Avoiding Anemia (More Than Just “Get More Iron”)
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The Iron Dilemma: Factors To Consider
Anemia affects around 10% of American seniors, and that number jumps to 34–39% if there’s a comorbidity such as diabetes, hypertension, or hypercholesterolemia, which in turn climbs with increasing age or with other chronic conditions:
So, what can we do about it?
Get iron yes, but how?
We’d be remiss not to say: yes, do of course make sure you get plenty of iron.
Most people know that red meats, which are terrible for the heart and for cancer risk, are good sources of iron.
Well, good insofar as they provide plenty of it! They’re bad for other reasons.
❝Studies consistently show that consumption of red meat has been contributory to a multitude of chronic conditions such as diabetes, CVD, and malignancies.
There are various emerging reasons that strengthen this link-from the basic constituents of red meat like the heme iron component, the metabolic reactions that take place after consumption, and finally to the methods used to cook it.
The causative links show that even occasional use raises the risk of T2DM.❞
Source: Red Meat Consumption (Heme Iron Intake) and Risk for Diabetes and Comorbidities?
To heme or not to heme
Did you catch that in the middle there, about the heme iron component?
Dietary iron is broadly divided into two kinds: heme, and non-heme.
- Heme iron comes from animals
- Non-heme iron comes from plants
Bad news for vegans: non-heme iron is not so easily absorbed as heme iron.
This means that if you’re just eating plants, the RDA may be significantly lowballing the amount actually required. As a rule, about 1.8x more iron may be needed for vegans, to compensate for it being less easily absorbed.
Why this happens: it’s because of the phytic acid / phytate in the plants that contain the iron, blocking its absorption.
Good news for vegans: however, taking iron with vitamin C increases its absorption rate by about 5x better absorption, and several other side-along nutrients do similarly, including allium (from garlic), carotenoids (from many colorful plants), and fermented foods.
Why this happens: it’s because they bind with similar sites as phytic acid, without causing the same effect. To make a metaphor: these foods steal phytic acid’s parking space, so phytic acid can’t do its iron-blocking thing.
By happy coincidence, today’s featured recipe has all of these things in, by the way (vitamin C, allium, carotenoids, and fermented foods), and the star ingredient (fava beans) is a rich source of iron.
What are good sources of iron, then?
In the category of plants:
- Beans (pick your favorites / eat a variety)
- Lentils (pick your favorites / eat a variety)
- Greens (especially dark leafy greens)
- Apricots (you can get these dried, for convenience!)
- Dark chocolate (5mg per 1oz square!)*
*Ok, technically dark chocolate is not a plant; cacao is a plant; dark chocolate is usually plant-based, though, as there is no reason to add milk.
In the category of dairy products:
That’s not a publication error; dairy products are just not great for iron. Cheeses are more nutrient-dense than milk, and have less than 0.5mg per oz, in other words, the top dairy product has around 10x less iron than dark chocolate, which came in 5th place and let’s face it, we were doing broad categories there. If we listed all the beans, lentils, greens, etc it’d be a much longer list.
Eggs, which are sometimes considered under the category of dairy by virtue of not being an animal (yet!) but an animal product, have around 1mg per egg, by the way, so considering eggs are nearer 2oz, that’s not much better than the cheese.
“But what about if…”
The above is good science and general good advice for most people. That said, some people may have conditions that preclude the foods we recommended, or have other considerations, and so things may be different. Anemia can sometimes be caused by things that can’t be fixed by diet (beyond the scope of today’s article; another time, perhaps), but for example, if you have leukemia then definitely discuss things with your doctors first. Other illnesses, and some medications, can also have troublesome effects that can contribute to anemia. Again, we can offer very good general information here, but we don’t know your medical history, and our standard legal/medical disclaimer applies as always.
See also: Do We Need Animal Products To Be Healthy?
Take care!
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Huperzine A: A Natural Nootropic
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Huperzine A: A Natural Nootropic
Huperzine A is a compound, specifically a naturally occurring sesquiterpene alkaloid, that functions as an acetylcholinesterase inhibitor. If that seems like a bunch of big words, don’t worry, we’ll translate in a moment.
First, a nod to its origins: it is found in certain kinds of firmoss, especially the “toothed clubmoss”, Huperzia serrata, which grows in many Asian countries.
What’s an acetylcholinesterase inhibitor?
Let’s do this step-by-step:
- An acetylcholinesterase inhibitor is a compound that inhibits acetylcholinesterase.
- Acetylcholinesterase is an enzyme that catalyzes (speeds up) the breakdown of acetylcholine.
- Acetylcholine is a neurotransmitter; it’s an ester of acetic acid and choline.
- This is the main neurotransmitter of the parasympathetic nervous system, and is also heavily involved in cognitive functions including memory and creative thinking.
What this means: if you take an acetylcholinesterase inhibitor like huperzine A, it will inhibit acetylcholinesterase, meaning you will have more acetylcholine to work with. That’s good.
What can I expect from it?
Huperzine A has been well-studied for a while, mostly for the prevention and treatment of Alzheimer’s disease:
- New insights into huperzine A for the treatment of Alzheimer’s disease
- Huperzine A: Is it an Effective Disease-Modifying Drug for Alzheimer’s Disease?
- Huperzine A and Its Neuroprotective Molecular Signaling in Alzheimer’s Disease
However, research has suggested that huperzine A is much better as a prevention than a treatment:
❝A central event in the pathogenesis of Alzheimer’s disease (AD) is the accumulation of senile plaques composed of aggregated amyloid-β (Aβ) peptides.
Ex vivo electrophysiological experiments showed that 10 μM of Aβ1-40 significantly decreased the effect of the AChE inhibitor huperzine A on the synaptic potential parameters. ❞
~ Dr. Irina Zueva
In other words: the answer to the titular question is “Yes, yes it can”
And, to translate Dr. Zueva’s words into simple English:
- People with Alzheimer’s have amyloid-β plaque in their brains
- That plaque reduces the effectiveness of huperzine A
So, what if we take it in advance? That works much better:
❝Pre-treatment with [huperzine A] at concentrations of 50, 100, and 150 µg/mL completely inhibited the secretion of PGE2, TNF-α, IL-6, and IL-1β compared to post-treatment with [huperzine A].
This suggests that prophylactic treatment is better than post-inflammation treatment. ❞
~ Dr. Thu Kim Dang
Source: Anti-neuroinflammatory effects of alkaloid-enriched extract from Huperzia serrata
As you may know, neuroinflammation is a big part of Alzheimer’s pathology, so we want to keep that down. The above research suggests we should do that sooner rather than later.
Aside from holding off dementia, can it improve memory now, too?
There’s been a lot less research done into this (medicine is generally more concerned with preventing/treating disease, than improving the health of healthy people), but there is some:
^This is a small (n=68) old (1999) study for which the full paper has mysteriously disappeared and we only get to see the abstract. It gave favorable results, though.
The effects of huperzine A and IDRA 21 on visual recognition memory in young macaques
^This, like most non-dementia research into HupA, is an animal study. But we chose to spotlight this one because, unlike most of the studies, it did not chemically lobotomize the animals first; they were and remained healthy. That said, huperzine A improved the memory scores most for the monkeys that performed worst without it initially.
Where can I get it?
As ever, we don’t sell it, but here’s an example product on Amazon for your convenience
Enjoy!
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The Power of Fun – by Catherine Price
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It’s said that nobody’s dying regret is to wish they’d spent more time at the office, yet many of don’t make enough time for fun.
This book has been published with two different subtitles:
- Why fun is the key to a happy and healthy life
- How to feel alive again
One offers a sensible reason to read this book; the other offers a deeply emotional reason. Both are entirely valid.
Catherine Price sets out in this work to identify what fun actually is (she puts it at the intersection of playfulness, connection and flow) and how to have more of it (she gives a five-step method to build and integrate it into life).
In the category of criticism, this 334-page book is (in this reviewer’s opinion) a little padded and could have been an article instead. But the advice contained within it is sound, and the impact it can have might be profound.
Bottom line: if you find you’ve settled into a routine that’s perhaps comfortable, but not actually that much fun, this book will help you to liven things up.
Click here to check out The Power Of Fun, and feel more alive!
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The Path to Longevity – by Dr. Luigi Fontana
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We’ve reviewed other “expand your healthspan” books, and while they’re good (or else we wouldn’t include them), this is top-tier, up there with Dr. Greger’s books while being more accessible (more on this later).
This book is far more informational than opinionated, and while some reviewers have described the book as motivating them, that’s not at all the tone, and it’s clear that (beyond hoping for the reader to have to information to promote a long healthy life), the author has no particular agenda to push.
One example: while he gives a whole-foods, plant-based diet a “A+” rating, he puts the (often meat/fish-heavy) paleo diet at a close “A-“, depending on the animal products chosen (which can swing it a lot, and he discusses this in some detail).
In the category of criticism… This reviewer has none. Sometimes it seemed something was going unaddressed, but it would be addressed later.
Stylistically, the text is easy-reading and/but has a lot of references to hard science, complete with charts, diagrams, and so forth. The impression that this reviewer got is that Dr. Fontana took pains to convey as much science as possible, with (unlike Dr. Greger) as little jargon as possible. And that goes a long way.
Bottom line: if you’re looking for a “healthy aging” book that has a lot more science than “copy the Blue Zone supercentenarians and hope” without being so scientifically dense as “How Not To Die” or “How Not To Age“, then this is the book for you.
Click here to check out The Path to Longevity, and optimize the path you take!
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Fast Like A Girl – by Dr. Mindy Pelz
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A lot of information out there when it comes to intermittent fasting is very much centered on men in the 25–35 years age range. What about the rest of us?
Our physiological needs are not the same, and it’d be foolhardy to ignore that. But what things do still stand the same, and what things would benefit from a different approach in our cases?
Dr. Pelz has our back with this book packed with information based on the best science currently out there. She gives a general overview of fasting with full consideration to the fact that we the reader may well be female or over a certain age or both. In addition, the book offers:
- Metabolic switching (the “missing key to weight loss”)
- Building a fasting lifestyle (that works with your actual life, not just on paper)
- How to time fasting according to your menstrual cycle (if you don’t have a cycle, she has you covered too)
- How to break a fast—properly (and many other hacks/tips/tricks to make fasting so much easier)
Bottom line: if you want to do intermittent fasting and want to work with rather than against your body, then this book is a fine option.
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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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Which Plant Milk?
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Plant-based milks—what’s best?
You asked us to look at some popular plant milks and their health properties, and we said we’d do a main feature, so here it is!
We’ll also give a quick nod to environmental considerations at the end too (they might not be quite what you expect!). That said, as a health and productivity newsletter, we’ll be focusing on the health benefits.
While we can give a broad overview, please note that individual brands may vary, especially in two important ways:
- Pro: many (most?) brands of plant milks fortify their products with extra vitamins and minerals, especially vitamin D and calcium.
- Con: some brands also add sugar.
So, by all means use this guide to learn about the different plants’ properties, and/but still do check labels later.
Alternatively, consider making your own!
- Pros: no added sugar + cheaper
- Cons: no added vitamins and minerals + some equipment required
Almond milk
Almond milk is low in carbs and thus good for a carb-controlled diet. It’s also high in vitamin E and a collection of minerals.
Oat milk
Oats are one of the healthiest “staple foods” around, and while drinking oat milk doesn’t convey all the benefits, it does a lot. It also has one of the highest soluble fiber contents of any milk, which is good for reducing LDL (bad) cholesterol levels.
See for example: Consumption of oat milk for 5 weeks lowers serum cholesterol and LDL cholesterol in free-living men with moderate hypercholesterolemia
Coconut milk
Coconut has a higher fat content than most plant milks, but also contains medium-chain triglycerides (MCTs). These raise HDL (good) cholesterol levels.
Read the study: How well do plant based alternatives fare nutritionally compared to cow’s milk?
Hemp milk
Being made from hemp seeds that contain a lot of protein and healthy fats (including omega-3 and omega-6), hemp milk packs a nutritious punch. It’s carb-free. It’s also THC-free, in case you were wondering, which means no, it does not have psychoactive effects.
Pea milk
It’s very high in protein, and contains an array of vitamins and minerals. It’s not very popular yet, so there isn’t as much research about it. This 2021 study found that it had the nutritional profile the closest to cow’s milk (beating soy by a narrow margin) and praised it as a good alternative for those with a soy allergy.
This is Research Review Monday so we try to stick to pure science, but for your interest… here’s an interesting pop-science article (ostensibly in affiliation with the pea milk brand, Ripple) about the nutritional qualities of their pea milk specifically, which uses particularly nutrient-dense yellow peas, plus some extra vitamin and mineral fortifications:
Read: Ripple Milk: 6 Reasons Why You Should Try Pea Milk
Soy milk
Perhaps the most popular plant milk, and certainly usually the cheapest in stores. It’s high in protein, similar to cow’s milk. In fact, nutritionally, it’s one of the closest to cow’s milk without involving cows as a middleman. (Did you know three quarters of all soy in the world is grown to feed to livestock, not humans? Now you do).
And no, gentlemen-readers, it won’t have any feminizing effects. The human body can’t use the plant estrogens in soy for that. It does give some isoflavone benefits though, which are broadly good for everyone’s health. See for example this research review with 439 sources of its own:
Read: Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature
Quick note on flavor: nut milks have the flavor of the nut they were made from. Coconut milk tastes of coconut. The other milks listed above don’t have much of a flavor—which in many cases may be what you want.
Note on environmental considerations:
A lot of us try to be as socially responsible as reasonably possible in our choices, so this may be an influencing factor. In a nutshell:
- Oats and Soy are generally grown as vast monocrops, and these are bad for the environment
- They are still better for the environment than cow’s milk though, as for example most soy is grown to feed to cows, not humans. So including cows in the process means four times as much monocrop farming, plus adds several other environmental issues that are beyond the scope of this newsletter.
- Almonds are particularly resource-intensive when it comes to water use.
- Still nowhere near as much as cows, though.
- Peas are grown in places that naturally have very high rainfall, so are a good option here. Same generally goes for rice, which didn’t make the cut today. (Nor did hazelnuts, sorry—we can only include so much!)
- Hemp is by far and away the most environmentally friendly, assuming it is grown in a climate naturally conducive to such.
- Making plant milk at home is usually most environmentally friendly, depending on where your ingredients came from.
- Literally any plant milk is much more environmentally friendly than cow’s milk.
See the science for yourself: Reducing food’s environmental impacts through producers and consumers
See also (if you like graphs and charts): Environmental footprints of dairy and plant-based milks
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