New News From The Centenarian Blue Zones
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From Blue To Green…
We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.
This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.
In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:
- Lifespan: how long we live
- Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)
Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:
- The basics: The Blue Zones’ Five Pillars Of Longevity
- Going beyond: The Five Key Traits Of Healthy Aging
You may be wondering… How much good will this do me? And, we do have an answer for that:
When All’s Said And Done, How Likely Are You To Live To 100?
Now that we’re all caught-up…
The news from the Blues
A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.
Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:
- A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
- Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
- Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
- Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).
And showing that yes, even parks in cities make a significant difference:
Want to know more?
You can read the study in full here:
A systematic review of diet and medication use among centenarians and near-centenarians worldwide
Take care!
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The Hormone Therapy That Reduces Breast Cancer Risk & More
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The Hormone Balancing Act
We’ve written before about menopausal HRT:
What You Should Have Been Told About Menopause Beforehand
…and even specifically about the considerations when it comes to breast cancer risk:
Menopausal Hormone Replacement Therapy
this really does bear reading, by the way—scroll down to the bit about breast cancer risk, because it’s not a simple increased/decreased risk; it can go either way, and which way it goes will depend on various factors including your medical history and what HRT, if any, you are taking.
Hormone Modulating Therapy
Hormone modulating therapy, henceforth HMT, is something a little different.
Instead of replacing hormones, as hormone replacement therapy does, guess what hormone modulating therapy does instead? That’s right…
MHT can modulate hormones by various means, but the one we’re going to talk about today does it by blocking estrogen receptors,
Isn’t that the opposite of what we want?
You would think so, but since for many people with an increased breast cancer risk, the presence of estrogen increases that risk, which leaves menopausal (peri- or post) people in an unfortunate situation, having to choose between increased breast cancer risk (with estrogen), or osteoporosis and increased dementia risk, amongst other problems (without).
However, the key here (in fact, that’s a very good analogy) is in how the blocker works. Hormones and their receptors are like keys and locks, meaning that the wrong-shaped hormone won’t accidentally trigger it. And when the right-shaped hormone comes along, it gets activated and the message (in this case, “do estrogenic stuff here!” gets conveyed). A blocker is sufficiently similar to fit into the receptor, without being so similar as to otherwise act as the hormone.
In this case, it has been found that HMT blocking estrogen receptors was sufficient to alleviate the breast cancer risk, while also being associated with a 7% lower risk of developing Alzheimer’s disease or related dementias, with that risk reduction being even greater for some demographics depending on race and age. Black women in the 65–74 age bracket enjoyed a 24% relative risk reduction, with white women of the same age getting an 11% relative risk reduction. Black women enjoyed the same benefits after that age, whereas white women starting it at that age did not get the same benefits. The conclusion drawn from this is that it’s good to start this at 65 if relevant and practicable, especially if white, because the protective effect is strongest when gained aged 65–69.
Here’s a pop-science article that goes into the details more deeply than we have room for here:
Hormone therapy for breast cancer linked with lower dementia risk
And here’s the paper itself; we highly recommend reading at least the abstract, because it goes into the numbers in much more detail than we reasonably can here. It’s a huge cohort study of 18,808 women aged 65 years or older, so this is highly relevant data:
Want to learn more?
If you’d like a much deeper understanding of breast cancer risk management, including in the context of hormone therapy, you might like this excellent book that we reviewed recently:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
Take care!
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Balanced Energy Cake Bars
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Unlike a lot of commercially available products, these bars won’t spike your blood sugars in the same way. There’s technically plenty of sugar in them, mostly from the chopped dates, but they’re also full of fiber, protein, and healthy fats. This means they can give you an energy boost (along with lots of gut-healthy, heart-healthy, and brain-healthy ingredients) without any crash later. They’re also delicious, and make for a great afternoon snack!
You will need
- 1 cup oats
- 15 Medjool dates, pitted and soaked in hot water for 15 minutes
- 3 carrots, grated
- 4oz almond butter
- 2 tbsp tahini
- 2 tbsp flaxseeds, milled
- 1 tbsp sesame seeds, toasted
- Optional: your choice of dried fruit and/or chopped nuts (mix it up; diversity is good!)
Method
(we suggest you read everything at least once before doing anything)
1) Steam the grated carrots for 3–4 minutes; pat dry and allow to cool
2) Drain and pat dry the dates, roughly chop them and add them to a bowl with the carrots. Because we chopped the dates rather than blended them (as many recipes do), they keep their fiber, which is important.
3) Add the oats, seeds, almond butter, and tahini. Also add in any additional dried fruit and/or chopped nuts you selected for the optional part. Mix well; the mixture should be quite firm. If it isn’t, add more oats.
4) Press the mixture into a 10″ square baking tin lined with baking paper. Refrigerate for a few hours, before cutting into bar shapes (or squares if you prefer). These can now be eaten immediately or stored for up to a week.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
Take care!
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The Lost Art of Silence – by Sarah Anderson
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From “A Room Of One’s Own” to “Silent Mondays”, from spiritual retreats to noise-cancelling headphones, this book covers the many benefits of silence—and a couple of downsides too.
In an age where most things are available at the touch of a button, a little peaceful solitude can come at quite a premium, but what it offers can effect all manner of physical changes, from reduced stress responses to increased neurogenesis (growing new brain cells).
The tone throughout is a combination of personal and pop-science, and it’s very motivating to find a little more space-between-the-things in life.
The book is best enjoyed in a quiet room.
Bottom line: if you get the feeling sometimes that you could rest and recover fully and properly if you could just find the downtime, this book will help you find exactly that.
Click here to check out the Lost Art of Silence, and find peace and strength in it!
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Savory Protein Crêpe
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Pancakes have a bad reputation healthwise, but they don’t have to be so. Here’s a very healthy crêpe recipe, with around 20g of protein per serving (which is about how much protein most people’s body’s can use at one sitting) and a healthy dose of fiber too:
You will need
Per crêpe:
- ½ cup milk (your preference what kind; we recommend oat milk for this)
- 2 oz chickpea flour (also called garbanzo bean flour, or gram flour)
- 1 tsp nutritional yeast
- 1 tsp ras el-hanout (optional but tasty and contains an array of beneficial phytochemicals)
- 1 tsp dried mixed herbs
- ⅛ tsp MSG or ¼ tsp low-sodium salt
For the filling (also per crêpe):
- 6 cherry tomatoes, halved
- Small handful baby spinach
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Mix the dry crêpe ingredients in a bowl, and then stir in the milk, whisking to mix thoroughly. Leave to stand for at least 5 minutes.
2) Meanwhile, heat a little olive oil in a skillet, add the tomatoes and fry for 1 minute, before adding the spinach, stirring, and turning off the heat. As soon as the spinach begins to wilt, set it aside.
3) Heat a little olive oil either in the same skillet (having been carefully wiped clean) or a crêpe pan if you have one, and pour in a little of the batter you made, tipping the pan so that it coats the pan evenly and thinly. Once the top is set, jiggle the pan to see that it’s not stuck, and then flip your crêpe to finish on the other side.
If you’re not confident of your pancake-tossing skills, or your pan isn’t good enough quality to permit this, you can slide it out onto a heatproof chopping board, and use that to carefully turn it back into the pan to finish the other side.
4) Add the filling to one half of the crêpe, and fold it over, pushing down at the edges with a spatula to make a seal, cooking for another 30 seconds or so. Alternatively, you can just serve a stack of crêpes and add the filling at the table, folding or rolling per personal preference:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Three Daily Servings of Beans?
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Sea Salt vs MSG – Which is Healthier?
Take care!
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Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants
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There is increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.
Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.
While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.
An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.
Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.
chomplearn/Shutterstock How tongue tie can affect babies
When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.
Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.
Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.
The frenulum is a band of tissue under the tongue that is attached to the gumline base of the mouth. Akkalak Aiempradit/Shutterstock Where to get advice
If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.
Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.
When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.
Getting a tongue tie assessment
During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.
They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.
Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.
A properly qualified lactation consultant can help with positioning and attachment. HarryKiiM Stock/Shutterstock Treatment options
The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.
Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.
If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.
There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.
Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.
We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.
Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Calm For Surgery – by Dr Chris Bonney
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As a general rule of thumb, nobody likes having surgery. We may like the results of the surgery, we may like having the surgery done and behind us, but surgery itself is not most people’s idea of fun, and honestly, the recovery period afterwards can be a pain in every sense of the word.
Dr. Chris Bonney, an anesthesiologist, gives us the industry-secrets low-down, and is the voice of experience when it comes to the things to know about and/or prepare in advance—the little things that make a world of difference to your in-hospital experience and afterwards.
Think of it like “frequent flyer traveller tips” but for surgeries, whereupon knowing a given tip can mean the difference between deeply traumatic suffering and merely not being at your usual best. We think that’s worth it.
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