The Truth About Statins – by Barbara H. Roberts, M.D.
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All too often, doctors looking to dispense a “quick fix” will prescribe from their playbook of a dozen or so “this will get you out of my office” drugs. Most commonly, things that treat symptoms rather than the cause. Sometimes, this can be fine! For example, in some cases, painkillers and antidepressants can make a big improvement to people’s lives. What about statins, though?
Prescribed to lower cholesterol, they broadly do exactly that. However…
Dr. Roberts wants us to know that we could be missing the big picture of heart health, and making a potentially fatal mistake.
This is not to say that the book argues that statins are necessarily terrible, or that they don’t have their place. Just, we need to understand what they will and won’t do, and make an informed choice.
To which end, she does advise regards when statins can help the most, and when they may not help at all. She also covers the questions to ask if your doctor wants to prescribe them. And—all so frequently overlooked—the important differences between men’s and women’s heart health, and the implications these have for the efficacy (or not) of statins.
With regard to the “alternatives to cholesterol-lowering drugs” promised in the subtitle… we won’t keep any secrets here:
Dr. Roberts (uncontroversially) recommends the Mediterranean diet. She also provides two weeks’ worth of recipes for such, in the final part of the book.
All in all, an important book to read if you or a loved one are taking, or thinking of taking, statins.
Pick up your copy of The Truth About Statins on Amazon today!
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Cognitive Enhancement Without Drugs
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Cognitive Enhancement Without Drugs
This is Elizabeth Ricker. She’s a Harvard-and-MIT-trained neuroscientist and researcher, who now runs the “Citizen Science” DIY-neurohacking organization, NeuroEducate.
Sounds fun! What’s it about?
The philosophy that spurs on her research and practice can be summed up as follows:
❝I’m not going to leave my brain up to my doctor or [anyone else]… My brain is my own responsibility, and I’m going to do the best that I can to optimize it❞
Her goal is not just to optimize her own brain though; she wants to make the science accessible to everyone.
What’s this about Citizen Science?
“Citizen Science” is the idea that while there’s definitely an important role in society for career academics, science itself should be accessible to all. And, not just the conclusions, but the process too.
This can take the form of huge experiments, often facilitated these days by apps where we opt-in to allow our health metrics (for example) to be collated with many thousands of others, for science. It can also involve such things as we talked about recently, getting our own raw genetic data and “running the numbers” at home to get far more comprehensive and direct information than the genetic testing company would ever provide us.
For Ricker, her focus is on the neuroscience side of biohacking, thus, neurohacking.
I’m ready to hack my brain! Do I need a drill?
Happily not! Although… Bone drills for the skull are very convenient instruments that make it quite hard to go wrong even with minimal training. The drill bit has a little step/ledge partway down, which means you can only drill through the thickness of the skull itself, before the bone meeting the wider part of the bit stops you from accidentally drilling into the brain. Still, please don’t do this at home.
What you can do at home is a different kind of self-experimentation…
If you want to consider which things are genuinely resulting in cognitive enhancement and which things are not, you need to approach the matter like a scientist. That means going about it in an organized fashion, and recording results.
There are several ways cognitive enhancement can be measured, including:
- Learning and memory
- Executive function
- Emotional regulation
- Creative intelligence
Let’s look at each of them, and what can be done. We don’t have a lot of room here; we’re a newsletter not a book, but we’ll cover one of Ricker’s approaches for each:
Learning and memory
This one’s easy. We’re going to leverage neuroplasticity (neurons that fire together, wire together!) by simple practice, and introduce an extra element to go alongside your recall. Perhaps a scent, or a certain item of clothing. Tell yourself that clinical studies have shown that this will boost your recall. It’s true, but that’s not what’s important; what’s important is that you believe it, and bring the placebo effect to bear on your endeavors.
You can test your memory with word lists, generated randomly by AI, such as this one:
You’ll soon find your memory improving—but don’t take our word for it!
Executive function
Executive function is the aspect of your brain that tells the other parts how to work, when to work, and when to stop working. If you’ve ever spent 30 minutes thinking “I need to get up” but you were stuck in scrolling social media, that was executive dysfunction.
This can be trained using the Stroop Color and Word Test, which shows you words, specifically the names of colors, which will themselves be colored, but not necessarily in the color the word pertains to. So for example, you might be shown the word “red”, colored green. Your task is to declare either the color of the word only, ignoring the word itself, or the meaning of the word only, ignoring its appearance. It can be quite challenging, but you’ll get better quite quickly:
The Stroop Test: Online Version
Emotional Regulation
This is the ability to not blow up angrily at the person with whom you need to be diplomatic, or to refrain from laughing when you thought of something funny in a sombre situation.
It’s an important part of cognitive function, and success or failure can have quite far-reaching consequences in life. And, it can be trained too.
There’s no online widget for this one, but: when and if you’re in a position to safely* do so, think about something that normally triggers a strong unwanted emotional reaction. It doesn’t have to be something life-shattering, but just something that you feel in some way bad about. Hold this in your mind, sit with it, and practice mindfulness. The idea is to be able to hold the unpleasant idea in your mind, without becoming reactive to it, or escaping to more pleasant distractions. Build this up.
*if you perchance have PTSD, C-PTSD, or an emotional regulation disorder, you might want to talk this one through with a qualified professional first.
Creative Intelligence
Another important cognitive skill, and again, one that can be cultivated and grown.
The trick here is volume. A good, repeatable test is to think of a common object (e.g. a rock, a towel, a banana) and, within a time constraint (such as 15 minutes) list how many uses you can think of for that item.
Writer’s storytime: once upon a time, I was sorting through an inventory of medical equipment with a colleague, and suggested throwing out our old arterial clamps, as we had newer, better ones—in abundance. My colleague didn’t want to part with them, so I challenged him “Give me one use for these, something we could in some possible world use them for that the new clamps don’t do better, and we’ll keep them”. He said “Thumbscrews”, and I threw my hands up in defeat, saying “Fine!”, as he had technically fulfilled my condition.
What’s the hack to improve this one? Just more volume. Creativity, as it turns out, isn’t something we can expend—like a muscle, it grows the more we use it. And because the above test is repeatable (with different objects), you can track your progress.
And if you feel like using your grown creative muscle to write/paint/compose/etc your magnum opus, great! Or if you just want to apply it to the problem-solving of everyday life, also great!
In summary…
Our brain is a wonderful organ with many functions. Society expects us to lose these as we get older, but the simple, scientific truth is that we can not only maintain our cognitive function, but also enhance and grow it as we go.
Want to know more from today’s featured expert?
You might enjoy her book, “Smarter Tomorrow”, which we reviewed back in March
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Ketogenic Diet: Burning Fat Or Burning Out?
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In Wednesday’s newsletter, we asked you for your opinion of the keto diet, and got the above-depicted, below-described set of responses:
- About 45% said “It has its benefits, but they don’t outweigh the risks”
- About 31% said “It is a good, evidence-based way to lose weight, be energized, and live healthily”
- About 24% said “It is a woeful fad diet and a fast-track to ruining one’s overall health”
So what does the science say?
First, what is the ketogenic diet?
There are two different stories here:
- Per science, it’s a medical diet designed to help treat refractory epilepsy in children.
- Per popular lore, it’s an energizing weight loss diet for Instagrammers and YouTubers.
Can it be both? The answer is: yes, but with some serious caveats, which we’ll cover over the course of today’s feature.
The ketogenic diet works by forcing the body to burn fat for energy: True or False?
True! This is why it helps for children with refractory epilepsy. By starving the body (including the brain) of glucose, the liver must convert fat into fatty acids and ketones, which latter the brain (and indeed the rest of the body) can now use for energy instead of glucose, thus avoiding one of the the main triggers of refractory epilepsy in children.
See: The Ketogenic Diet: One Decade Later | Pediatrics
Even the pediatric epilepsy studies, however, conclude it does have unwanted side effects, such as kidney stones, constipation, high cholesterol, and acidosis:
Source: Dietary Therapies for Epilepsy
The ketogenic diet is good for weight loss: True or False?
True! Insofar as it does cause weight loss, often rapidly. Of course, so do diarrhea and vomiting, but these are not usually held to be healthy methods of weight loss. As for keto, a team of researchers recently concluded:
❝As obesity rates in the populace keep rising, dietary fads such as the ketogenic diet are gaining traction.
Although they could help with weight loss, this study had a notable observation of severe hypercholesterolemia and increased risk of atherosclerotic cardiovascular disease among the ketogenic diet participants.❞
~ Dr. Shadan Khdher et al.
On which note…
The ketogenic diet is bad for the heart: True or False?
True! As Dr. Joanna Popiolek-Kalisz concluded recently:
❝In terms of cardiovascular mortality, the low-carb pattern is more beneficial than very low-carbohydrate (including the ketogenic diet). There is still scarce evidence comparing ketogenic to the Mediterranean diet.
Other safety concerns in cardiovascular patients such as adverse events related to ketosis, fat-free mass loss, or potential pharmacological interactions should be also taken into consideration in future research.❞
~ Dr. Joanna Popiolek-Kalisz
Read in full: Ketogenic diet and cardiovascular risk: state of the art review
The ketogenic diet is good for short-term weight loss, but not long-term maintenance: True or False?
True! Again, insofar as it works in the short term. It’s not the healthiest way to lose weight and we don’t recommend it, but it did does indeed precipitate short-term weight loss. Those benefits are not typically observed for longer than a short time, though, as the above-linked paper mentions:
❝The ketogenic diet does not fulfill the criteria of a healthy diet. It presents the potential for rapid short-term reduction of body mass, triglycerides level, Hb1Ac, and blood pressure.
Its efficacy for weight loss and the above-mentioned metabolic changes is not significant in long-term observations.❞
~ Ibid.
The ketogenic diet is a good, evidence-based way to lose weight, be energized, and live healthily: True or False?
False, simply, as you may have gathered from the above, but we’ve barely scratched the surface in terms of the risks.
That said, as mentioned, it will induce short-term weight loss, and as for being energized, typically there is a slump-spike-slump in energy:
- At first, the body is running out of glucose, and so naturally feels weak and tired.
- Next, the body enters ketosis, and so feels energized and enlivened ← this is the part where the popular enthusiastic reviews come from
- Then, the body starts experiencing all the longer-term problems associated with lacking carbohydrates and having an overabundance of fat, so becomes gradually more sick and tired.
Because of this, the signs of symptoms of being in ketosis (aside from: measurably increased ketones in blood, breath, and urine) are listed as:
- Bad breath
- Weight loss
- Appetite loss
- Increased focus and energy
- Increased fatigue and irritability
- Digestive issues
- Insomnia
The slump-spike-slump we mentioned is the reason for the seemingly contradictory symptoms of increased energy and increased fatigue—you get one and then the other.
Here’s a small but illustrative study, made clearer by its participants being a demographic whose energy levels are most strongly affected by dietary factors:
The ketogenic diet is a woeful fad diet and a fast-track to ruining one’s overall health: True or False?
True, subjectively in the first part, as it’s a little harsher than we usually go for in tone, though it has been called a fad diet in scientific literature. The latter part (ruining one’s overall health) is observably true.
One major problem is incidental-but-serious, which is that a low-carb diet is typically a de facto low-fiber diet, which is naturally bad for the gut and heart.
Other things are more specific to the keto diet, such as the problems with the kidneys:
However, kidney stones aren’t the worst of the problems:
Is Losing Weight Worth Losing Your Kidney: Keto Diet Resulting in Renal Failure
We’re running out of space and the risks associated with the keto diet are many, but for example even in the short term, it already increases osteoporosis risk:
❝Markers of bone modeling/remodeling were impaired after short-term low-carbohydrate high-fat diet, and only one marker of resorption recovered after acute carbohydrate restoration❞
~ Dr. Ida Heikura et al.
A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to Exercise
Want a healthier diet?
We recommend the Mediterranean diet.
See also: Four Ways To Upgrade The Mediterranean
(the above is about keeping to the Mediterranean diet, while tweaking one’s choices within it for a specific extra health focus such as an anti-inflammatory upgrade, a heart-healthy upgrade, a gut-healthy upgrade, and a brain-healthy upgrade)
Enjoy!
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Real Self-Care – by Pooja Lakshmin MD
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As the subtitle says, “crystals, cleanses, and bubble baths not included”. So, if it’s not about that sort of self-care, what is it about?
Dr. Lakshmin starts by acknowledging something that many self-help books don’t:
We can do everything correctly and still lose. Not only that, but for many of us, that is the probable outcome. Not because of any fault or weakness of ours, but simply because one way or another the game is rigged against us from the start.
So, should we throw in the towel, throw our hands in the air, and throw the book out of the window?
Nope! Dr. Lakshmin has actually helpful advice, that pertains to:
- creating healthy boundaries and challenging guilt
- treating oneself with compassion
- identifying and aligning oneself with one’s personal values
- asserting one’s personal power to fight for one’s own self-interest
If you’re reading this and thinking “that seems very selfish”, then let’s remember the “challenging guilt” part of that. We’ve all-too-often been conditioned to neglect our own needs and self-sacrifice for others.
And, while selfless service really does have its place, needlessly self-destructive martyrdom does not!
Bottom line: this book delivers a lot of “real talk” on a subject that otherwise often gets removed from reality rather. In short, it’s a great primer for finding the right place to draw the line between being a good-hearted person and being a doormat.
Click here to check out Real Self-Care and “put your own oxygen mask on first”!
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Gut Feelings – by Dr Will Cole
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More and more, science is uncovering links between our gut health and the rest of our health—including our mental health! We all know “get some fiber and consider probiotics”, but what else is there that we can do?
Quite a lot, actually. And part of it, which Dr. Cole also explores, is the fact that the gut-brain highway is a two-way street!
The book looks a lot especially at the particular relationship between shame and eating. The shame need not initially be about eating, though it can certainly end up that way too. But any kind of shame—be it relating to one’s body, work, relationship, or anything else, can not only have a direct effect on the gut, but indirect too:
Once our “eating our feelings” instinct kicks in, things can spiral from there, after all.
So, Dr. Cole walks us through tackling this from both sides—nutrition and psychology. With chapters full of tips and tricks, plus a 21-day plan (not a diet plan, a habit integration plan), this book hits shame (and inflammation, incidentally) hard and leads us into much healthier habits and cycles.
In short: if you’d like to have a better relationship with your food, improve your gut health, and/or reduce inflammation, this is definitely a book for you!
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The Five Key Traits Of Healthy Aging
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The Five Keys Of Aging Healthily
Image courtesy of Peter Prato. This is Dr. Daniel Levitin. He’s a neuroscientist, and his research focuses on aging, the brain, health, productivity, and creativity. Also music, and he himself is an accomplished musician also, but we’re not going to be focusing on that today.
We’re going to be looking at the traits that, according to science, promote healthy longevity in old age. In other words, the things that increase our healthspan, from the perspective of a cognitive scientist.
What does he say we should do?
Dr. Levitin offers us what he calls the “COACH” traits:
- Curiosity
- Openness
- Associations
- Conscientiousness
- Healthy practices
By “associations”, he means relationships. However, that would have made the acronym “CORCH”, and decisions had to be made.
Curiosity
Leonardo da Vinci had a list of seven traits he considered most important.
We’ll not go into those today (he is not our featured expert of the day!), but we will say that he agreed with Dr. Levitin on what goes at the top of the list: curiosity.
- Without curiosity, we will tend not to learn things, and learning things is key to keeping good cognitive function in old age
- Without curiosity, we will tend not to form hypotheses about how/why things are the way they are, so we will not exercise imagination, creativity, problem-solving, and other key functions of our brain
- Without curiosity, we will tend not to seek out new experiences, and consequently, our stimuli will be limited—and thus, so will our brains
Openness
Being curious about taking up ballroom dancing will do little for you, if you are not also open to actually trying it. But, openness is not just a tag-on to curiosity; it deserves its spot in its own right too.
Sometimes, ideas and opportunities come to us unbidden, and we have to be able to be open to those too. This doesn’t mean being naïve, but it does mean having at least a position of open-minded skepticism.
Basically, Dr. Levitin is asking us to be the opposite of the pejorative stereotype of “an old person stuck in their ways”.
Associations
People are complex, and so they bring complexities to our lives. Hopefully, positively stimulating ones. Without them to challenge us (again, hopefully in a positive way), we can get very stuck in a narrow field of experience.
And of course, having at least a few good friends has numerous benefits to health. There’s been a lot of research on this; 5 appears to be optimal.
- More than that, and the depth tends to tail off, and/or stresses ensue from juggling too many relationships
- Fewer than that, and we might be only a calendar clash away from loneliness
Friends provide social stimulation and mutual support; they’re good for our mental health and even our physiological immunity (counterintuitively, by means of shared germs).
And, a strong secure romantic relationship is something that has been found time and again to extend healthy life.
Note: by popular statistics, this benefit is conferred upon men partnered with women, men partnered with men, women partnered with women, but not women partnered with men.
There may be a causative factor that’s beyond the scope of this article which is about cognitive science, not feminism, but there could also be a mathematical explanation for this apparent odd-one-out:
Since women tend to live longer than men (who are also often older than their female partners), women who live the longest are often not in a relationship—precisely because they are widows. So these long-lived widows will tend to skew the stats, through no fault of their husbands.
On the flipside of this, for a woman to predecease her (statistically older and shorter-lived) husband will often require that she die quite early (perhaps due to accident or illness unrelated to age), which will again skew the stats to “women married to men die younger”, without anything nefarious going on.
Conscientiousness
People who score highly in the character trait “conscientiousness” will tend to live longer. The impact is so great, that a child’s scores will tend to dictate who dies in their 60s or their 80s, for example.
What does conscientiousness mean? It’s a broad character trait that’s scored in psychometric tests, so it can be things that have a direct impact on health, such as brushing one’s teeth, or things that are merely correlated, such as checking one’s work for typos (this writer does her best!).
In short, if you are the sort of person who attends to the paperwork for your taxes on time, you are probably also the sort of person who remembers to get your flu vaccination and cancer screening.
Healthy practices
This means “the usual things”, such as:
- Healthy diet (Mediterranean Diet consistently scores up top)
- Good exercise (especially the tendency to keep moving in general)
- Good sleep (7–9 hours, no compromises)
- Not drinking (or at least only very moderate consumption, but the only safe amount is zero)
- Not smoking (just don’t; there is no wiggle room on this one)
Want to learn more?
You can check out his book, which we reviewed all so recently, and you can also enjoy this video, in which he talks about matters concerning healthy aging from a neuroscientist’s perspective, ranging from heart health and neurodegeneration, to the myth of failing memory, to music and lifespan and more:
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Want the health benefits of strength training but not keen on the gym? Try ‘exercise snacking’
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The science is clear: resistance training is crucial to ageing well. Lifting weights (or doing bodyweight exercises like lunges, squats or push-ups) can help you live independently for longer, make your bones stronger, reduce your risk of diseases such as diabetes, and may even improve your sleep and mental health.
But not everyone loves the gym. Perhaps you feel you’re not a “gym person” and never will be, or you’re too old to start. Being a gym-goer can be expensive and time-consuming, and some people report feeling unwelcome or awkward at the gym.
The good news is you don’t need the gym, or lots of free time, to get the health benefits resistance training can offer.
You can try “exercise snacking” instead.
Pressmaster/Shutterstock What is exercise snacking?
Exercise snacking involves doing multiple shorter bouts (as little as 20 seconds) of exercise throughout the day – often with minimal or no equipment. It’s OK to have several hours of rest between.
You could do simple bodyweight exercises such as:
- chair sit-to-stand (squats)
- lunges
- box step-ups
- calf raises
- push-ups.
Exercise snacking like this can help improve muscle mass, strength and physical function.
It’s OK to hold onto a nearby object for balance, if you need. And doing these exercises regularly will also improve your balance. That, in turn, reduces your risk of falls and fractures.
OK I have done all those, now what?
Great! You can also try using resistance bands or dumbbells to do the previously mentioned five exercises as well as some of the following exercises:
When using resistance bands, make sure you hold them tightly and that they’re securely attached to an immovable object.
Exercise snacking works well when you pair it with an activity you do often throughout the day. Perhaps you could:
- do a few extra squats every time you get up from a bed or chair
- do some lunges during a TV ad break
- chuck in a few half squats while you’re waiting for your kettle to boil
- do a couple of elevated push-ups (where you support your body with your hands on a chair or a bench while doing the push-up) before tucking into lunch
- sneak in a couple of calf raises while you’re brushing your teeth.
Exercise snacking involves doing multiple shorter bouts (as little as 20 seconds) of exercise throughout the day. Cavan-Images/Shutterstock What does the evidence say about exercise snacking?
One study had older adults without a history of resistance training do exercise snacks at home twice per day for four weeks.
Each session involved five simple bodyweight exercises (chair sit-to-stand, seated knee extension, standing knee bends, marching on the spot, and standing calf raises). The participants did each exercise continuously for one minute, with a one-minute break between exercises.
These short and simple exercise sessions, which lasted just nine minutes, were enough to improve a person’s ability to stand up from a chair by 31% after four weeks (compared to a control group who didn’t exercise). Leg power and thigh muscle size improved, too.
Research involving one of us (Jackson Fyfe) has also shown older adults found “exercise snacking” feasible and enjoyable when done at home either once, twice, or three times per day for four weeks.
Exercise snacking may be a more sustainable approach to improve muscle health in those who don’t want to – or can’t – lift heavier weights in a gym.
A little can yield a lot
We know from other research that the more you exercise, the more likely it is you will keep exercising in future.
Very brief resistance training, albeit with heavier weights, may be more enjoyable than traditional approaches where people aim to do many, many sets.
We also know brief-and-frequent exercise sessions can break up periods of sedentary behaviour (which usually means sitting too much). Too much sitting increases your risk of chronic diseases such as diabetes, whereas exercise snacking can help keep your blood sugar levels steady.
Of course, longer-term studies are needed. But the evidence we do have suggests exercise snacking really helps.
Just a few short exercise sessions can do you a world of good. eggeegg/Shutterstock Why does any of this matter?
As you age, you lose strength and mass in the muscles you use to walk, or stand up. Everyday tasks can become a struggle.
All this contributes to disability, hospitalisation, chronic disease, and reliance on community and residential aged care support.
By preserving your muscle mass and strength, you can:
- reduce joint pain
- get on with activities you enjoy
- live independently in your own home
- delay or even eliminate the need for expensive health care or residential aged care.
What if I walk a lot – is that enough?
Walking may maintain some level of lower body muscle mass, but it won’t preserve your upper body muscles.
If you find it difficult to get out of a chair, or can only walk short distances without getting out of breath, resistance training is the best way to regain some of the independence and function you’ve lost.
It’s even more important for women, as muscle mass and strength are typically lower in older women than men. And if you’ve been diagnosed with osteoporosis, which is more common in older women than men, resistance exercise snacking at home can improve your balance, strength, and bone mineral density. All of this reduces the risk of falls and fractures.
You don’t need heavy weights or fancy equipment to benefit from resistance training.
So, will you start exercise snacking today?
Justin Keogh, Associate Dean of Research, Faculty of Health Sciences and Medicine, Bond University and Jackson Fyfe, Senior Lecturer, Strength and Conditioning Sciences, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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