Foot Drop!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Interesting about DVT after surgery. A friend recently got diagnosed with foot drop. Could you explain that? Thank you.❞
First, for reference, the article about DVT after surgery was:
DVT Risk Management Beyond The Socks
As for foot drop…
Foot drop is descriptive of the main symptom: the inability to raise the front part of the foot due to localized weakness/paralysis. Hence, if a person with foot drop dangles their feet over the edge of the bed, for example, the affected foot will simply flop down, while the other (if unaffected) can remain in place under its own power. The condition is usually neurological in origin, though there are various more specific causes:
When walking unassisted, this will typically result in a distinctive “steppage gait”, as it’s necessary to lift the foot higher to compensate, or else the toes will scuff along the ground.
There are mobility aids that can return one’s walking to more or less normal, like this example product on Amazon.
Incidentally, the above product will slightly shorten the lifespan of shoes, as it will necessarily pull a little at the front.
There are alternatives that won’t like this example product on Amazon, but this comes with the different problem that it limits the user to stepping flat-footedly, which is not only also not an ideal gait, but also, will serve to allow any muscles down there that were still (partially or fully) functional to atrophy. For this reason, we’d recommend the first product we mentioned over the second one, unless your personal physiotherapist or similar advises otherwise (because they know your situation and we don’t).
Both have their merits, though:
Trends and Technologies in Rehabilitation of Foot Drop: A Systematic Review
Of course, prevention is better than cure, so while some things are unavoidable (especially when it comes to neurological conditions), we can all look after our nerve health as well as possible along the way:
Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
…as well as the very useful:
What Does Lion’s Mane Actually Do, Anyway?
…which this writer personally takes daily and swears by (went from frequent pins-and-needles to no symptoms and have stayed that way, and that’s after many injuries over the years).
If you’d like a more general and less supplements-based approach though, check out:
Steps For Keeping Your Feet A Healthy Foundation
Take care!
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Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley
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Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.
(In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)
Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).
The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂
Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.
Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!
PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!
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The Off-Button For Your Brain
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The Off-Button For Your Brain
We evolved our emotions for our own benefit as a species. Even the “negative” ones:
- Stress keeps us safe by making sure we take important situations seriously
- Anger keeps us safe by protecting us from threats
- Disgust keeps us safe by helping us to avoid things that might cause disease
- Anxiety keeps us safe by ensuring we don’t get complacent
- Guilt keeps us safe by ensuring we can function as a community
- Sadness keeps us safe by ensuring we value things that are important to us, and learn to become averse to losing them
- …and so on
But that’s not always useful. What was once a very good response to a common source of fear (for example, a sabre-toothed tiger) is no longer a helpful response to a modern source of fear (for example, an important interview).
Sometimes it’s good to take the time and energy to process our feelings and the event(s) that prompted those feelings. Sometimes, we don’t have that luxury.
For example, if you are stressed about your workload? Then staying awake half the night thinking about it is only going to make your problems worse the next day.
So, how to switch that off, or at least put a pause on it?
The human mind tends to have a “negative bias”, evolved for our own protection. If something is “good enough”, we don’t need to worry about it, so we move on to the next thing, until we find something that is a problem, then we dwell on that. That’s not always helpful, and the good news is, there’s a way to flip the switch on this process:
Identifying the positive, and releasing the rest
This exercise can be done when you’re trying to sleep, or at any time you need a calmer, quieter mind.
Take a moment to notice whatever you’re experiencing.
If it’s something that feels good, or neutral, identify it with a single word. For example:
- Warmth
- Soft
- Security
- Smile
- Peace
If it’s something that feels bad, then instead of identifying it, simply say (or think) to yourself “release”.
You can’t fight bad feelings with force, and you can’t “just not think about them”, but you can dismiss them as soon as they arrive and move onto the next thing. So where your train of thought may previously have been:
It’s good to be in bed ➔ I have eight hours to sleep before my meeting ➔ Have I done everything I was supposed to? ➔ I hope that what I’ve done is good enough ➔ [Mentally rehearsing how the meeting might go] ➔ [various disaster preparations] ➔ What am I even going to wear? ➔ Ugh I forgot to do the laundry ➔ That reminds the electricity bill is due ➔ Etc
Now your train of thought may be more like:
Relief ➔ Rest ➔ But my meeti—release ➔ If I—release ➔ soft ➔ comfort ➔ release ➔ pillow ➔ smile ➔ release ➔ [and before you know it you’re asleep]
And if you do this in a situation where you’re not going to sleep? Same process, just a more wakeful result, for example, let’s move the scene to an office where your meeting will shortly take place:
Five minutes to go ➔ What a day ➔ Ok, I’d better clear my head a bit ➔ release ➔ release ➔ breath ➔ light ➔ chair ➔ what if—release ➔ prepared ➔ ready ➔ calm ➔ [and before you know it you’re impressing your work associate with your calm preparedness]
In summary:
If you need to stop a train of thought, this method may help. Especially if you’re in a situation where you can’t use some external distraction to keep you from thinking about the bad thing!
You’re probably still going to have to deal with the Bad Thing™ at some point—you’ve just recognized that now isn’t the time for that. Mentally postpone that so that you will be well-rested when you choose to deal with the Bad Thing™ later at your convenience.
So remember: identify the positive (with a single word), and anything else, just release.
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Holding Back The Clock on Aging
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Holding Back The Clock on Aging
This is Dr. Eric Verdin, President and CEO of the Buck Institute of Research on Aging. He’s also held faculty positions at the University of Brussels, the NIH, and the Picower Institute for Medical Research. Dr. Verdin is also a professor of medicine at University of California, San Francisco.
Dr. Verdin’s laboratory focuses on the role of epigenetic regulators (especially the behaviors of certain enzymes) in the aging process. He studies how metabolism, diet, and chemical factors regulate the aging process and its associated diseases, including Alzheimer’s.
He has published more than 210 scientific papers and holds more than 15 patents. He is a highly cited scientist and has been recognized for his research with a Glenn Award for Research in Biological Mechanisms of Aging.
And that’s just what we could fit here! Basically, he knows his stuff.
What we can do
Dr. Verdin’s position is bold, but rooted in evidence:
❝Lifestyle is responsible for about 93% of our longevity—only about 7% is genetics. Based on the data, if implementing health lifestyle choices, most people could live to 95 in good health. So there’s 15 to 17 extra years of healthy life that is up for grabs❞
~ Dr. Eric Verdin
See for example:
- From discoveries in aging research to therapeutics for healthy aging
- Optimism, lifestyle, and longevity in a racially diverse cohort of women
- Well-being, food habits, and lifestyle for longevity—evidence from supercentenarians
How we can do it
Well, we all know “the big five”:
- Good diet (Mediterranean Diet as usual is recommended)
- Good exercise (more on this in a moment)
- Good sleep (more on this in a moment)
- Avoid alcohol (not controversial)
- Don’t smoke (need we say more)
When it comes to exercise, generally recognized as good is at least 150 minutes per week of moderate intensity exercise (for example, a brisk walk, or doing the gardening), and at least three small sessions a week of high intensity exercise, unless contraindicated by some medical condition.
As for Dr. Verdin’s take on this…
What Dr. Verdin recommends is:
- make it personalized
- make it pre-emptive
- make it better
The perfect exercise plan is only perfect if you actually do it. And if you actually can do it, for that matter.
Prevention is so much better (and easier) than cure for a whole array of maladies. So while there may be merit in thinking “what needs fixing”, Dr. Verdin encourages us to take extra care to not neglect factors of our health that seem “good enough”. Because, give them time and neglect, and they won’t be!
Wherever we’re at in life and health, there’s always at least some little way we could make it a bit better. Dr. Verdin advises us to seek out those little improvements, even if it’s just a nudge better here, a nudge better there, all those nudges add up!
About sleep…
It’s perhaps the easiest one to neglect (writer’s note: as a writer, I certainly feel that way!), but his biggest take-away tip for this is:
Worry less about what time you set an alarm for in the morning. Instead, set an alarm for the evening—to remind you when to go to bed.
Want to hear directly from the man himself?
Here he is speaking on progress we can expect for the next decade in the field of aging research, as part of the 100 Minutes of Longevity session at The Longevity Forum, a few months ago:
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Stop Cancer 20 Years Ago
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Get Abreast And Keep Abreast
This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.
What does she want us to know?
Start now
If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.
What this means for those of us without breast cancer (or a history therof) is: start now
Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.
Start what, you ask? Taking away its roots. And how?
Inflammation as the root of cancer
To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.
Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:
“and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”
So, fight inflammation now, and have a reduced risk of a lot of other woes later.
See: How to Prevent (or Reduce) Inflammation
Don’t settle for “normal”
People are told, correctly but not always helpfully, such things as:
- It’s normal to have less energy at your age
- It’s normal to have a weaker immune system at your age
- It’s normal to be at a higher risk of diabetes, heart disease, etc
…and many more. And these things are true! But that doesn’t mean we have to settle for them.
We can be all the way over on the healthy end of the distribution curve. We can do that!
(so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)
If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.
So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:
See: Focusing On Health In Our Sixties
Fast to live
Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.
This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.
See: Intermittent Fasting: We Sort The Science From The Hype
While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.
It’s never too late
All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”
The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.
Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.
Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:
- Knowing stuff
- Doing stuff
So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.
Want to know more?
We recently reviewed her book, and heartily recommend it:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Enjoy!
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The Sucralose News: Scaremongering Or Serious?
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What’s the news on sucralose?
These past days the press has been abuzz with frightening tales:
- This Common Artificial Sweetener Can Break Down DNA, Scientists Warn
- Sucralose Damages DNA, Linked to Leaky Gut
- Chemical found in common sweetener damages DNA
- Chemical found in widely used sweetener breaks up DNA
- Chemical from Splenda breaks up DNA
How true and/or serious is this?
Firstly, let’s manage expectations. Pineapple juice also breaks down DNA, but is not generally considered a health risk. So let’s keep that in mind, while we look into the science.
Is sucralose as scary as pineapple juice, or is it something actually dangerous?
The new study (that sparked off these headlines)
The much-referenced study is publicly available to read in full—here it is:
You may notice that this doesn’t have quite the snappy punchiness of some of the headlines, but let’s break this down, if you’ll pardon the turn of phrase:
- Toxicological: pertaining to whether or not it has toxic qualities
- Pharmacokinetic: the science of asking, of chemicals in bodies, “where did it come from; where did it go; what could it do there; what can we know?”
- Sucralose-6-acetate: an impurity that can be found in sucralose. For perspective, the study found that the sucralose in Splenda contained “up to” 0.67% sucralose-6-acetate.
- Sucralose: a modified form of sucrose, that makes it hundreds of times sweeter, and non-caloric because the body cannot break it down so it’s treated as a dietary fiber and just passes through
- In vitro: things are happening in petri dishes, not in animals (human or otherwise), which would be called “in vivo”
- Screening assays: “we set up a very closed-parameters chemical test, to see what happens when we add this to this” ⇽ oversimplification, but this is the basic format of a screening assay
Great, now we understand the title, but what about the study?
Researchers looked primarily at the effects of sucralose-6-acetate and sucralose (together and separately) on epithelial cells (these are very simple cells that are easy to study; conveniently, they are also most of what makes up our intestinal walls). For this, they used a fancy way of replicating human intestinal walls, that’s actually quite fascinating but beyond the scope of today’s newsletter. Suffice it to say: it’s quite good, and/but has its limitations too. They also looked at some in vivo rat studies.
What they found was…
Based on samples from the rat feces (somehow this didn’t make it into the headlines), it appears that sucralose may be acetylated in the intestines. What that means is that we, if we are like the rats (definitely not a given, but a reasonable hypothesis), might convert up to 10% of sucralose into sucralose-6-acetate inside us. Iff we do, the next part of the findings become more serious.
Based on the in vitro simulations, both sucralose and sucralose-6-acetate reduced intestinal barrier integrity at least a little, but sucralose-6-acetate was the kicker when it came to most of the effects—at least, so we (reasonably!) suppose.
Basically, there’s a lot of supposition going on here but the suppositions are reasonable. That’s how science works; there’s usually little we can know for sure from a single study; it’s when more studies roll in that we start to get a more complete picture.
What was sucralose-6-acetate found to do? It increased the expression of genes associated with inflammation, oxidative stress, and cancer (granted those three things generally go together). So that’s a “this probably has this end result” supposition.
More concretely, and which most of the headlines latched onto, it was found (in vitro) to induce cytogenic damage, specifically, of the clastogenic variety (produces DNA strand breaks—so this is different than pineapple’s bromelain and DNA-helicase’s relatively harmless unzipping of genes).
The dose makes the poison
So, how much is too much and is that 0.67% something to worry about?
- Remembering the rat study, it may be more like 10% once our intestines have done their thing. Iff we’re like rats.
- But, even if it’s only 0.67%, this will still be above the “threshold of toxicological concern for genotoxicity”, of 0.15µg/person/day.
- On the other hand, the fact that these were in vitro studies is a serious limitation.
- Sometimes something is very dangerous in vitro, because it’s being put directly onto cells, whereas in vivo we may have mechanisms for dealing with that.
We won’t know for sure until we get in vivo studies in human subjects, and that may not happen any time soon, if ever, depending on the technical limitations and ethical considerations that sometimes preclude doing certain studies in humans.
Bottom line:
- The headlines are written to be scary, but aren’t wrong; their claims are fundamentally true
- What that means for us as actual humans may not be the same, however; we don’t know yet
- For now, it is probably reasonable to avoid sucralose just in case
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Millet vs Buckwheat – Which is Healthier?
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Our Verdict
When comparing millet to buckwheat, we picked the buckwheat.
Why?
Both of these naturally gluten-free grains* have their merits, but we say buckwheat comes out on top for most people (we’ll discuss the exception later).
*actually buckwheat is a flowering pseudocereal, but in culinary terms, we’ll call it a grain, much like we call tomato a vegetable.
Considering the macros first of all, millet has slightly more carbs while buckwheat has more than 2x the fiber. An easy win for buckwheat (they’re about equal on protein, by the way).
In the category of vitamins, millet has more of vitamins B1, B2, B3, B6, and B9, while buckwheat has more of vitamins B5, E, K, and choline. Superficially that’s a 5:4 win for millet, though buckwheat’s margins of difference are notably greater, so the overall vitamin coverage could arguably be considered a tie.
When it comes to minerals, millet has more phosphorus and zinc, while buckwheat has more calcium, copper, iron, magnesium, manganese, potassium, and selenium. For most of them, buckwheat’s margins of difference are again greater. An easy win for buckwheat, in any case.
This all adds up to a clear win for buckwheat, but as promised, there is an exception: if you have issues with your kidneys that mean you are avoiding oxalates, then millet becomes the healthier choice, as buckwheat is rather high in oxalates while millet is low in same.
For everyone else: enjoy both! Diversity is good. But if you’re going to pick one, buckwheat’s the winner.
Want to learn more?
You might like to read:
Grains: Bread Of Life, Or Cereal Killer?
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
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