pump and a multipronged robotic assembly with needles to administer anaesthetic as it goes and small blades to cut the connective tissues under the skin:

    Tissue Stabilized–Guided Subcision for the Treatment of Cellulite

    That last one definitely sounds like the least fun, but it’s also the only one that doesn’t take months to maybe see results.

    Cellulite can and almost certainly will come back after all of these.

    Home remedies

    Aside from at-home versions of the above (not the robots with vacuum pumps and needles and microblades, hopefully, but for example homemade caffeine creams), and of course diet and exercise which can be considered “home remedies”, there are two more things worth mentioning:

    Dry brushing: using a body brush to, as the name suggests, simply brush one’s skin. The “dry” aspect here is simply that it’s not done in the bath or shower; it’s done while dry. It can improve local circulation of blood and lymph, allowing for better detoxification and redistribution of needed bodily resources.

    Here’s an example dry brushing body brush on Amazon; this writer has one and hates it, but I’ve also tried with other kinds of brush and hate them too, so it seems to be a me thing rather than a brush thing, and I have desisted in trying, now. Maybe you will like it better; many people do.

    Self-massage: or massage by someone else, if that’s an option for you and you prefer. In this case, it works by a different mechanism than dry brushing; this time it’s working by the same principle as the medical techniques described in the previous section; it’s physically breaking down the toughened bits of connective tissue.

    Here’s an example wooden massage roller on Amazon; this writer has one and loves it; it’s sooooooo good. I got it as a matter of general maintenance for my fascia, but it’s also very good if I get a muscular pain now and again. As for cellulite, I personally get just a little cellulite sometimes (in the backs of my thighs), and whenever I use this regularly, it goes away for at least a while.

    A quick note in closing

    Cellulite is normal for women and is not unhealthy. Much like gray hair for example, it’s something that can be increased by poor health, but the thing itself isn’t intrinsically unhealthy, and most of us get it to some degree at some point.

    Nevertheless, aesthetic factors can also have a role to play in mental health, and we tend to feel best when we like the way our body looks. If for you that means wanting less/no cellulite, then the above are some ways towards that.

    As a bonus, most of the nonmedical options are directly good for the physical health anyway, so doing them is of course good.

    In particular that last one (the wooden massage roller), because that connective tissue we talked about? It matters for a lot more than just cellulite, and is heavily implicated in a lot of kinds of chronic pain, so it pays to keep it in good health:

    Fascia: Why (And How) You Should Take Care Of Yours

    (that article, also written by this same writer by the way, suggests a vibrating foam roller—those are very popular; I just really love my wooden one, and find it more effective)

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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