The Other Circadian Rhythms
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We’ve talked before about how circadian rhythm pertains not just to when it is ideal for us to sleep or be awake, but also at what times it is best to eat, exercise, and so forth:
The Circadian Rhythm: Far More Than Most People Know
Most people just know about the light consideration, per for example:
- How light can shift your mood and mental health, and
- How light tells you when to sleep, focus and poo
When your body parts clock on and off at the wrong time…
Now, new research has brought attention to how these things and more are governed by different physiological clocks within our bodies—and what this means for our health. In other words, if you are doing the various things at different times than you “should”, you will be training the different parts of your body (each with their independent clocks) to be on a different schedule, and so the different parts of your body will out of temporal sync with each other.
To put this in jet-lag terms: if your brain is in New York, while your heart is in Istanbul (not Constantinople) and your gut is in Tokyo, then this arrangement is not good for the health.
As for how it is not good for your health (i.e. the consequences) there’s still research to be done on some of the longer-term implications, but in the short term, one of the biggest effects is on our mood—most notably, increasing depression scores significantly.
And even more importantly, this is in the real world. That is to say, until quite recently, most data we had from studies on the circadian rhythm was from sleep clinic laboratories, which is great for RCTs but will always have as a limitation that someone sleeping in a lab is going to have some differences than someone sleeping in their own bed at home.
As the researchers said:
❝A critical step to addressing this is the noninvasive collection of physiological time-series data outside laboratory settings in large populations. Digital tools offer promise in this endeavor. Here, using wearable data, we first quantify the degrees of circadian disruption, both between different internal rhythms and between each internal rhythm and the sleep-wake cycle. Our analysis, based on over 50,000 days of data from over 800 first-year training physicians, reveals bidirectional links between digital markers of circadian disruption and mood both before and after they began shift work, while accounting for confounders such as demographic and geographic variables. We further validate this by finding clinically relevant changes in the 9-item Patient Health Questionnaire score.❞
Read in full: The real-world association between digital markers of circadian disruption and mental health risks
That questionnaire by the way sounds like an arbitrary thing they just made up, but the PHQ-9 (as it is known to its friends) is in fact the current intentional gold standard for measuring depression; we share it at the top of our article about depression, here:
The Mental Health First-Aid That You’ll Hopefully Never Need ← the test takes 2 minutes and you get immediate results
Want to know more?
For more about getting one’s entire self back into temporal sync (hey, wasn’t that the plot of a Star Trek episode?), sleep specialist Dr. Michael Breus wrote this excellent book that we reviewed a little while back:
Enjoy!
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Build Strong Feet: Exercises To Strengthen Your Foot & Ankle
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A lot depends on the health of our feet, especially when it comes to their strength and stability. But they often get quite neglected, when it comes to maintenance. Here’s how to help your feet keep the rest of your body in good condition:
On a good footing
The foot-specific exercises recommended here include:
- Active toe flexion/extension: curl and extend your toes
- Active toe adduction/abduction: use a towel for feedback this time as you spread your toes
- “Short foot” exercise: create an arch by bringing the base of your big toe towards your heel
- Resisted big toe flexion: use resistance bands; flex your big toe while controlling the others.
- Standing big toe flexion (isometric): press your big toe against an inclined surface as forcefully as you can
- Foot bridge exercise: hold your position with the front part of your feet on an elevated surface, to strengthen the arch.
- Heel raises: which can be progressed from basic to more advanced variations, increasing difficulty
- Ankle movements: dorsiflexion, inversion, etc, to increase mobility
It’s important to also look after your general lower body strength and stability, including (for example) single-leg deadlifts, step-downs, and lunges
Balance and proprioceptive exercises are good too, such as a static or dynamic one-leg balances, progressing to doing them with your eyes closed and/or on unstable surfaces (be careful, of course, and progress to this only when confident).
For more on all of these, an explanation of the anatomy, some other exercises too, and visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Steps For Keeping Your Feet A Healthy Foundation
Take care!
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CBD Against Diabetes!
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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
❝CBD for diabetes! I’ve taken CBD for body pain. Did no good. Didn’t pay attention as to diabetes. I’m type 1 for 62 years. Any ideas?❞
Thanks for asking! First up, for reference, here’s our previous main feature on the topic of CBD:
CBD Oil: What Does The Science Say?
There, we touched on CBD’s effects re diabetes:
in mice / in vitro / in humans
In summary, according to the above studies, it…
- lowered incidence of diabetes in non-obese diabetic mice. By this they mean that pancreatic function improved (reduced insulitis and reduced inflammatory Th1-associated cytokine production). Obviously this has strong implications for Type 1 Diabetes in humans—but so far, just that, implications (because you are not a mouse).
- attenuated high glucose-induced endothelial cell inflammatory response and barrier disruption. Again, this is promising, but it was an in vitro study in very controlled lab conditions, and sometimes “what happens in the Petri dish, stays in the Petri dish”—in order words, these results may or may not translate to actual living humans.
- Improved insulin response ← is the main take-away that we got from reading through their numerical results, since there was no convenient conclusion given. Superficially, this may be of more interest to those with type 2 diabetes, but then again, if you have T1D and then acquire insulin resistance on top of that, you stand a good chance of dying on account of your exogenous insulin no longer working. In the case of T2D, “the pancreas will provide” (more or less), T1D, not so much.
So, what else is there out there?
The American Diabetes Association does not give a glowing review:
❝There’s a lot of hype surrounding CBD oil and diabetes. There is no noticeable effect on blood glucose (blood sugar) or insulin levels in people with type 2 diabetes. Researchers continue to study the effects of CBD on diabetes in animal studies. ❞
~ American Diabetes Association
Source: ADA | CBD & Diabetes
Of course, that’s type 2, but most research out there is for type 2, or else have been in vitro or rodent studies (and not many of those, at that).
Here’s a relatively more recent study that echoes the results of the previous mouse study we mentioned; it found:
❝CBD-treated non-obese diabetic mice developed T1D later and showed significantly reduced leukocyte activation and increased FCD in the pancreatic microcirculation.
Conclusions: Experimental CBD treatment reduced markers of inflammation in the microcirculation of the pancreas studied by intravital microscopy. ❞
~ Dr. Christian Lehmann et al.
Read more: Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes
…and here’s a 2020 study (so, more recent again) that was this time rats, and/but still more promising, insofar as it was with rats that had full-blown T1D already:
Read in full: Two-weeks treatment with cannabidiol improves biophysical and behavioral deficits associated with experimental type-1 diabetes
Finally, a paper in July 2023 (so, since our previous article about CBD), looked at the benefits of CBD against diabetes-related complications (so, applicable to most people with any kind of diabetes), and concluded:
❝CBDis of great value in the treatment of diabetes and its complications. CBD can improve pancreatic islet function, reduce pancreatic inflammation and improve insulin resistance. For diabetic complications, CBD not only has a preventive effect but also has a therapeutic value for existing diabetic complications and improves the function of target organs❞
…before continuing:
❝However, the safety and effectiveness of CBD are still needed to prove. It should be acknowledged that the clinical application of CBD in the treatment of diabetes and its complications has a long way to go.
The dissecting of the pharmacology and therapeutic role of CBD in diabetes would guide the future development of CBD-based therapeutics for treating diabetes and diabetic complications❞
~ Ibid.
Now, the first part of that is standard ass-covering, and the second part of that is standard “please fund more studies please”. Nevertheless, we must also not fail to take heed—little is guaranteed, especially when it comes to an area of research where the science is still very young.
In summary…
It seems well worth a try, and with ostensibly nothing to lose except the financial cost of the CBD.
If you do, you might want to keep careful track of a) your usual diabetes metrics (blood sugar levels before and after meals, insulin taken), and b) when you took CBD, what dose, etc, so you can do some citizen science here.
Lastly: please remember our standard disclaimer; we are not doctors, let alone your doctors, so please do check with your endocrinologist before undertaking any such changes!
Want to read more?
You might like our previous main feature:
How To Prevent And Reverse Type 2 Diabetes ← obviously this will not prevent or reverse Type 1 Diabetes, but avoiding insulin resistance is good in any case!
If you’re not diabetic and you’ve perhaps been confused throughout this article, then firstly thank you for your patience, and secondly you might like this quick primer:
The Sweet Truth About Diabetes: Debunking Diabetes Myths! ← this gives a simplified but fair overview of types 1 & 2
(for space, we didn’t cover the much less common types 3 & 4; perhaps another time we will)
Meanwhile, take care!
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Healthy Longevity As A Lifestyle Choice
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7 Keys To Healthy Longevity
This is Dr. Luigi Fontana. He’s a research professor of Geriatrics & Nutritional Science, and co-director of the Longevity Research Program at Washington University in St. Louis.
What does he want us to know?
He has a many-fold approach to healthy longevity, most of which may not be news to you, but you might want to prioritize some things:
Consider caloric restriction with optimal nutrition (CRON)
This is about reducing the metabolic load on your body, which frees up bodily resources for keeping yourself young.
Keeping your body young and healthy is your body’s favorite thing to do, but it can’t do that if it never gets a chance because of all the urgent metabolic tasks you’re giving it.
If CRON isn’t your thing (isn’t practicable for you, causes undue suffering, etc) then intermittent fasting is a great CR mimetic, and he recommends that too. See also:
- Is Cutting Calories The Key To Healthy Long Life?
- Fasting Without Crashing? We Sort The Science From The Hype
Keep your waistline small
Whichever approach you prefer to use to look after your metabolic health, keeping your waistline down is much more important for health than BMI.
Specifically, he recommends keeping it:
- under 31.5” for women
- under 37” for men
The disparity here is because of hormonal differences that influence both metabolism and fat distribution.
Exercise as part of your lifestyle
For Dr. Fontana, he loves mountain-biking (this writer could never!) and weight-lifting (also not my thing). But what’s key is not the specifics, but what’s going on:
- Some kind of frequent movement
- Some kind of high-intensity interval training
- Some kind of resistance training
Frequent movement because our bodies are evolved to be moving more often than not:
The Doctor Who Wants Us To Exercise Less, & Move More
High-Intensity Interval Training because unlike most forms of exercise (which slow metabolism afterwards to compensate), it boosts metabolism for up to 2 hours after training:
How To Do HIIT (Without Wrecking Your Body)
Resistance training because strength (of muscles and bones) matters too:
Resistance Is Useful! (Especially As We Get Older)
Writer’s examples:
So while I don’t care for mountain-biking or weight-lifting, what I do is:
1) movement: walk (briskly!) everywhere and also use a standing desk
2) HIIT: 2-minute bursts of hindu squats and/or exercise bike sprints
3) resistance: pilates and other calisthenicsModeration is not key
Dr. Fontana advises that we do not smoke, and that we do not drink alcohol, for example. He also notes that just as the only healthy amount of alcohol is zero, less ultra-processed food is always better than more.
Maybe you don’t want to abstain completely, but mindful wilful consumption of something unhealthy is preferable to believing “moderate consumption is good for the health” and an unhealthy habit develops!
Greens and beans
Shocking absolutely nobody, Dr. Fontana advocates for (what has been the most evidence-based gold standard of healthy-aging diets for quite some years now) the Mediterranean diet.
See also: Four Ways To Upgrade The Mediterranean Diet ← this is about tweaking the Mediterranean diet per personal area of focus, e.g. anti-inflammatory bonus, best for gut, heart healthiest, and most neuroprotective.
Take it easy
Dr. Fontana advises us (again, with a wealth of evidence) Mindfulness-Based Stress Reduction, and to get good sleep.
Not shocked?
To quote the good doctor,
❝There are no shortcuts. No magic pills or expensive procedures can replace the beneficial effects of a healthy diet, exercise, mindfulness, or a regenerating night’s sleep.❞
Always a good reminder!
Want to know more?
You might enjoy his book “The Path to Longevity: How to Reach 100 with the Health and Stamina of a 40-Year-Old”, which we reviewed previously
You might also like this video of his, about changing the conversation from “chronic disease” to “chronic health”:
Want to watch it, but not right now? Bookmark it for later
Take care!
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Citicoline: Better Than Dietary Choline?
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Citicoline: Better Than Dietary Choline?
Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?
Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.
As for citicoline specifically… it appears to do the job better than dietary sources of choline:
❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.
It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).
Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞
Source: Citicoline: A Superior Form of Choline?
Great! What does it do?
What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.
Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.
One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.
Long version: Citicoline: pharmacological and clinical review, 2022 update
(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)
Spotlight study in memory
For a quick-reading example of how it helps memory specifically:
Keeping dementia at bay
For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.
Dr. Maria Bonvicini et al. looked into this:
❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia
All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞
The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).
Another team looked at 47 pre-existing reviews, and concluded:
❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.
Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.
Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞
Source: Application of Citicoline in Neurological Disorders: A Systematic Review
The dopamine bonus
Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:
❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.
Citicoline allowed effective reduction of levodopa by up to 50%.
Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞
Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review
Where to get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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Do You Have A Personalized Health Plan? (Here’s How)
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“Good health” is quite a broad umbrella, and while we all have a general idea of what “healthy” looks like, it’s easy to focus on some areas and overlook others.
Of course, how much one does this will still depend on one’s level of interest in health, which can change over the course of life, and (barring serious midlife health-related curveballs such as a cancer diagnosis or something) often looks like an inverse bell curve:
- As small kids, we probably barely thought about health
- As teenagers, we probably had a narrow view of health (often related to whatever is considered sexually attractive at the time)
- In our 20s, may have a bit of a health kick in which we learn and apply a lot… Which often then gets to later take a bit of a back seat to work responsibilities and so forth
- This is commonly followed by a few decades of just trying to make it to Friday by any means necessary (definite risk factor for substance abuse of various kinds), double if we have kids, triple if we have work, kids, and are also solely responsible for managing the household.
- Then just as suddenly as it is predictably, we are ambushed when approaching retirement age by a cluster of age-related increased health risks that we now get to do our best to mitigate—the focus here is “not dying early”. A lot of health education occurs at this time.
- Finally, upon retirement, we actually get the time to truly focus on our health again, and now it’s easier to learn about all aspects of health, even if now there’s a need to juggle many health issues all at once, most of which affect the others.
See also: How Likely Are You To Live To 100? ← in which we can also see a graph of 10almonds subscribers’ ages, consistent with the above
So, let’s recap, and personalize our health plan
There are often things we wish we could have focused on sooner, so now’s the time to figure out what future-you in your next decade (or later!) is going to thank you for having done now.
So, while 20-year-old us might have been focusing on fat levels or athletic performance, how much does that really help us now? (With apologies to any readers in their 20s, but also, with the bonus for you: now’s the perfect time to plan ahead!)
At 10almonds, while we cover very many health topics, we often especially focus on:
- Brain health
- Heart health
- Gut health
…because they affect everything else so much. We’ve listed them there in the order they appear in the body, but in fact it can be useful to view them upside down, because:
- Gut health is critical for good metabolic health (a happy efficient gut allows us to process nutrients, including energy, efficiently)
- Metabolic health is critical for good heart health (a nicely ticking metabolism will not strain our heart)
- Heart health is critical for good brain health (a strong heart will nourish the brain with well-oxygenated blood and the nutrients it also carries)
So, this isn’t a catch-22 at all! There is a clear starting point:
“How do I do the other bits, though?”
We have you covered here: Your Health Audit, From Head To Toe
“Wait, where’s the personalization?”
This comes once you’ve got those above things in order.
Hopefully you know what particular health risks you have—as in, particular to you.
First, you will have any current diagnoses, and a plan for treating those. Many chronic illnesses can be reversed or at least lessened with lifestyle changes, in particular, if we reduce chronic inflammation, which is implicated in countless chronic illnesses, and exacerbates most of the rest.
So: How to Prevent (or Reduce) Inflammation
The same goes for any heightened risks you have as a result of those current diagnoses.
Next, you will have any genetic health risks—so here’s where genetic testing is a good one-shot tool, to get a lot of information all in one go.
Learn more: The Real Benefit Of Genetic Testing
…and then, of course, take appropriate steps to avoid suffering the things of which you are at increased genetic risk.
Finally, you will have any personal concerns or goals—in other words, what do you want to still be able to do, later in life? It’s easy to say “everything”, but what’s most important?
This writer’s example: I want to remain mobile, free from pain, and sharp of mind.
That doesn’t mean I’ll neglect the rest of my health, but it does mean that I will regularly weigh my choices against whether they are consistent with those three things.
As for how to plan for that?
Check out: Train For The Event Of Your Life! ← this one is mostly about the mobility aspect; staying free from pain is in large part a matter of avoiding inflammation which we already discussed, and staying sharp of mind relies on the gut-heart-brain pipeline we also covered.
You can also, of course, personalize your diet per which areas of health are the most important for you:
Four Ways To Upgrade The Mediterranean (most anti-inflammatory, gut-healthiest, heart-healthiest, brain-healthiest)
Take care!
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Dealing With Waking Up In The Night
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝I’m now in my sixties and find that I invariably wake up at least once during the night. Is this normal? Even if it is, I would still like, once in a while, to sleep right through like a teenager. How might this be achieved, without pills?❞
Most people wake up briefly between sleep cycles, and forget doing so. But waking up for more than a brief moment is indeed best avoided. In men of your age, if you’re waking to pee (especially if it’s then not actually that easy to pee), it can be a sign of an enlarged prostate. Which is again a) normal b) not optimal.
By “without pills” we’ll assume you mean “without sleeping pills”. There are options to treat an enlarged prostate, including well-established supplements. We did a main feature on this:
Prostate Health: What You Should Know
If the cause of waking up is something else, then again this is common for everyone as we get older, and again it’s not optimal. But since there are so many possible causes (and thus solutions), it’s more than we can cover in less than a main feature, so we’ll have to revisit this later.
Meanwhile, take care!
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