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Somatic Exercises For Nervous System Regulation – by Rose Kilian
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We’ve written before about the vagus nerve, its importance, and how to make use of it, but it’s easy to let it slip from one’s mind when it comes to exercises. This book fixes that!
The promised 35 exercises are quite a range, and are organized into sections:
- Revitalizing through breath
- Stress and tension release
- Spinal and postural health
- Mindfulness and grounding
- Movements for flexibility
- Graceful balance and focus
While it’s not necessary to do all 35 exercises, it’s recommended to do at least some from each section, to “cover one’s bases”, and enjoy the best of all worlds.
The exercises are drawn from many sources, but tai chi and yoga are certainly the most well-represented. Others, meanwhile, are straight from physiotherapy or are things one might expect to be advised at a neurology consultation.
Bottom line: if you’d like to take better care of your vagus nerve, the better for it to take care of you, this book can certainly help with that.
Click here to check out Somatic Exercises For Nervous System Regulation, and take care of yourself!
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When BMI Doesn’t Measure Up
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When BMI Doesn’t Quite Measure Up
Last month, we did a “Friday Mythbusters” edition of 10almonds, tackling many of the misconceptions surrounding obesity. Amongst them, we took a brief look at the usefulness (or lack thereof) of the Body Mass Index (BMI) scale of weight-related health for individuals. By popular subscriber request, we’re now going to dive a little deeper into that today!
The wrong tool for the job
BMI was developed as a tool to look at large-scale demographic trends, stemming from a population study of white European men, who were for the purpose of the study (the widescale health of the working class in that geographic area in that era), considered a reasonable default demographic.
In other words: as a system, it’s now being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
If you want to know yours…
Here’s the magic formula for calculating your BMI:
- Metric: divide your weight in kilograms by your height in square meters
- Imperial: divide your weight in pounds by your height in square inches and then multiply by 703
“What if my height doesn’t come in square meters or square inches, because it’s a height, not an area?”
We know. Take your height and square it anyway. If this seems convoluted and arbitrary, yes, it is.
But!
While on the one hand it’s convoluted and arbitrary… On the other hand, it’s also a gross oversimplification. So, yay for the worst of both worlds?
If you don’t want to grab a calculator, here’s a quick online tool to calculate it for you.
So, how did you score?
According to the CDC, a BMI score…
- Under 18.5 is underweight
- 18.5 to 24.9 is normal
- 25 to 29.9 is overweight
- 30 and over is obese
And, if we’re looking at a representative sample of the population, where the representation is average white European men of working age, that’s not a bad general rule of thumb.
For the rest of us, not so representative
BMI is a great and accurate tool as a rule of thumb, except for…
Women
An easily forgotten demographic, due to being a mere 51% of the world’s population, women generally have a higher percentage of body fat than men, and this throws out BMI’s usefulness.
If pregnant or nursing
A much higher body weight and body fat percentage—note that these are two things, not one. Some of the extra weight will be fat to nourish the baby; some will be water weight, and if pregnant, some will be the baby (or babies!). BMI neither knows nor cares about any of these things. And, this is a big deal, because BMI gets used by healthcare providers to judge health risks and guide medical advice.
People under the age of 16 or over the age of 65
Not only do people below and above those ages (respectively) tend to be shorter—which throws out the calculations and mean health risks may increase before the BMI qualifies as overweight—but also:
- BMI under 23 in people over the age of 65 is associated with a higher health risk
- A meta-analysis showed that a BMI of 27 was the best in terms of decreased mortality risk for the over-65 age group
This obviously flies in the face of conventional standards regards BMI—as you’ll recall from the BMI brackets we listed above.
Read the science: BMI and all-cause mortality in older adults: a meta-analysis
Athletic people
A demographic often described in scientific literature as “athletes”, but that can be misleading. When we say “athletes”, what comes to mind? Probably Olympians, or other professional sportspeople.
But also athletic, when it comes to body composition, are such people as fitness enthusiasts and manual laborers. Which makes for a lot more people affected by this!
Athletic people tend to have more lean muscle mass (muscle weighs more than fat), and heavier bones (can’t build strong muscles on weak bones, so the bones get stronger too, which means denser)… But that lean muscle mass can actually increase metabolism and help ward off many of the very same things that BMI is used as a risk indicator for (e.g. heart disease, and diabetes). So people in this category will actually be at lower risk, while (by BMI) getting told they are at higher risk.
If not white
Physical characteristics of race can vary by more than skin color, relevant considerations in this case include, for example:
- Black people, on average, not only have more lean muscle mass and less fat than white people, but also, have completely different risk factors for diseases such as diabetes.
- Asian people, on average, are shorter than white people, and as such may see increased health risks before BMI qualifies as overweight.
- Hispanic people, on average, again have different physical characteristics that throw out the results, in a manner that would need lower cutoffs to be even as “useful” as it is for white people.
Further reading on this: BMI and the BIPOC Community
In summary:
If you’re an average white European working-age man, BMI can sometimes be a useful general guide. If however you fall into one or more of the above categories, it is likely to be inaccurate at best, if not outright telling the opposite of the truth.
What’s more useful, then?
For heart disease risk and diabetes risk both, waist circumference is a much more universally reliable indicator. And since those two things tend to affect a lot of other health risks, it becomes an excellent starting point for being aware of many aspects of health.
Pregnancy will still throw off waist circumference a little (measure below the bump, not around it!), but it will nevertheless be more helpful than BMI even then, as it becomes necessary to just increase the numbers a little, according to gestational month and any confounding factors e.g. twins, triplets, etc. Ask your obstetrician about this, as it’s beyond the scope of today’s newsletter!
As to what’s considered a risk:
- Waist circumference of more than 35 inches for women
- Waist circumference of more than 40 inches for men
These numbers are considered applicable across demographics of age, sex, ethnicity, and lifestyle.
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The Physical Exercises That Build Your Brain
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Jim Kwik: from broken brain to brain coach
Image from Kwik Learning This is Jim Kwik. He suffered a traumatic brain injury as a small child, and later taught himself to read and write by reading comic books. He became fascinated with the process of learning, and in his late 20s he set up Kwik Learning, to teach accelerated learning in classrooms and companies, which he continued until 2009 when he launched his online learning platform. His courses have now been enjoyed by people in 195 countries.
So, since accelerated learning is his thing, you might wonder…
What does he have to share that we can benefit from in the next five minutes?
Three brain exercises to improve memory and concentration
A lot of problems we have with working memory are a case of executive dysfunction, but there are tricks we can use to get our brains into gear and make them cumulatively stronger:
First exercise
You can strengthen your corpus callosum (the little bridge between the two hemispheres of the brain) by performing a simple kinesiological exercise, such as alternating touching your left elbow to your right knee, and touching your right elbow to your left knee.
Do it for about a minute, but the goal here is not a cardio exercise, it’s accuracy!
You want to touch your elbow and opposite knee to each other as precisely as possible each time. Not missing slightly off to the side, not falling slightly short, not hitting it too hard.
Second exercise
Put your hands out in front of you, as though you’re about to type at a keyboard. Now, turn your hands palm-upwards. Now back to where they were. Now palm-upwards again. Got it? Good.
That’s not the exercise, the exercise is:
You’re now going to do the same thing, but do it twice as quickly with one hand than the other. So they’ll still be flipping to the same basic “beat”, put it in musical terms, the tempo on one hand will now be twice that of the other. When you get the hang of that, switch hands and do the other side.
This is again about the corpus callosum, but it’s now adding an extra level of challenge because of holding the two rhythms separately, which is also working the frontal lobe of the cerebral cortex.
The pre-frontal cortex in particular is incredibly important to executive function, self-discipline, and being able to “do” delayed gratification. So this exercise is really important!
Third exercise
This one works the same features of the brain, but most people find it harder. So, consider it a level-up on the previous:
Imagine there’s a bicycle wheel in front of you (as though the bike is facing you at chest-height). Turn the wheel towards you with your hands, one on each side.
Now, do the same thing, but each of your hands is going in the opposite direction. So one is turning the wheel towards you; the other is turning it away from you.
Now, do the same thing, but one hand goes twice as quickly as the other.
Switch sides.
Why is this harder for most people than the previous? Because the previous involved processing discrete (distinct from each other) movements while this one involves analog continuous movements.
It’s like reading an analog clock vs a digital clock, but while using both halves of your brain, your corpus callosum, your pre-frontal cortex, and the motor cortex too.
Want to learn more?
You might enjoy his book, which as well as offering exercises like the above, also offers a lot about learning strategies, memory processes, and generally building a quicker more efficient brain:
Limitless: Upgrade Your Brain, Learn Anything Faster, and Unlock Your Exceptional Life
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Chia Seeds vs Flax Seeds – Which is Healthier?
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Our Verdict
When comparing chia to flax, we picked the chia.
Why?
Both are great! And it’s certainly close. Both are good sources of protein, fiber, and healthy fats.
Flax seeds contain a little more fat (but it is healthy fat), while chia seeds contain a little more fiber.
They’re both good sources of vitamins and minerals, but chia seeds contain more. In particular, chia seeds have about twice as much calcium and selenium, and notably more iron and phosphorous—though flax seeds do have more potassium.
Of course the perfect solution is to enjoy both, but since for the purpose of this exercise we have to pick one, we’d say chia comes out on top—even if flax is not far behind.
Enjoy!
Learn more
For more on these, check out:
Take care!
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Olive Oil vs Coconut Oil – Which is Healthier?
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Our Verdict
When comparing extra virgin olive oil to cold-pressed coconut oil, we picked the olive oil.
Why?
While the cold-pressed coconut oil may offer some health benefits due to its lauric acid content, its 80–90% saturated fat content isn’t great for most people. It’s a great oil when applied topically for healthy skin and hair, though!
The extra virgin olive oil has a much more uncontroversially healthy blend of triglycerides, and (in moderation) is universally recognized as very heart-healthy.
Your local supermarket, most likely, has a good extra virgin olive oil, but if you’d like to get some online, here’s an example product on Amazon for your convenience.
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Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight
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Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight
Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.”
That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. She twice was rushed from her local hospital to Vanderbilt University Medical Center in Nashville, 79 miles away, where she was treated by brain specialists. She died Oct. 31 at age 70.
One of Prichard’s trips to the Nashville hospital was via helicopter ambulance. Wieberg said she had heard such flights could be pricey, but she didn’t realize how extraordinary the charge would be — or how her mother’s skimping on Medicare coverage could leave the family on the hook.
Then the bill came.
The Patient: Debra Prichard, who had Medicare Part A insurance before she died.
Medical Service: An air-ambulance flight to Vanderbilt University Medical Center.
Service Provider: Med-Trans Corp., a medical transportation service that is part of Global Medical Response, an industry giant backed by private equity investors. The larger company operates in all 50 states and says it has a total of 498 helicopters and airplanes.
Total Bill: $81,739.40, none of which was covered by insurance.
What Gives: Sky-high bills from air-ambulance providers have sparked complaints and federal action in recent years.
For patients with private insurance coverage, the No Surprises Act, which went into effect in 2022, bars air-ambulance companies from billing people more than they would pay if the service were considered “in-network” with their health insurers. For patients with public coverage, such as Medicare or Medicaid, the government sets payment rates at much lower levels than the companies charge.
But Prichard had opted out of the portion of Medicare that covers ambulance services.
That meant when the bill arrived less than two weeks after her death, her estate was expected to pay the full air-ambulance fee of nearly $82,000. The main assets are 12 acres of land and her home in Decherd, Tennessee, where she lived for 48 years and raised two children. The bill for a single helicopter ride could eat up roughly a third of the estate’s value, said Wieberg, who is executor.
The family’s predicament stems from the complicated nature of Medicare coverage.
Prichard was enrolled only in Medicare Part A, which is free to most Americans 65 or older. That section of the federal insurance program covers inpatient care, and it paid most of her hospital bills, her daughter said.
But Prichard declined other Medicare coverage, including Part B, which handles such things as doctor visits, outpatient treatment, and ambulance rides. Her daughter suspects she skipped that coverage to avoid the premiums most recipients pay, which currently are about $175 a month.
Loren Adler, a health economist for the Brookings Institution who studies ambulance bills, estimated the maximum charge that Medicare would have allowed for Prichard’s flight would have been less than $10,000 if she’d signed up for Part B. The patient’s share of that would have been less than $2,000. Her estate might have owed nothing if she’d also purchased supplemental “Medigap” coverage, as many Medicare members do to cover things like coinsurance, he said.
Nicole Michel, a spokesperson for Global Medical Response, the ambulance provider, agreed with Adler’s estimate that Medicare would have limited the charge for the flight to less than $10,000. But she said the federal program’s payment rates don’t cover the cost of providing air-ambulance services.
“Our patient advocacy team is actively engaged with Ms. Wieberg’s attorney to determine if there was any other applicable medical coverage on the date of service that we could bill to,” Michel wrote in an email to KFF Health News. “If not, we are fully committed to working with Ms. Wieberg, as we do with all our patients, to find an equitable solution.”
The Resolution: In mid-February, Wieberg said the company had not offered to reduce the bill.
Wieberg said she and the attorney handling her mother’s estate both contacted the company, seeking a reduction in the bill. She said she also contacted Medicare officials, filled out a form on the No Surprises Act website, and filed a complaint with Tennessee regulators who oversee ambulance services. She said she was notified Feb. 12 that the company filed a legal claim against the estate for the entire amount.
Wieberg said other health care providers, including ground ambulance services and the Vanderbilt hospital, wound up waiving several thousand dollars in unpaid fees for services they provided to Prichard that are normally covered by Medicare Part B.
But as it stands, Prichard’s estate owes about $81,740 to the air-ambulance company.
More from Bill of the Month
- The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags. Jan 25, 2024
- When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill Dec 19, 2023
- Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400 Nov 21, 2023
The Takeaway: People who are eligible for Medicare are encouraged to sign up for Part B, unless they have private health insurance through an employer or spouse.
“If someone with Medicare finds that they are having difficulty paying the Medicare Part B premiums, there are resources available to help compare Medicare coverage choices and learn about options to help pay for Medicare costs,” Meena Seshamani, director of the federal Center for Medicare, said in an email to KFF Health News.
She noted that every state offers free counseling to help people navigate Medicare.
In Tennessee, that counseling is offered by the State Health Insurance Assistance Program. Its director, Lori Galbreath, told KFF Health News she wishes more seniors would discuss their health coverage options with trained counselors like hers.
“Every Medicare recipient’s experience is different,” she said. “We can look at their different situations and give them an unbiased view of what their next best steps could be.”
Counselors advise that many people with modest incomes enroll in a Medicare Savings Program, which can cover their Part B premiums. In 2023, Tennessee residents could qualify for such assistance if they made less than $1,660 monthly as a single person or $2,239 as a married couple. Many people also could obtain help with other out-of-pocket expenses, such as copays for medical services.
Wieberg, who lives in Missouri, has been preparing the family home for sale.
She said the struggle over her mother’s air-ambulance bill makes her wonder why Medicare is split into pieces, with free coverage for inpatient care under Part A, but premiums for coverage of other crucial services under Part B.
“Anybody past the age of 70 is likely going to need both,” she said. “And so why make it a decision of what you can afford or not afford, or what you think you’re going to use or not use?”
Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Better Sex Through Mindfulness – by Dr. Lori Brotto
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Female sexuality is such a taboo topic that, if one searches for (ob/gyn professor, women’s health research director, and psychologist) Dr. Brotto’s book on Google or Amazon, it suggests only “lori brotto mindfulness book”. So, for those brave enough to read a book that would have shocked Victorians, what does this one contain?
The focus is on, as the title suggests, better sex, by and for women. That said, it’s mostly because typically women are more likely to experience the problems described in the book; it’s nothing actually intrinsic to womanhood. A man with the same problems could read this book and benefit just the same.
While the book covers many possible problems between the sheets, the overarching theme is problems of the mind, such as:
- Not getting into the mood in the first place
- Losing the mood quickly and easily, such as by becoming distracted
- Difficulty achieving orgasm even when mechanically everything’s delightful
- Physical discomfort creating a barrier to enjoyment
…and yes, that last one is in part mind-stuff too! Though Dr. Brotto isn’t arguing that mindfulness is a panacea, just an incredibly useful tool. And, it’s one she not only explains very well, but also explains from the position of a wealth of scientific evidence… Enough so, that we see a one-star Amazon reviewer from Canada complained that it was too well-referenced! For us, though, it’s what we like to see.
Good science, presented clearly and usefully, giving practical tips that improve people’s lives.
Bottom line: if you’ve ever lost the mood because you got distracted into thinking about taxes or that meeting on Tuesday, this is the book for you.
Click here to check out Better Sex Through Mindfulness—you can thank us later!
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