Good (Or Bad) Health Starts With Your Blood
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Blood Should Be Only Slightly Thicker Than Water
This is Dr. Casey Means, a physician, lecturer (mostly at Stanford), and CMO of a metabolic health company, Levels, as well as being Associate Editor of the International Journal of Diabetes Reversal and Prevention, where she serves alongside such names as Dr. Colin Campbell, Dr. Joel Fuhrman, Dr. Michael Greger, Dr. William Li, Dr. Dean Ornish, and you get the idea: it’s a star-studded cast.
What does she want us to know?
The big blood problem:
❝We’re spending 3.8 trillion dollars a year on healthcare costs in the U.S., and the reality is that people are getting sicker, fatter, and more depressed.
Over 50% of Americans have pre-diabetes or type 2 diabetes; it’s insane, that number should be close to zero.❞
~ Dr. Casey Means
Indeed, pre-diabetes and especially type 2 diabetes should be very avoidable in any wealthy nation.
Unfortunately, the kind of diet that avoids it tends to rely on having at least 2/3 of the following:
- Money
- Time
- Knowledge
For example:
- if you have money and time, you can buy lots of fresh ingredients without undue worry, and take the time to carefully prep and cook them
- if you have money and knowledge you can have someone else shop and cook for you, or at least get meal kits delivered
- if you have time and knowledge, you can actually eat very healthily on a shoestring budget
If you have all three, then the world’s your oyster mushroom steak sautéed in extra virgin olive oil with garlic and cracked black pepper served on a bed of Swiss chard and lashed with Balsamic vinegar.
However, many Americans aren’t in the happy position of having at least 2/3, and a not-insignificant portion of the population don’t even have 1/3.
As an aside: there is a food scientist and chef who’s made it her mission to educate people about food that’s cheap, easy, and healthy:
…but today is about Dr. Means, so, what does she suggest?
Know thyself thy blood sugars
Dr. Means argues (reasonably; this is well-backed up by general scientific consensus) that much of human disease stems from the diabetes and pre-diabetes that she mentioned above, and so we should focus on that most of all.
Our blood sugar levels being unhealthy will swiftly lead to other metabolic disorders:
Heart disease and non-alcoholic fatty liver disease are perhaps first in line, but waiting in the wings are inflammation-mediated autoimmune disorders, and even dementia, because neuroinflammation is at least as bad as inflammation anywhere else, arguably worse, and our brain can only be as healthy as the blood that feeds it and takes things that shouldn’t be there away.
Indeed,
❝Alzheimer’s dementia is now being called type 3 diabetes because it’s so related to blood sugar❞
~ Dr. Casey Means
…which sounds like a bold claim, but it’s true, even if the name is not “official” yet, it’s well-established in professional circulation:
❝We conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both T1DM and T2DM❞
~ Dr. Suzanne M. de la Monte & Dr. Jack Wands
Read in full: Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed ← this is from the very respectable Journal of Diabetes Science and Technology.
What to do about it
Dr. Means suggests we avoid the “glucose roller-coaster” that most Americans are on, meaning dramatic sugar spikes, or to put it in sciencese: high glycemic variability.
This leads to inflammation, oxidative stress, glycation (where sugar sticks to proteins and DNA), and metabolic dysfunction. Then there’s the flipside: reactive hypoglycemia, a result of a rapid drop in blood sugar after a spike, can cause anxiety, fatigue, weakness/trembling, brain fog, and of course cravings. And so the cycle repeats.
But it doesn’t have to!
By taking it upon ourselves to learn about what causes our blood sugars to rise suddenly or gently, we can manage our diet and other lifestyle factors accordingly.
And yes, it’s not just about diet, Dr. Means tells us. While added sugar and refined carbohydrates or indeed the main drivers of glycemic variability, our sleep, movement, stress management, and even toxin exposure play important parts too.
One way to do this, that Dr. Means recommends, is with a continuous glucose monitor:
Track Your Blood Sugars For Better Personalized Health
Another way is to just apply principles that work for almost everyone:
10 Ways To Balance Blood Sugars
Want to know more from Dr. Means?
You might like her book:
Good Energy – by Dr. Casey Means
…which goes into this in far more detail than we have room to today.
Enjoy!
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Carbonated Water: For Weight Loss, Satiety, Or Just Gas?
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There are two main mechanisms of action by which sparkling water is considered to help satiety and/or weight loss; they are:
- It “fills us up” such that we feel fuller sooner, and thus eat less, and thus (all other things being equal) perhaps lose weight
- The carbon dioxide is absorbed into the bloodstream, where (as a matter of chemistry) it improves glucose metabolism, thus lowering blood sugars and indirectly leading (potentially) to weight loss, but even if not, lowered blood sugars are good for most people most of the time, right?
However, there are just a few problems:
Full of gas?
Many people self-report enjoying sparkling water as a way to feel fuller while fasting (or even while eating). However, the plural of “anecdote” is not “data”, so, here be data… Ish:
❝In order to determine whether such satiating effects occur through oral carbonic stimulation alone, we conducted modified sham-feeding (SF) tests (carbonated water ingestion (CW), water ingestion (W), carbonated water sham-feeding (CW-SF), and water sham-feeding (W-SF)), employing an equivalent volume and standardized temperature of carbonated and plain water, in a randomized crossover design.
Thirteen young women began fasting at 10 p.m. on the previous night and were loaded with each sample (15ºC, 250 mL) at 9 a.m. on separate days. Electrogastrography (EGG) recordings were obtained from 20 min before to 45 min after the loading to determine the power and frequency of the gastric myoelectrical activity. Appetite was assessed using visual analog scales. After ingestion, significantly increased fullness and decreased hunger ratings were observed in the CW group. After the load, transiently but significantly increased fullness as well as decreased hunger ratings were observed in the CW-SF group. The powers of normogastria (2-4 cpm) and tachygastria (4-9 cpm) showed significant increases in the CW and W groups, but not in the CW-SF and W-SF groups. The peak frequency of normogastria tended to shift toward a higher band in the CW group, whereas it shifted toward a lower band in the CW-SF group, indicating a different EGG rhythm.
Our results suggest that CO2-induced oral stimulation is solely responsible for the feeling of satiety.❞
~ Dr. Maki Suzuki et al.
Now, that’s self-reported, and a sample size of 13, so it’s not the most airtight science ever, but it is at least science. Here’s the paper, by the way:
Oral Carbonation Attenuates Feeling of Hunger and Gastric Myoelectrical Activity in Young Women
Here’s another small study with 8 people, which found that still and sparkling water had the exact same effect:
Effect of carbonated water on gastric emptying and intragastric meal distribution
However, drinking water (still or sparkling) with a meal will not have anywhere near the same effect for satiety as consuming food that has a high water-content.
See also: Some Surprising Truths About Hunger And Satiety ← our main feature in which we examine the science of volumetrics, including a study that shows how water incorporated into a food (but not served with a food) decreases caloric intake.
As an aside, one difference that carbonation can make is to increase ghrelin levels—that’s the hunger hormone (the satiety hormone is leptin, by the way). This one’s a rat study, but it seems reasonable that the same will be true of humans:
…which is worth bearing in mind even if you yourself are not, in fact, a male rat.
The glucose guzzler?
This one has simply been the case of a study being misrepresented, for example here:
Fizzy water might aid weight loss by providing a small boost to glucose uptake and metabolism
The idea is that higher levels of carbon dioxide in the blood mean faster glucose metabolism, which is technically true. Now, often “technically true” is the best kind of true, but not here, because it’s simply not useful.
In short, we produce so much carbon dioxide as part of our normal respiratory processes, that any carbon dioxide we might consume in a carbonated water is barely a blip in the graph.
Oh, and that article we just linked? Even within the article, despite running with that headline, the actual scientists quoted are saying such things as:
❝While there is a hypothetical link between carbonated water and glucose metabolism, this has yet to be tested in well-designed human intervention studies❞
~ Professor Sumantra Ray
Note: the word “hypothetical” means “one level lower than theoretical”. This is very far from being a conclusion.
And the study itself? Wasn’t even about carbonated water, it was about kidney dialysis and how the carbon dioxide content can result in hypoglycemia:
The mechanism of hypoglycemia caused by hemodialysis
…which got referenced in this paper (not a study):
Can carbonated water support weight loss?
…and even that concluded:
❝CO2 in carbonated water may promote weight loss by enhancing glucose uptake and metabolism in red blood cells.
However, the amount is so small that it is difficult to expect weight loss effects solely from the CO2 in carbonated water.
Drinking carbonated water may also affect blood glucose measurements.❞
Note: the word “may”, when used by a scientist and in the absence of any stronger claims, means “we haven’t ruled out the possibility”.
What breaking news that is.
Stop the press! No, really, stop it!
So… What does work?
There are various ways of going about actually hacking hunger (and they stack; i.e. you can use multiple methods and get cumulative results), and we wrote about them here:
Enjoy!
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The Recipe For Empowered Leadership – by Doug Meyer-Cuno
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This is not a “here’s how to become a leader, you young would-be Machiavelli”; it’s more a “so you’re in a leadership role; now what?” book. The book’s subtitle describes well its contents: “25 Ingredients For Creating Value & Empowering Others”
The book is written with the voice of experience, but without the ego-driven padding that accompanies many such books. Especially: any anecdotal illustrations are short and to-the-point, no chapter-long diversions here.
Which we love!
Equally helpful is where the author does spend a little more time and energy: on the “down to brass tacks” of how exactly to do various things.
In short: if instead of a lofty-minded book of vague idealized notions selling a pipedream, you’d rather have a manual of how to actually be a good leader when it comes down to it, this is the book for you.
Pick Up The Recipe For Empowered Leadership On Amazon Today!
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Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?
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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 😎
❝Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder) and how much does it matter for health e.g. waist size etc?❞
Let’s break it down into two parts:
Is it possible for anyone to get 6-pack abs (even if genetics makes it easier or harder)?
Short answer: no
First, a quick anatomy lesson: while “abs” (abdominal muscles) are considered in the plural and indeed they are, what we see as a six-pack is actually only one muscle, the rectus abdominis, which is nestled in between other abdominal muscles that are beyond the scope of our answer here.
The reason that the rectus abdominis looks like six muscles is because there are bands of fascia (connective tissue) lying over it, so we see where it bulges between those bands.
The main difference genes make are as follows:
- Number of fascia bands (and thus the reason that some people get a four-, six-, eight-, or rarely, even ten-pack). Obviously, no amount of training can change this number, any more than doing extra bicep curls will grow you additional arms.
- Density of muscle fibers. Some people have what has been called “superathlete muscle type”, which, while prized by Olympians and other athletes, is on bodybuilding forums less glamorously called being a “hard gainer”. What this means is that muscle fibers are denser, so while training will make muscles stronger, you won’t see as much difference in size. This means that size for size, the person with this muscle type will always be stronger than someone the same size without it, but that may be annoying if you’re trying to build visible definition.
- Twitch type of muscle fibers. Some people have more fast-twitch fibers, some have more slow-twitch fibers. Fast-twitch fibers are better suited for visible abs (and, as the name suggests, quick changes between contracting and relaxing). Slow-twitch fibers are better for endurance, but yield less bulky muscles.
- Inclination to subcutaneous fat storage. This is by no means purely genetic; hormones make the biggest difference, followed by diet. But, genes are an influencing factor, and if your body fat percentage is inclined to be higher than someone else’s, then it’ll take more work to see muscle definition under that fat.
The first of those items is why our simple answer is “no”; because some people are destined to, if muscle is visible, have a four-, eight, or (rarely) ten-pack, making a six-pack unobtainable.
It’s worth noting here that while a bigger number is more highly prized aesthetically, there is literally zero difference healthwise or in terms of performance, because it’s nothing to do with the muscle, and is only about the fascia layout.
The density of muscle fibers is again purely genetic, but it only makes things easier or harder; this part’s not impossible for anyone.
The inclination to subcutaneous fat storage is by far the most modifiable factor, and the thus most readily overcome, if you feel so inclined. That doesn’t mean it will necessarily be easy! But it does mean that it’s relatively less difficult than the others.
How much does it matter for health, e.g. waist size etc?
As you may have gathered from the above, having a six-pack (or indeed a differently-numbered “pack”, if that be your genetic lot) makes no important difference to health:
- The fascia layout is completely irrelevant to health
- The muscle fiber types do make a difference to athletic performance, but not general health when at rest
- The subcutaneous fat storage is a health factor, but probably not how most people think
Healthy body fat percentages are (assuming normal hormones) in the range of 20–25% for women and 15–20% for men.
For most people, having clearly visible abs requires going below those healthy levels. For most people, that’s not optimally healthy. And those you see on magazine covers or in bodybuilding competitions are usually acutely dehydrated for the photo, which is of course not good. They will rehydrate after the shoot.
However, waist size (especially as a ratio, compared to hip size) is very important to health. This has less to do with subcutaneous fat, though, and is more to do with visceral belly fat, which goes under the muscles and thus does not obscure them:
Visceral Belly Fat & How To Lose It
One final note: fat notwithstanding, and aesthetics notwithstanding, having a strong core is very good for general health; it helps keeps one’s internal organs in place and well-protected, and improves stability, making falls less likely as we get older. Additionally, having muscle improves our metabolic base rate, which is good for our heart. Abs are just one part of core strength (the back being important too, for example), but should not be neglected.
Top-tier exercises to do include planks, and hanging leg raises (i.e. hang from some support, such as a chin-up bar, and raise your legs, which counterintuitively works your abs a lot more than your legs).
Take care!
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Can We Drink To Good Health?
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Can we drink to good health?
We asked you for your thoughts on alcohol and heart health, and we got quite an even spread of results!
If perchance that’s too tiny to read, the figures were:
- 32% voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!”
- 32% voted for: “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️”
- 36% voted for: “Alcohol is bad for pretty much everything, including heart health ✋”
One subscriber who voted for “Alcohol is a relaxant, reduces stress, and can contain resveratrol too. It’s good for the heart!” added the following thoughts:
❝While it isn’t necessary to consume alcohol, moderate amounts can be beneficial and contribute to well-being through social activity, celebrations, etc.❞
That’s an interesting point, and definitely many people do see alcohol that way! Of course, that does not mean that one will find no social activities, celebrations, etc, in parts of the world where alcohol consumption is uncommon. Indeed, in India, wedding parties where no alcohol is consumed can go on for days!
But, “we live in a society” and all that, and while we’re a health newsletter not a social issues newsletter, it’d be remiss of us to not acknowledge the importance of socialization for good mental health—and thus the rest of our health too.
So, if indeed all our friends and family drink alcohol, it can certainly make abstaining more of a challenge.
On that note, let’s take a moment to consider “The French Paradox” (an observation of a low prevalence of ischemic heart disease despite high intakes of saturated fat, a phenomenon accredited to the consumption of red wine).
As it happens, a comprehensive review in “Circulation”, a cardiovascular health journal, has suggested the French Paradox may not be so paradoxical after all.
Research suggests it has more to do with other lifestyle factors (and historic under-reporting of cardiovascular disease by French doctors), which would explain why Japan has lower rates of heart disease, despite drinking little wine, and more beer and spirits.
So, our subscriber’s note may not be completely without reason! It’s just about the party, not the alcohol.
One subscriber who voted for “Moderate alcohol consumption can be at least neutral for the health, if not positive ⚖️” wrote:
❝Keeping in mind, moderate means one glass of wine for women a day and two for men. Hard alcohol doesn’t have the same heart benefits as wine❞
That is indeed the guideline according to some health bodies!
In other places with different guiding advisory bodies, that’s been dropped down to one a day for everyone (the science may be universal, but how government institutions interpret that is not).
About that wine… Specifically, red wine, for its resveratrol content:
While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, you might even need more.
To this end, many people prefer resveratrol supplementation. ← link is to an example product, but there are plenty more so feel free to shop around
A subscriber who voted for “Alcohol is bad for pretty much everything, including heart health ✋” says:
❝New guidelines suggest 1 to 2 drinks a week are okay but the less the better.❞
If you haven’t heard these new guidelines, we’ll mention again: every government has its own official bodies and guidelines so perhaps your local guidelines differ, but for example here’s what that World Health Organization has to say (as of January this year):
WHO: No level of alcohol consumption is safe for our health
So, whom to believe? The governments who hopefully consider the welfare of their citizenry more important than the tax dollars from alcohol sales, or the World Health Organization?
It’s a tough one, but we’ll always err on the side of the science.
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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:
! Don’t Forget…
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Paulina Porizkova (Former Supermodel) Talks Menopause, Aging, & Appearances
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Are supermodels destined to all eventually become “Grizabella the Glamor Cat”, a washed-up shell of their former glory? Is it true that “men grow cold as girls grow old, and we all lose our charms in the end”? And what—if anything—can we do about it?
Insights from a retired professional
Paulina Porizkova is 56, and she looks like she’s… 56, maybe? Perhaps a little younger or a bit older depending on the camera and lighting and such.
It’s usually the case, on glossy magazine covers and YouTube thumbnails, that there’s a 20-year difference between appearance and reality, but not here. Why’s that?
Porizkova noted that many celebrities of a similar age look younger, and felt bad. But then she noted that they’d all had various cosmetic work done, and looked for images of “real” women in their mid-50s, and didn’t find them.
Note: we at 10almonds do disagree with one thing here: we say that someone who has had cosmetic work done is no less real for it; it’s a simple matter of personal choice and bodily autonomy. She is, in our opinion, making the same mistake as people make when they say such things as “real people, rather than models”, as though models are not also real people.
Porizkova found modelling highly lucrative but dehumanizing, and did not enjoy the objectification involved—and she enjoyed even less, when she reached a certain age, negative comments about aging, and people being visibly wrong-footed when meeting her, as they had misconceptions based on past images.
As a child and younger adult through her modelling career, she felt very much “seen and not heard”, and these days, she realizes she’s more interesting now but feels less seen. Menopause coincided with her marriage ending, and she felt unattractive and ignored by her husband; she questioned her self-worth, and felt very bad about it. Then her husband (they had separated, but had not divorced) died, and she felt even more isolated—but it heightened her sensitivity to life.
In her pain and longing for recognition, she reached out through her Instagram, crying, and received positive feedback—but still she struggles with expressing needs and feeling worthy.
And yet, when it comes to looks, she embraces her wrinkles as a form of expression, and values her natural appearance over cosmetic alterations.
She describes herself as a work in progress—still broken, still needing cleansing and healing, but proud of how far she’s come so far, and optimistic with regard to the future.
For all this and more in her own words, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Many Faces Of Cosmetic Surgery
Take care!
Don’t Forget…
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