Winter Wellness & The Pills That Increase Your Alzheimer’s Risk

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This week in health news…

Do not go gentle into that good night

As wildfires rage in California, snow is falling from Texas to Georgia, meaning that a lot of people are facing weather they’re not accustomed to, in houses that were not built for it. And that’s the lucky ones; there are many thousands of people who are homeless, of whom many will die.

Hopefully all our readers are safe, but it pays to watch out for the signs of hypothermia as it is a condition that really sneaks up on people and, in the process, takes away their ability to notice the hypothermia. You and your loved ones are not immune to this, so it’s good to keep an eye on each other, looking out for:

  • Shivering, first ← when this stops, assuming it’s not because the temperature has risen, it is often a sign of hypothermia entering a later stage, in which the body is no longer responding appropriately to the cold
  • Slurred speech or mumbling
  • Slow, shallow breathing
  • A weak pulse
  • Clumsiness or lack of coordination
  • Drowsiness or very low energy
  • Confusion or memory loss
  • Loss of consciousness
  • In infants, bright red, cold skin

How cold is too cold? It doesn’t even have to be sub-zero. According to the CDC, temperatures of 4℃ (40℉) can be low enough to cause hypothermia.

Read in full: The warning signs to notice if someone has hypothermia

Related: Cold Weather Health Risks

Lethal lottery of pathogens

In Minnesota, hospital emergency room waiting times have skyrocketed since yesterday (at time of writing), with 40% of Minnesota’s 1,763 flu-related hospitalizations this fall and winter occurring in the same week, according to yesterday’s report. To put it further into perspective, 17 out of 20 of this season’s flu outbreaks have occurred in the past two weeks.

And that’s just the flu, without considering COVID, RSV, and Norovirus, which are also all running rampant in MN right now.

The advice presently is:

❝Go to the ER if you are super-sick. If you are not super-sick, go to urgent care, go to your clinic, schedule a virtual appointment.❞

And if you’re not in Minneapolis? These stats won’t apply, but definitely consider, before going to the hospital, whether you might leave sicker than you arrived, and plan accordingly, making use of telehealth where reasonably possible.

Read in full: Minnesota ERs stressed by “quad-demic” of COVID, flu, RSV, norovirus

Related: Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now

Sleep, but at what cost?

This was a study looking at the effects of sleeping pills on the brain, specifically zolpidem (most well-known by its brand name of Ambien).

What they found is that while it does indeed effectively induce sleep, part of how it does that is suppressing norepinephrine oscillations (which might otherwise potentially wake you up, though in healthy people these oscillations and the micro-arousals that they cause shouldn’t disrupt sleep at all, and are just considered part of our normal sleep cycles), which oscillations are necessary to generate the pumping action required to move cerebrospinal fluid through the glymphatic system while asleep.

This is a big problem, because the glymphatic system is almost entirely responsible for keeping the brain free from waste products such as beta-amyloids (whose build-up is associated with Alzheimer’s disease and is considered to be a significant part of Alzheimer’s pathogensesis) and alpha-synuclein (same but for Parkinson’s disease), amongst others:

Read in full: Common sleeping pill may pave way for disorders like Alzheimer’s

Related: How To Clean Your Brain (Glymphatic Health Primer)

Take care!

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  • The Art of Being Unflappable (Tricks For Daily Life)

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    The Art of Being Unflappable

    From Stoicism to CBT, thinkers through the ages have sought the unflappable life.

    Today, in true 10almonds fashion, we’re going to distil it down to some concentrated essentials that we can all apply in our daily lives:

    Most Common/Impactful Cognitive Distortions To Catch (And Thus Avoid)

    These are like the rhetorical fallacies with which you might be familiar (ad hominem, no true Scotsman, begging the question, tu quoque, straw man, etc), but are about what goes on between your own ears, pertaining to your own life.

    If we learn about them and how to recognize them, however, we can catch them before they sabotage us, and remain “unflappable” in situations that could otherwise turn disastrous.

    Let’s take a look at a few:

    Catastrophizing / Crystal Ball

    • Distortion: not just blowing something out of proportion, but taking an idea and running with it to its worst possible conclusion. For example, we cook one meal that’s a “miss” and conclude we are a terrible cook, and in fact for this reason a terrible housewife/mother/friend/etc, and for this reason everyone will probably abandon us and would be right to do so
    • Reality: by tomorrow, you’ll probably be the only one who even remembers it happened

    Mind Reading

    • Distortion: attributing motivations that may or may not be there, and making assumptions about other people’s thoughts/feelings. An example is the joke about two partners’ diary entries; one is long and full of feelings about how the other is surely dissatisfied in their marriage, has been acting “off” with them all day, is closed and distant, probably wants to divorce, may be having an affair and is wondering which way to jump, and/or is just wondering how to break the news—the other partner’s diary entry is short, and reads “motorcycle won’t start; can’t figure out why”
    • Reality: sometimes, asking open questions is better than guessing, and much better than assuming!

    All-or-Nothing Thinking / Disqualifying the Positive / Magnifying the Negative

    • Distortion: having a negative bias that not only finds a cloud in every silver lining, but stretches it out so that it’s all that we can see. In a relationship, this might mean that one argument makes us feel like our relationship is nothing but strife. In life in general, it may lead us to feel like we are “naturally unlucky”.
    • Reality: those negative things wouldn’t even register as negative to us if there weren’t a commensurate positive we’ve experienced to hold them in contrast against. So, find and remember that positive too.

    For brevity, we put a spotlight on (and in some cases, clumped together) the ones we think have the most bang-for-buck to know about, but there are many more.

    So for the curious, here’s some further reading:

    Psychology Today: 50 Common Cognitive Distortions

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  • Chickpeas vs Black-Eyed Peas – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing chickpeas to black-eyed peas, we picked the chickpeas.

    Why?

    In terms of macros, chickpeas have more protein, carbs, and fiber, the ratio of the latter two also giving them the lower glycemic index. An easy win for chickpeas.

    In the category of vitamins, chickpeas have more of vitamins B2, B6, C, E, K, and choline, while black-eyed peas have more of vitamins B1, B5, and B9. Another victory for chickpeas.

    When it comes to minerals, things are even more pronounced: chickpeas have more calcium, copper, iron, manganese, phosphorus, potassium, selenium, and zinc, while black-eyed peas have (barely) more magnesium. An overwhelming win for chickpeas.

    Adding up the sections makes for a very evident overall win for chickpeas; as ever, do enjoy either or both though; diversity is good!

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Enjoy!

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  • Intuitive Eating Might Not Be What You Think

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    In our recent Expert Insights main features, we’ve looked at two fairly opposing schools of thought when it comes to managing what we eat.

    First we looked at:

    What Flexible Dieting Really Means

    …and the notion of doing things imperfectly for greater sustainability, and reducing the cognitive load of dieting by measuring only the things that are necessary.

    And then in opposition to that,

    What Are The “Bright Lines” Of Bright Line Eating?

    …and the notion of doing things perfectly so as to not go astray, and reducing the cognitive load of dieting by having hard-and-fast rules that one does not second-guess or reconsider later when hungry.

    Today we’re going to look at Intuitive Eating, and what it does and doesn’t mean.

    Intuitive Eating does mean paying attention to hunger signals (each way)

    Intuitive Eating means listening to one’s body, and responding to hunger signals, whether those signals are saying “time to eat” or “time to stop”.

    A common recommendation is to “check in” with one’s body several times per meal, reflecting on such questions as:

    • Do I have hunger pangs? Would I seek food now if I weren’t already at the table?
    • If I hadn’t made more food than I’ve already eaten so far, would that have been enough, or would I have to look for something else to eat?
    • Am I craving any of the foods that are still before me? Which one(s)?
    • How much “room” do I feel I still have, really? Am I still in the comfort zone, and/or am I about to pass into having overeaten?
    • Am I eating for pleasure only at this point? (This is not inherently bad, by the way—it’s ok to have a little more just for pleasure! But it is good to note that this is the reason we’re eating, and take it as a cue to slow down and remember to eat mindfully, and enjoy every bite)
    • Have I, in fact, passed the point of pleasure, and I’m just eating because it’s in front of me, or so as to “not be wasteful”?

    See also: Interoception: Improving Our Awareness Of Body Cues

    And for that matter: Mindful Eating: How To Get More Out Of What’s On Your Plate

    Intuitive Eating is not “80:20”

    When it comes to food, the 80:20 rule is the idea of having 80% of one’s diet healthy, and the other 20% “free”, not necessarily unhealthy, but certainly not moderated either.

    Do you know what else the 80:20 food rule is?

    A food rule.

    Intuitive Eating doesn’t do those.

    The problem with food rules is that they can get us into the sorts of problems described in the studies showing how flexible dieting generally works better than rigid dieting.

    Suddenly, what should have been our free-eating 20% becomes “wait, is this still 20%, or have I now eaten so much compared to the healthy food, that I’m at 110% for my overall food consumption today?”

    Then one gets into “Well, I’ve already failed to do 80:20 today, so I’ll try again tomorrow [and binge meanwhile, since today is already written off]”

    See also: Eating Disorders: More Varied (And Prevalent) Than People Think

    It’s not “eat anything, anytime”, either

    Intuitive Eating is about listening to your body, and your brain is also part of your body.

    • If your body is saying “give me sugar”, your brain might add the information “fruit is healthier than candy”.
    • If your body is saying “give me fat”, your brain might add the information “nuts are healthier than fried food”
    • If your body is saying “give me salt”, your brain might add the information “kimchi is healthier than potato chips”

    That doesn’t mean you have to swear off candy, fried food, or potato chips.

    But it does mean that you might try satisfying your craving with the healthier option first, giving yourself permission to have the less healthy option afterwards if you still want it (you probably won’t).

    See also:

    I want to eat healthily. So why do I crave sugar, salt and carbs?

    Want to know more about Intuitive Eating?

    You might like this book that we reviewed previously:

    Intuitive Eating – by Evelyn Tribole and Elyse Resch

    Enjoy!

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  • Fixing Fascia

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Fascia: Why (And How) You Should Take Care Of Yours

    Fascia is the web-like layer of connective tissue that divides your muscles and organs from each other. It simultaneously holds some stuff in place, and allows other parts to glide over each other with minimal friction.

    At least, that’s what it’s supposed to do.

    Like any body part, it can go wrong. More on this later. But first…

    A quick note on terms

    It may seem like sometimes people say “myofascial” because it sounds fancier, but it does actually have a specific meaning too:

    • Fascia” is what we just described above
    • Myofascial” means “of or relating to muscles and fascia

    For example, “myofascial release” means “stopping the fascia from sticking to the muscle where it shouldn’t” and “myofascial pain” means “pain that has to do with the muscles and fascia”. See also:

    Myofascial vs Fascia: When To Use Each One? What To Consider

    Why fascia is so ignored

    For millennia, it was mostly disregarded as a “neither this nor that” tissue that just happens to be in the body. We didn’t pay attention to it, just like we mostly don’t pay attention to the air around us.

    But, much like the air around us, we sure pay attention when something goes wrong with it!

    However, even in more recent years, we’ve been held back until quite new developments like musculoskeletal ultrasound that could show us problems with the fascia.

    What can go wrong

    It’s supposed to be strong, thin, supple, and slippery. It holds on in the necessary places like a spiderweb, but for the most part, it is evolved for minimum friction.

    Some things can cause it to thicken and become sticky in the wrong places. Things such as:

    • Physical trauma, e.g. an injury or surgery—but we repeat ourselves, because a surgery is an injury! It’s a (usually) necessary injury, but an injury nonetheless.
    • Compensation for pain. If a body part hurts for some reason, and your posture changes to accommodate that, doing so can mess up your fascia, and cause you different problems somewhere else entirely.
      • This is not witchcraft; think of how, when using a corded vacuum cleaner, sometimes the cord can get snagged on something in the next room and we nearly break something because we expected it to just come with us and it didn’t? It’s like that.
    • Repetitive movements (repetitive strain injury is partly a myofascial issue)
    • Not enough movement: when it comes to range of motion, it’s “use it or lose it”.
      • The human body tries its best to be as efficient as possible for us! So eventually it will go “Hey, I notice you never move more than 30º in this direction, so I’m going to stop making fascia that allows you to go past that point, and I’ll just dump the materials here instead”

    “I’ll just dump the materials here instead” is also part of the problem—it creates what we colloquially call “knots”, which are not so much part of the muscle as the fascia that covers it. That’s an actual physical sticky lumpy bit.

    What to do about it

    Firstly, avoid the above things! But, if for whatever reason something has gone wrong and you now have sticky lumpy fascia that doesn’t let you move the way you’d like (if you have any mobility/flexibility issues that aren’t for another known reason, then this is usually it), there are things can be done:

    • Heat—is definitely not a cure-all, but it’s a good first step before doing the other things. A heating pad or a warm bath are great.
    • Massage—ideally, by someone else who knows what they are doing. Self-massage is possible, as is teaching oneself (there are plenty of video tutorials available), but skilled professional therapeutic myofascial release massage is the gold standard.
      • Foam rollers are a great no-skill way to get going with self-massage, whether because that’s what’s available to you, or because you just want something you can do between sessions. Here’s an example of the kind we mean.
    • Acupuncture—triggering localized muscular relaxation, an important part of myofascial release, is something acupuncture is good at.
      • See also: Pinpointing The Usefulness Of Acupuncture ← noteworthily, the strongest criticism of acupuncture for pain relief is that it performs only slightly better than sham acupuncture, but taken in practical terms, all that really means is “sticking little needles in does work, even if not necessarily by the mechanism acupuncturists believe”
    • Calisthenics—Pilates, yoga, and other forms of body movement training can help gradually get one’s fascia to where and how it’s supposed to be.
    • This is that “use it or lose it” bodily efficiency we talked about!

    Remember, the body is always rebuilding itself. It never stops, until you die. So on any given day, you get to choose whether it rebuilds itself a little bit worse or a little bit better.

    Take care!

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  • From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained

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    More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.

    However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.

    While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.

    The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.

    Svitlana Hulko/Shutterstock

    Immunotherapy before surgery

    Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.

    Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.

    Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.

    This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.

    A woman's arm with a mole on it.
    More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock

    Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.

    The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.

    Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.

    Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.

    Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.

    The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.

    mRNA vaccines

    Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).

    While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.

    mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).

    However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.

    The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.

    It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.

    Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.

    It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.

    Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.

    Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Behavioral Activation Against Depression & Anxiety

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    Behavioral Activation Against Depression & Anxiety

    Psychologists do love making fancy new names for things.

    You thought you were merely “eating your breakfast”, but now it’s “Happiness-Oriented Basic Behavioral Intervention Therapy (HOBBIT)” or something.

    This one’s quite simple, so we’ll keep it short for today, but it is one more tool for your toolbox:

    What is Behavioral Activation?

    Behavioral Activation is about improving our mood (something we can’t directly choose) by changing our behavior (something we usually can directly choose).

    An oversimplified (and insufficient, as we will explain, but we’ll use this one to get us started) example would be “whistle a happy tune and you will be happy”.

    Behavioral Activation is not a silver bullet

    Or if it is, then it’s the kind you have to keep shooting, because one shot is not enough. However, this becomes easier than you might think, because Behavioral Activation works by…

    Creating a Positive Feedback Loop

    A lot of internal problems in depression and anxiety are created by the fact that necessary and otherwise desirable activities are being written off by the brain as:

    • Pointless (depression)
    • Dangerous (anxiety)

    The inaction that results from these aversions creates a negative feedback loop as one’s life gradually declines (as does one’s energy, and interest in life), or as the outside world seems more and more unwelcoming/scary.

    Instead, Behavioral Activation plans activities (usually with the help of a therapist, as depressed/anxious people are not the most inclined to plan activities) that will be:

    • attainable
    • rewarding

    The first part is important, because the maximum of what is “attainable” to a depressed/anxious person can often be quite a small thing. So, small goals are ideal at first.

    The second part is important, because there needs to be some way of jump-starting a healthier dopamine cycle. It also has to feel rewarding during/after doing it, not next year, so short term plans are ideal at first.

    So, what behavior should we do?

    That depends on you. Behavioral Activation calls for keeping track of our activities (bullet-journaling is fine, and there are apps* that can help you, too) and corresponding moods.

    *This writer uses the pragmatic Daylio for its nice statistical analyses of bullet-journaling data-points, and the very cute Finch for more keyword-oriented insights and suggestions. Whatever works for you, works for you, though! It could even be paper and pen.

    Sometimes the very thought of an activity fills us with dread, but the actual execution of it brings us relief. Bullet-journaling can track that sort of thing, and inform decisions about “what we should do” going forwards.

    Want a ready-made brainstorm to jump-start your creativity?

    Here’s list of activities suggested by TherapistAid (a resource hub for therapists)

    Want to know more?

    You might like:

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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