Pneumonia: Prevention Is Better Than Cure
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Pneumonia: What We Can & Can’t Do About It
Pneumonia is a significant killer of persons over the age of 65, with the risk increasing with age after that, rising very sharply around the age of 85:
While pneumonia is treatable, especially in young healthy adults, the risks get more severe in the older age brackets, and it’s often the case that someone goes into hospital with one thing, then develops pneumonia, which the person was already not in good physical shape to fight, because of whatever hospitalized them in the first place:
American Lung Association | Pneumonia Treatment and Recovery
Other risk factors besides age
There are a lot of things that can increase our risk factor for pneumonia; they mainly fall into the following categories:
- Autoimmune diseases
- Other diseases of the immune system (e.g. HIV)
- Medication-mediated immunosuppression (e.g. after an organ transplant)
- Chronic lung diseases (e.g. asthma, COPD, Long Covid, emphysema, etc)
- Other serious health conditions ← we know this one’s broad, but it encompasses such things as diabetes, heart disease, and cancer
See also:
Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
Things we can do about it
When it comes to risks, we can’t do much about our age and some of the other above factors, but there are other things we can do to reduce our risk, including:
- Get vaccinated against pneumonia if you are over 65 and/or have one of the aforementioned risk factors. This is not perfect (it only reduces the risk for certain kinds of infection) and may not be advisable for everyone (like most vaccines, it can put the body through its paces a bit after taking it), so speak with your own doctor about this, of course.
- See also: Vaccine Mythbusting
- Avoid contagion. While pneumonia itself is not spread person-to-person, it is caused by bacteria or viruses (there are numerous kinds) that are opportunistic and often become a secondary infection when the immune system is already busy with the first one. So, if possible avoid being in confined spaces with many people, and do wash your hands regularly (as a lot of germs are transferred that way and can get into the respiratory tract because you touched your face or such).
- See also: The Truth About Handwashing
- If you have a cold, or flu, or other respiratory infection, take it seriously, rest well, drink fluids, get good immune-boosting nutrients. There’s no such thing as “just a cold”; not anymore.
- Look after your general health too—health doesn’t exist in a vacuum, and nor does disease. Every part of us affects every other part of us, so anything that can be in good order, you want to be in good order.
This last one, by the way? It’s an important reminder that while some diseases (such as some of the respiratory infections that can precede pneumonia) are seasonal, good health isn’t.
We need to take care of our health as best we can every day along the way, because we never know when something could change.
Want to do more?
Check out: Seven Things To Do For Good Lung Health!
Take care!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, and the good news is, the heat of pasteurization kills it:
With all this bird flu around, how safe are eggs, chicken or milk?
Take care!
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Fast-Pickled Cucumbers
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Pickled vegetables are great for the gut, and homemade is invariably better than store-bought. But if you don’t have pickling jars big enough for cucumbers, and don’t want to wait a couple of weeks for the results, here’s a great way to do it quickly and easily.
You will need
- 1 large cucumber, sliced
- 2 tbsp apple cider vinegar
- 1½ tbsp salt (do not omit or substitute)
- 3 cloves garlic, whole, peeled
- 3 large sprigs fresh dill
- 2 tsp whole black peppercorns
- ½ tsp crushed red pepper flakes
- 1 bay leaf
Method
(we suggest you read everything at least once before doing anything)
1) Mix the vinegar and salt with 1½ cups of water in a bowl.
2) Assemble the rest of the ingredients, except the cucumber, into a quart-size glass jar with an airtight lid.
3) Add the cucumber slices into the jar.
4) Add the pickling brine that you made, leaving ½” space at the top.
5) Close the lid, and shake well.
6) Refrigerate for 2 days, after which, serve at your leisure:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Our Top 5 Spices: How Much Is Enough For Benefits? ← 3/5 of these spices are in this recipe!
Take care!
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ADHD… As An Adult?
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ADHD—not just for kids!
Consider the following:
- If a kid has consistent problems paying attention, it’s easy and common to say “Aha, ADHD!”
- If a young adult has consistent problems paying attention, it’s easy and common to say “Aha, a disinterested ne’er-do-well!”
- If an older adult has consistent problems paying attention, it’s easy and common to say “Aha, a senior moment!”
Yet, if we recognize that ADHD is fundamentally a brain difference in children (and we do; there are physiological characteristics that we can test), and we can recognize that as people get older our brains typically have less neuroplasticity (ability to change) than when we are younger rather than less, then… Surely, there are just as many adults with ADHD as kids!
After all, that rather goes with the linear nature of time and the progressive nature of getting older.
So why do kids get diagnoses so much more often than adults?
Parents—and schools—can find children’s ADHD challenging, and it’s their problem, so they look for an explanation, and ADHD isn’t too difficult to find as a diagnosis.
Meanwhile, adults with ADHD have usually developed coping mechanisms, have learned to mask and/or compensate for their symptoms, and we expect adults to manage their own problems, so nobody’s rushing to find an explanation on their behalf.
Additionally, the stigma of neurodivergence—especially something popularly associated with children—isn’t something that many adults will want for themselves.
But, if you have an ADHD brain, then recognizing that (even if just privately to yourself) can open the door to much better management of your symptoms… and your life.
So what does ADHD look like in adults?
ADHD involves a spread of symptoms, and not everyone will have them all, or have them in the same magnitude. However, very commonly most noticeable traits include:
- Lack of focus (ease of distraction)
- Conversely: high focus (on the wrong things)
- To illustrate: someone with ADHD might set out to quickly tidy the sock drawer, and end up Marie Kondo-ing their entire wardrobe… when they were supposed to doing something else
- Conversely: high focus (on the wrong things)
- Poor time management (especially: tendency to procrastinate)
- Forgetfulness (of various kinds—for example, forgetting information, and forgetting to do things)
Want To Take A Quick Test? Click Here ← this one is reputable, and free. No sign in required; the test is right there.
Wait, where’s the hyperactivity in this Attention Deficit Hyperactivity Disorder?
It’s often not there. ADHD is simply badly-named. This stems from how a lot of mental health issues are considered by society in terms of how much they affect (and are observable by) other people. Since ADHD was originally noticed in children (in fact being originally called “Hyperkinetic Reaction of Childhood”), it ended up being something like:
“Oh, your brain has an inconvenient relationship with dopamine and you are driven to try to correct that by shifting attention from boring things to stimulating things? You might have trouble-sitting-still disorder”
Hmm, this sounds like me (or my loved one); what to do now at the age of __?
Some things to consider:
- If you don’t want medication (there are pros and cons, beyond the scope of today’s article), you might consider an official diagnosis not worth pursuing. That’s fine if so, because…
- More important than whether or not you meet certain diagnostic criteria, is whether or not the strategies recommended for it might help you.
- Whether or not you talk to other people about it is entirely up to you. Maybe it’s a stigma you’d rather avoid… Or maybe it’ll help those around you to better understand and support you.
- Either way, you might want to learn more about ADHD in adults. Today’s article was about recognizing it—we’ll write more about managing it another time!
In the meantime… We recommended a great book about this a couple of weeks ago; you might want to check it out:
Click here to see our review of “The Silent Struggle: Taking Charge of ADHD in Adults”!
Note: the review is at the bottom of that page. You’ll need to scroll past the video (which is also about ADHD) without getting distracted by it and forgetting you were there to see about the book. So:
- Click the above link
- Scroll straight to the review!
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Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Ron Lach/Pexels Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.
Eating a meal with medicine will delay its onset. Farhad/Pexels Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isn’t enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.
If it doesn’t upset your stomach, ibuprofen can be taken with water. Tbel Abuseridze/Unsplash A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Natto, Taurine + Black Pepper, And Other Game-Changers
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝Loved the info on nuts; of course I always eat pecans, which didn’t make the list of healthy nuts!❞
Dear subscriber, pardon the paraphrase of your comment—somehow it got deleted and now exists only in this writer’s memory. However, to address it:
Pecans are great too! We can’t include everything in every article (indeed, we got another feedback the same day saying the article was too long), but we love when you come to us with stuff for us to look at and write about (seriously, writer here: the more you ask, the easier it makes my job), so let’s talk pecans for a moment:
Pecans would have been number six on our list if we’d have written more!
Like many nuts, they’ve an abundance of healthy fats, fiber, vitamins, and minerals.
They’re particularly good for zinc, which is vital for immune function, healing (including normal recovery after normal exercise), and DNA synthesis (so: anti-aging).
Pecans are also great for reducing LDL (“bad” cholesterol) and triglycerides (which are also bad for heart health); check it out:
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How To Grow In Comfort
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How To Grow (Without Leaving Your Comfort Zone)
“You have to get out of your comfort zone!” we are told, from cradle to grave.
When we are young, we are advised (or sometimes more forcefully instructed!) that we have to try new things. In our middle age, we are expected to be the world’s greatest go-getters, afraid of nothing and always pushing limits. And when we are old, people bid us “don’t be such a dinosaur”.
It is assumed, unquestioned, that growth can only occur through hardship and discomfort.
But what if that’s a discomforting lie?
Butler (2023) posited an idea: “We never achieve success faster and with less effort than when we are in our comfort zone”
Her words are an obvious callback to the ideas of Csikszentmihalyi (1970) in the sense of “flow”, in the sense in which that word is used in psychology.
Flow is: when a person is in a state of energized focus, full involvement, and enjoyment of an activity.
As a necessary truth (i.e: a function of syllogistic logic), the conditions of “in a state of flow” and “outside of one’s comfort zone” cannot overlap.
From there, we can further deduce (again by simple logic) that if flow can be found, and/but cannot be found outside of the comfort zone, then flow can only be found within the comfort zone.
That is indeed comforting, but what about growth?
Imagine you’ve never gone camping in your life, but you want to get outside of your comfort zone, and now’s the time to do it. So, you check out some maps of the Yukon, purchase some camping gear, and off you go into the wilderness. In the event that you survive to report it, you will indeed be able to say “it was not comfortable”.
But, did growth occur? Maybe, but… it’s a folly to say “what doesn’t kill us makes us stronger” as a reason to pursue such things. Firstly, there’s a high chance it may kill us. Secondly, what doesn’t kill us often leaves us incredibly weakened and vulnerable.
When Hannibal famously took his large army of mostly African mercenaries across the Alps during winter to march on Rome from the other side, he lost most of his men on the way, before proceeding to terrorize Northern Italy convincingly with the small remainder. But! Their hard experience hadn’t made them stronger; it had just removed the weaker soldiers, making the resultant formations harder to break.
All this to say, please do not inflict hardship and discomfort and danger in the hopes it’ll make you stronger; it will probably do the opposite.
But…
If, instead of wilderness trekking in the Yukon…
- You start off with a camper van holiday, then you’ll be taking a fair amount of your comfort with you. In effect, you will be stretching and expanding your comfort zone without leaving it.
- Then maybe another year you might try camping in a tent on a well-catered camping site.
- Later, you might try “roughing it” at a much less well-catered camping site.
- And so on.
Congratulations, you have tried new things and undergone growth, taking your comfort zone with you all the way!
This is more than just “easing yourself into” something
It really is about taking your comfort with you too. If you want to take up running, don’t ask “how can I run just a little bit first” or “how can I make it easier” (well, feel free to ask those things too, but) ask yourself: how can I bring my comfort with me? Comfortable shoes, perhaps, an ergonomic water bottle, shade for your head, maybe.
❝Any fool can rough it, but a good soldier can make himself comfortable in any circumstances❞
~ British Army maxim
This goes for more than just physical stuff, too
If you want to learn a new skill, the initial learning curve can be anxiety-inducing, especially if you are taking a course and worried about keeping up or “not being good enough”.
So, “secretly” study in advance, at your leisure, get yourself a head start. Find a degree of comfort in what you’ve learned so far, and then bring that comfort with you into your entry-level course that is now less intimidating.
Discomfort isn’t a badge of honor (and impedes growth)
Take that extra rest stop on the highway. Bring your favorite coffee with you. Use that walking stick, if it helps.
Whatever it takes to bring your comfort with you, bring it.
Trust us, you’ll get further that way.
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