How (And Why) To Train Your Pre-Frontal Cortex
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Dr. Chapman’s Keys For Mental Focus
This is Dr. Sandra Chapman; she’s a cognitive neuroscientist, on a mission to, in her words, further our understanding of:
- what makes the brain stronger, faster and last longer
- what enhances human cognitive capacity, and
- what enhances the underlying brain systems across the lifespan.
To this end, she’s also the founder and Chief Director of the Center For Brain Health, where she has worked on her mission for the past 25 years (clocking up hundreds of peer-reviewed publications to her name), as well as being a professor of Behavioral and Brain Sciences at UT Dallas.
What does she want us to know?
Get your brain into gear
When it comes to your brainpower, it is “use it or lose it”, but it is also perfectly possible to use it and lose it.
Why?
Very often, what we are using our brains for is high-strain, low-yield stuff, such as multitasking, overthinking, or overthinking while multitasking. And to make it worse, we often do it without sufficient rest.
This is the equivalent of owning a Ferrari but trying to drive it in second and third gear at once by switching between the two as rapidly as possible. And doing that for 18 hours each day.
Suffice it to say, you’ll be going nowhere quickly.
An alternative “use” of brainpower is low-strain, low-yield stuff, such as having to pay close attention to a boring conversation. It’s enough to stop your mind from doing anything else, but not enough to actually stimulate you.
This is the equivalent of owning a Ferrari but keeping it idling. The wear and tear is minimal this time, but you’re not actually going anywhere either.
Better, of course, are the other two quadrants:
- low-strain, high-yield: consistently using our brain in relatively non-taxing ways that encourage its development
- high-strain, high-yield: here the Ferrari metaphor definitely fails, because unlike cars, our bodies (including our brains) are machines that benefit from judicious regular progressive overloading (but just by a bit, and with adequate recovery time between overloads).
See also: 12 Weeks To Measurably Boost Your Brain
How to do the “low-strain, low-yield” part
When it comes to “what’s the most important part of the brain to help in the face of cognitive decline?” the usual answer is either to focus on memory (hippocampi) or language (various parts, but for example Wernicke’s area and Broca’s area), since people most fear losing memory, and language is very important both socially and practically.
Those are indeed critical, and we at 10almonds stand by them, but Dr. Chapman (herself having originally trained as speech and language pathologist!) makes a strong case for adding a third brain part to the list.
Specifically, she advocates for strengthening the pre-frontal cortex, which is responsible for inhibition, task-switching, working memory, and cognitive flexibility. If that seems like a lot, do remember it’s a whole cortex and not one of the assorted important-but-small brain bits we mentioned above.
How? She has developed training programs for this, based on what she calls Strategic Memory Advanced Reasoning Tactics (SMART), to support support attention, planning, judgment and emotional management.
You can read more about those programs here:
Center For Brain Health | Our Programs
Participation in those is mostly not free, however, if you join their…
Center For Brain Health | BrainHealth Project
…then they will periodically invite you to join pilot programs, research programs, and the like, which will either be free or they-pay-you affairs—because this is how science is done, and you can read about yourself (anonymized, of course) later in peer-reviewed papers of the kind we often cite here.
If you’re not interested in any of that though, we will say that according to Dr. Chapman, the keys are:
Inhibition: be conscious of this function of your brain, and develop it. This is the function of your brain that stops you from making mistakes—or put differently: stops you from saying/doing something stupid.
Switching: do this consciously; per “I am now doing this task, now I am switching to this other task”, rather than doing the gear-grinding thing we discussed earlier
Working memory: this is effectively your brain’s RAM. Unlike the RAM of a computer (can be enhanced by adding another chip or replacing with a bigger chip), our brain’s RAM can be increased by frequent use, and especially by judicious use of progressive overloading (with rests between!) which we’ll discuss in the high-strain, high-yield section.
Flexibility: this is about creative problem-solving, openness to new ideas, and curiosity
See also: Curiosity Kills The Neurodegeneration
How to do the “high-strain, high-yield” part
Delighting this chess-playing writer, Dr. Chapman recommends chess. Although, similar games such as go (a Chinese game that looks simpler than chess but actually requires more calculation) work equally well too.
Why?
Games like chess and go cause structural changes that are particularly helpful, in terms of engaging in such foundational tasks as learning, abstract reasoning, problem-solving and self-control:
Chess Practice as a Protective Factor in Dementia
Basically, it checks (so to speak) a lot of boxes, especially for the pre-frontal cortex. Some notes:
- Focusing on the game is required for brain improvement; simply pushing wood casually will not do it. Ideally, calculating several moves ahead will allow for strong working memory use (because to calculate several moves ahead, one will have to hold increasingly many possible positions in the mind while doing so).
- The speed of play must be sufficiently slow as to allow not only for thinking, but also for what in chess is called “blunder-checking”, in other words, having decided on one’s move, pausing to consider whether it is a mistake, and actively trying to find evidence that it is. This is the crucial “inhibition habit”, and when one does it reflexively, one will make fewer mistakes. Tying this to dementia, see for example how one of the common symptoms of dementia is falling for scams that one wouldn’t have previously. How did cognitive decline make someone naïve? It didn’t, per se; it just took away their ability to, having decided what to do, pause to consider whether it was a mistake, and actively trying to find evidence that it is.
- That “conscious switching” that we talked about, rather than multitasking? In chess, there is a difference between strategy and tactics. Don’t worry about what that difference is for now (learn it if you want to take up chess), but know that strong players will only strategize while it is their opponent’s turn, and only calculate (tactics) while it is their own turn. It’s very tempting to flit constantly between one and the other, but chess requires players to have the mental discipline be able to focus on one task or the other and stick with that task until it’s the appointed time to switch.
If you feel like taking up chess, this site (and related app, if you want it) is free (it’s been funded by voluntary donations for a long time now) and good and even comes with free tuition and training tools: LiChess.org
Here’s another site that this writer (hi, it’s me) personally uses—it has great features too, but many are paywalled (I’m mostly there just because I’ve been there nearly since its inception, so I’m baked into the community now): Chess.com
Want to know more?
You might like this book by Dr. Chapman, which we haven’t reviewed yet but it did inform large parts of today’s article:
Make Your Brain Smarter: Increase Your Brain’s Creativity, Energy, and Focus – by Dr. Sandra Chapman
Enjoy!
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Metformin For Weight-Loss & More
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Metformin Without Diabetes?
Metformin is a diabetes drug; it works by:
- decreasing glucose absorption from the gut
- decreasing glucose production in the liver
- increasing glucose sensitivity
It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.
It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).
Today we’ll examine its off-label uses and see what the science says!
A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.
Other examples include modafinil against depression, and beta-blockers against anxiety.
Why take it if not diabetic?
There are many reasons people take it, including just general health and life extension:
However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:
❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞
But, it seems it does more, as this more recent review found:
❝Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.
Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.
Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞
Source: Metformin for diabetes prevention: update of the evidence base
We were wondering about that cardioprotective effect, so…
Cardioprotective effect
In short, another review (published a few months after the above one) confirmed the previous findings, and also added:
❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞
We wondered about the weight loss implications of this, and…
For weight loss
The short version is, it works:
- Effectiveness of metformin on weight loss in non-diabetic individuals with obesity
- Metformin for weight reduction in non-diabetic patients: a systematic review and meta-analysis
- Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women
…and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.
Compared/contrasted with GLP-1 agonists
It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:
Or if you prefer a reader-friendly pop-science version:
Ozempic vs Metformin: Comparing The Two Diabetes Medications
Is it safe?
For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:
- Usually contraindicated if you have kidney problems of any kind
- Usually contraindicated if you have liver problems of any kind
- May be contraindicated if you have issues with B12 levels
See also: Metformin: Is it a drug for all reasons and diseases?
Where can I get it?
As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.
However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).
If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:
Off-label indications of Metformin – Review of Literature
Take care!
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The Connection Cure – by Julia Hotz
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You may recognize some of the things in the subtitle as being notable elements of the Blue Zones supercentenarians’ lifestyles, but this book looks at numerous quite diverse countries, and people from many walks of life.
What they have in common—and this is mostly a very person-centered book, relying a lot on case studies, with additional references coming from wider sociological data—is social prescribing.
What is social prescribing? That’s what the author (a journalist by general profession) answers comprehensively here, and it’s about looking at the ways medical problems can often have nonmedical solutions. It doesn’t necessarily mean that walking will cure your cancer or art will cure your diabetes, but it does mean that very often a key part of an unhealthy lifestyle is fundamentally something that can be fixed by one or more of: movement, nature, art, service, and belonging.
She looks at social prescribing in its birthplace (the UK, where cheap solutions that are nevertheless evidence-based are very much prioritized), in big countries like Canada and Australia, in aging countries like Singapore and South Korea, and yes, also in the #1 country of pill prescribing, the US.
The structure of the book is interesting, we first have 5 person-centered chapters addressing each of the social prescribing aspects and how they helped in two example case studies for each one, then 5 country-by-country epidemiological chapters looking at the big picture, then 5 person-centered chapters again, this time looking at personalizing social prescribing for oneself (this section of the book being headed “Social Prescribing For You And Me”), looking at what is going on in one’s life and health, which of the 5 elements might be missing, and what tangible goal-oriented benefits can—according to the evidence—be obtained by tending to what one actually needs in terms of social prescribing.
The style is narrative and journalistic, with very little hard science, but very little that’s wishy-washy either. It is, in short, a pleasant and informative read that helps the reader really understand social prescribing, the better to implement it in our own lives.
Bottom line: if you like having extra nonmedical approaches to avoid or alleviate medical problems, then this book will really help you achieve that.
Click here to check out The Connection Cure, and get social prescribing!
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Hoisin Sauce vs Teriyaki Sauce – Which is Healthier?
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Our Verdict
When comparing hoisin sauce to teriyaki sauce, we picked the teriyaki sauce.
Why?
Neither are great! But spoonful for spoonful, the hoisin sauce has about 5x as much sugar.
Of course, exact amounts will vary by brand, but the hoisin will invariably be much more sugary than the teriyaki.
On the flipside, the teriyaki sauce may sometimes have slightly more salt, but they are usually in approximately the same ballpark of saltiness, so this is not a big deciding factor.
As a general rule of thumb, the first few ingredients will look like this for each, respectively:
Hoisin:
- Sugar
- Water
- Soybeans
Teriyaki:
- Soy sauce (water, soybeans, salt)
- Rice wine
- Sugar
In essence: hoisin is a soy-flavored syrup, while teriyaki is a sweetened soy sauce
Wondering about that rice wine? The alcohol content is negligible, sufficiently so that teriyaki sauce is not considered alcoholic. For health purposes, it is well under the 0.05% required to be considered alcohol-free.
For religious purposes, we are not your rabbi or imam, but to our best understanding, teriyaki sauce is generally considered kosher* (the rice wine being made from rice) and halal (the rice wine being de-alcoholized by the processing, making the sauce non-intoxicating).
Want to try some?
You can compare these examples side-by-side yourself:
Enjoy!
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Here’s To Getting Assuredly Good Health
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An unusual amount of excitement in the health news world this week, with health insurance in the spotlight:
Deny, Delay, Depose?
Insurance company UnitedHealthcare, which used AI with a 90% error rate to deny insurance claims (of which, disproportionately denying insurance claims of the elderly), has come under extra public scrutiny this week for its recent-years business practices:
❝Nearly 1 in 5 insured adults experienced claim denials during a 12-month period.
Those with job-based insurance or Affordable Care Act policies ran into this problem about twice as often as those covered by Medicare or Medicaid❞
…although, the company has dramatically increased its care denials for Medicare Advantage enrollees, doubling the rate of denials as it implemented its new, automated denials process.
Anesthesiologist Dr. Brain Schmutzler noted:
❝We have a bigger issue with the insurance companies in general, who, essentially, it’s their job to make money, not to actually pay for health care❞
And in those cases where healthcare is not denied, it is often dangerously delayed, as insurance companies can stall for time to decide whether they’re going to pay or not.
One useful take-away from all of this is that if your insurance claim is denied, consider fighting it, as often they can be overturned.
Specifically, it can be good to insist on knowing who (named persons) was involved in the denial process, and their qualifications. Once upon a time, this was mostly unqualified interns, which prompted insurance companies to reverse the denial rather than admit that; nowadays it’s mostly AI, which many companies can hope will shield them from culpability—either way, fighting for one’s rights can often be successful.
Read in full: Killing of UnitedHealthcare CEO prompts flurry of stories on social media over denied insurance claims
Related: With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help
Rest Easy
Health insurer Elevance Health (formerly Anthem Blue Cross Blue Shield), had last month announced plans to limit its coverage for anesthesia used in operations, whereby they would pay for only a certain amount of anesthetic, and if the procedure was still ongoing when that amount had been used, then well, you were on your own.
However, on Thursday afternoon and allegedly completely coincidentally in the wake of the Wednesday assassination of the CEO who oversaw the denial of so many health insurance claims, this decision to limit paying for anesthesia was reversed, retracted, and they are now doing their best to downplay what the proposal would have meant for anesthesiologists and patients:
Read in full: Insurance company halts plan to put time limits on coverage for anesthesia during surgery
Related: The Insider’s Guide To Making Hospital As Comfortable As Possible ← an anesthesiologist’s tips
Getting a good grip of your health
What’s the best indicator of good health when it comes to age-related health issues? It’s not BMI! Could it be blood pressure? It could, but the news presently is about grip strength.
While training to have an amazing grip (and neglecting all else) will not necessarily increase your general healthspan, having a weak or strong grip is strongly associated with, respectively, having weak or strong general health in later years.
This is because unless someone has been training very unnaturally, grip strength is a good general measure of overall muscle strength, which in turn is a good indicator of metabolic health, as well as bodily robustness.
Read in full: Handgrip strength is a reliable predictor for age-related disease and disability, finds study
Related: Resistance Is Useful! (Especially As We Get Older)
Take care!
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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
thyselfthy blood sugarsDr. 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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Kidney Beans vs Chickpeas – Which is Healthier?
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Our Verdict
When comparing kidney beans to chickpeas, we picked the chickpeas.
Why?
Both are great! But there’s a clear winner here today:
In terms of macros, chickpeas have more protein, carbs, and fiber, making them the more nutrient-dense option in this category.
In the category of vitamins, kidney beans have more of vitamins B1, B3, and K, while chickpeas have more of vitamins A, B2, B5, B6, B7, B9, C, E, and choline, taking the victory again here.
When it comes to minerals, it’s a similar story: kidney beans have more potassium, while chickpeas have more calcium, copper, iron, magnesium, manganese, phosphorus, selenium, and zinc. Another easy win for chickpeas.
Adding up the three wins makes chickpeas the clear overall winner, but of course, as ever, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
Don’t Forget…
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