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Hypertension: Factors Far More Relevant Than Salt
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Hypertension: Factors Far More Relevant Than Salt
Firstly, what is high blood pressure vs normal, and what do those blood pressure readings mean?
Rather than take up undue space here, we’ll just quickly link to…
Blood Pressure Readings Explained (With A Colorful Chart)
More details of specifics, at:
Hypotension | Normal | Elevated | Stage 1 | Stage 2 | Danger zone
Keeping Blood Pressure Down
As with most health-related things (and in fact, much of life in general), prevention is better than cure.
People usually know “limit salt” and “manage stress”, but there’s a lot more to it!
Salt isn’t as big a factor as you probably think
That doesn’t mean go crazy on the salt, as it can cause a lot of other problems, including organ failure. But it does mean that you can’t skip the salt and assume your blood pressure will take care of itself.
This paper, for example, considers “high” sodium consumption to be more than 5g per day, and urinary excretion under 3g per day is considered to represent a low sodium dietary intake:
Sodium Intake and Hypertension
Meanwhile, health organizations often recommend to keep sodium intake to under 2g or under 1.5g
Top tip: if you replace your table salt with “reduced sodium” salt, this is usually sodium chloride (regular table salt) cut with potassium chloride, which is almost as “salty” tastewise, but obviously contains less sodium. Not only that, but potassium actually helps the body eliminate sodium, too.
The rest of what you eat is important too
The Mediterranean Diet is as great for this as it is for most health conditions.
If you sometimes see the DASH diet mentioned, that stands for “Dietary Approaches to Stop Hypertension”, and is basically the Mediterranean Diet with a few tweaks.
What are the tweaks?
- Beans went down a bit in priority
- Red meat got removed entirely instead of “limit to a tiny amount”
- Olive oil was deprioritized, and/but vegetable oil is at the bottom of the list (i.e., use sparingly)
You can check out the details here, with an overview and examples:
DASH Eating Plan—Description, Charts, and Recipes
Don’t drink or smoke
And no, a glass of red a day will not help your heart. Alcohol does make us feel relaxed, but that is because of what it does to our brain, not what it does to our heart.
In reality, even a single drink will increase blood pressure. Yes, really:
And smoking? It’s so bad that even second-hand smoke increases blood pressure:
Get those Zs in
Sleep is a commonly underestimated/forgotten part of health, precisely because in a way, we’re not there for it when it happens. We sleep through it! But it is important, including to protect against hypertension:
Short- and long-term health consequences of sleep disruption
Move your body!
Moving your body often is far more important for your heart than running marathons or bench-pressing your spouse.
Those 150 minutes “moderate exercise” (e.g. walking) per week are important, and can be for example:
- 22 minutes per day, 7 days per week
- 25 minutes per day, 6 days per week
- 30 minutes per day, 5 days per week
- 75 minutes per day, 2 days per week
If you’d like to know more about the science and evidence for this, as well as practical suggestions, you can download the complete second edition of the Physical Activity Guidelines for Americans here (it’s free, and no sign-up required!)
If you prefer a bite-size summary, then here’s their own:
Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans
PS: Want a blood pressure monitor? We don’t sell them (or anything else), but for your convenience, here’s a good one you might want to consider.
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Walking… Better.
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Walking… Better.
We recently reviewed “52 Ways To Walk” by Annabel Streets. You asked us to share some more of our learnings from that book, and… Obviously we can’t do all 52, nor go into such detail, but here are three top tips inspired by that book…
Walk in the cold!
While cold weather is often seen as a reason to not walk, in fact, it has numerous health benefits, the most exciting of which might be:
Walking in the cold causes us to convert white and yellow fat into the healthier brown fat. If you didn’t know about this, neither did scientists until about 15 years ago.
In fact, scientists didn’t even know that adult humans could even have brown adipose tissue! It was really quite groundbreaking.
In case you missed it: The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
Work while you walk!
Obviously this is only appropriate for some kinds of work… but if in your life you have any kind of work that is chiefly thinking, a bunch of it can be done while walking.
Open your phone’s note-taking app, lock the screen and pocket your phone, and think on some problem that you need to solve. Whenever you have an “aha” moment, take out your phone and make a quick note on the go.
For that matter, if you have the money and space (or are fortunate to have an employer disposed towards facilitating such), you could even set up a treadmill desk… At worst, it wouldn’t harm your work (and it’ll be a LOT better than sitting for so long).
Walk within an hour of waking!
No, this doesn’t mean that if you don’t get out of the house within 60 minutes you say “Oh no, missed the window, guess it’s a day in today”
But it does mean: in the evening, make preparations to head out first thing in the morning. Set out your clothes and appropriate footwear, find your flask to fill with the beverage of your choice in the morning and set that with them.
Then, when morning arrives… do your morning necessaries (e.g. some manner of morning ablutions and perhaps a light breakfast), make that drink for your flask, and hit the road.
Why? We’ll tell you a secret:
You ever wondered why some people seem to be more able to keep a daylight-regulated circadian rhythm than others? It’s not just about smartphones and coffees…
This study found that getting sunlight (not electric light, not artificial sunlight, but actual sunlight, from the sun, even if filtered through partial cloud) between 08:30—09:00 resulted in higher levels of a protein called PER2. PER2 is critical for setting circadian rhythms, improving metabolism, and fortifying blood vessels.
Besides, on a more simplistic level, it’s also a wonderful and energizing start to a healthy and productive day!
Read: Beneficial effects of daytime light exposure on daily rhythms, metabolic state and affect
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Capsaicin For Weight Loss And Against Inflammation
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Capsaicin’s Hot Benefits
Capsaicin, the compound in hot peppers that makes them spicy, is a chemical irritant and a neurotoxin. However, humans being humans, we decided to eat them for fun.
In contrast to many other ways in which humans recreationally enjoy things that are objectively poisonous, consuming capsaicin (in moderation) is considered to have health benefits, such as aiding weight loss (by boosting metabolism) and reducing inflammation.
Let’s see what the science says…
First: is it safe?
Capsaicin is classified as “Generally Recognized As Safe”. That said, the same mechanism that causes them to boost metabolism, does increase blood pressure:
Mechanisms underlying the hypertensive response induced by capsaicin
If you are in good cardiovascular health, this increase should be slight and not pose any threat, unless for example you enter a chili-eating contest when not acclimated to such:
Capsaicin and arterial hypertensive crisis
As ever, if unsure, do check with your doctor first, especially if you are taking any blood pressure medications, or otherwise have known blood pressure issues.
Does it really boost metabolism?
It certainly does; it works by increasing oxygen consumption and raising body temperature, both of which mean more calories will be burned for the same amount of work:
Dietary capsaicin and its anti-obesity potency: from mechanism to clinical implications
This means, of course, that chili peppers enjoy the status of being functionally a “negative calorie” food, and a top-tier one at that:
Chili pepper as a body weight-loss food
Here’s a good quality study that showed a statistically significant* fat loss improvement over placebo:
*To put it in numbers, the benefit was:
- 5.91 percentage points lower body fat percentage than placebo
- 6.68 percentage points greater change in body fat mass than placebo
See also: Difference between percentages and percentage points
For those who prefer big reviews than single studies, we’ve got you covered:
Does it really reduce inflammation?
Counterintuitive as it may seem, yes. By means of reducing oxidative stress. Given that things that reduce oxidative stress tend to reduce inflammation, and in turn tend to reduce assorted disease risks (from diabetes to cancer to Alzheimer’s), this probably has more knock-on benefits too, but we don’t have room to explore all of those today.
Fresh peppers are best for this, but dried peppers (such as when purchased as a ground spice in the supermarket, or when purchased as a capsule-based supplement) still have a very respectable anti-inflammatory effect:
- Capsaicinoids, Polyphenols and Antioxidant Activities of Capsicum annuum: Comparative Study of the Effect of Ripening Stage and Cooking Methods
- A Review on the Effect of Drying on Antioxidant Potential of Fruits and Vegetables
How much should we take?
It’s recommended to start at a low dose and gradually increase it, but 2–6mg of capsaicin per day is the standard range used in studies.
If you’re getting this from peppers, then for example cayenne pepper (a good source of capsaicin) contains around 2.5mg of capsaicin per 1 gram of cayenne.
In the case of capsules, if for example you don’t like eating hot pepper, this will usually mean taking 2–6 capsules per day, depending on dosage.
Make sure to take it with plenty of water!
Where can we get it?
Fresh peppers or ground spice from your local grocery store is fine. Your local health food store probably sells the supplements, too.
If you’d like to buy it online, here is an example product on Amazon.
Note: options on Amazon were more limited than usual, so this product is not vegan, and probably not halal or kosher, as the capsule contains an unspecified gelatin.
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Black Cohosh vs The Menopause
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Black Cohosh, By Any Other Name…
Black cohosh is a flowering plant whose extracts are popularly used to relieve menopausal (and postmenopausal) symptoms.
Note on terms: we’ll use “black cohosh” in this article, but if you see the botanical names in studies, the reason it sometimes appears as Actaea racemosa and sometimes as Cimicfuga racemosa, is because it got changed and changed back on account of some disagreements between botanists. It’s the same plant, in any case!
Read: Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae)
Does it work?
In few words: it works for physical symptoms, but not emotional ones, based on this large (n=2,310) meta-analysis of studies:
❝Black cohosh extracts were associated with significant improvements in overall menopausal symptoms (Hedges’ g = 0.575, 95% CI = 0.283 to 0.867, P < 0.001), as well as in hot flashes (Hedges’ g = 0.315, 95% CIs = 0.107 to 0.524, P = 0.003), and somatic symptoms (Hedges’ g = 0.418, 95% CI = 0.165 to 0.670, P = 0.001), compared with placebo.
However, black cohosh did not significantly improve anxiety (Hedges’ g = 0.194, 95% CI = -0.296 to 0.684, P = 0.438) or depressive symptoms (Hedges’ g = 0.406, 95% CI = -0.121 to 0.932, P = 0.131)❞
~ Dr. Ryochi Sadahiro et al., 2023
Source: Black cohosh extracts in women with menopausal symptoms: an updated pairwise meta-analysis
Here’s an even larger (n=43,759) one that found similarly, and also noted on safety:
❝Treatment with iCR/iCR+HP was well tolerated with few minor adverse events, with a frequency comparable to placebo. The clinical data did not reveal any evidence of hepatotoxicity.
Hormone levels remained unchanged and estrogen-sensitive tissues (e.g. breast, endometrium) were unaffected by iCR treatment.
As benefits clearly outweigh risks, iCR/iCR+HP should be recommended as an evidence-based treatment option for natural climacteric symptoms.
With its good safety profile in general and at estrogen-sensitive organs, iCR as a non-hormonal herbal therapy can also be used in patients with hormone-dependent diseases who suffer from iatrogenic climacteric symptoms.❞
~ Dr. Castelo-Branco et al., 2020
(iCR = isopropanolic Cimicifuga racemosa)
So, is this estrogenic or not?
This is the question many scientists were asking, about 20 or so years ago. There are many papers from around 2000–2005, but here’s a good one that’s quite representative:
❝These new data dispute the estrogenic theory and demonstrate that extracts of black cohosh do not bind to the estrogen receptor in vitro, up-regulate estrogen-dependent genes, or stimulate the growth of estrogen-dependent tumors❞
Source: Is Black Cohosh Estrogenic?
(the abstract is a little vague, but if you click on the PDF icon, you can read the full paper, which is a lot clearer and more detailed)
The short answer: no, black cohosh is not estrogenic
Is it safe?
As ever, check with your doctor as everyone’s situation can vary, but broadly speaking, yes, it has a very good safety profile—including for breast cancer patients, at that. See for example:
- Black cohosh efficacy and safety for menopausal symptoms: the Spanish Menopause Society statement
- Black cohosh (Cimicifuga racemosa): safety and efficacy for cancer patients
- The safety of black cohosh (Actaea racemosa, Cimicifuga racemosa)
Where can I get some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Come As You Are – by Dr. Emily Nagoski
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We’ve all heard the jokes, things like: Q: “Why is the clitoris like Antarctica?” A: “Most men know it’s there; most don’t give a damn”
But… How much do people, in general, really know about the anatomy and physiology of sexual function? Usually very little, but often without knowing how little we know.
This book looks to change that. Geared to a female audience, but almost everyone will gain useful knowledge from this.
The writing style is very easy-to-read, and there are “tl;dr” summaries for those who prefer to skim for relevant information in this rather sizeable (400 pages) tome.
Yes, that’s “what most people don’t know”. Four. Hundred. Pages.
We recommend reading it. You can thank us later!
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Screaming at Screens?
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I Screen, You Screen, We All Screen For…?
Dr. Kathryn Birkenbach is a postdoctoral research fellow in the Department of Neuroscience at Columbia University, and Manager of Research at Early Medical in New York.
Kathryn has things to tell us about kids’ neurological development, and screen time spent with electronic devices including phones, tablets, computers, and TVs.
From the 1960s criticism of “the gogglebox” to the modern-day critiques of “iPad babies” as a watchword of parental neglect, there’s plenty people can say against screen time, but Dr. Birkenbach tells us the that the reality is more nuanced:
Context Is Key
On a positive note”: consistent exposure to age-appropriate educational material results in quicker language acquisition than media that’s purely for entertainment purposes, or not age-appropriate.
Contrary to popular belief, children do not in fact learn by osmosis!
Interaction Is Far More Valuable Than Inaction
Kathryn advises that while adults tend to quite easily grasp things from instructional videos, the same does not go for small children.
This means that a lot of educational programming can be beneficial to small children if and only if there is an adult with them to help translate the visual into the practical!
There’s a story that does the rounds on the Internet: a young boy wanted to train his puppy, but didn’t know how. He asked, and was told “search for puppy training on YouTube”. His parents came back later and found him with his iPad, earnestly showing the training videos to the puppy.
We can laugh at the child’s naïvety, knowing that’s not how it works and the puppy will not learn that way, so why make the same mistake in turn?
❝The phenomenon known as the “video deficit effect” can be overcome, when an on-screen guide interacts with the child or a parent is physically present and draws the child’s attention to relevant information.
In other words, interaction with others appears to enhance the perceived salience of on-screen information, unlocking a child’s ability to learn from a medium which would otherwise offer no real-world benefit.❞
Screens Can Supplement, But Can’t Replace, Live Learning & Play
Sci-fi may show us “education pods” in which children learn all they need to from their screen… but according to our most up-to-date science, Dr. Birkenbach says, that simply would not work at all.
Screen time without adult interactions will typically fail to provide small children any benefit.
There is one thing it’s good at, though… attracting and keeping attention.
Thus, even a mere background presence of a TV show in the room will tend to actively reduce the time a small child spends on other activities, including live learning and exploratory play.
The attention-grabbing abilities of TV shows don’t stop at children, though! Adult caregivers will also tend to engage in fewer interactions with their children… and the interactions will be shorter and of lower quality.
In Summary:
- Young children will tend not to learn from non-interactive screen time
- Interactive screen time, ideally with a caregiver, can be educational
- Interactive screen time, not with a carer, can be beneficial (but a weak substitute)
- Interactive screen time refers to shows such as Dora The Explorer, where Dora directly addresses the viewer and asks questions…But it’s reliant on the child caring to answer!
- It can also mean interactive educational apps, provided the child does consciously interact!
- Randomly pressing things is not conscious interaction! The key here is engaging with it intelligently and thoughtfully
- A screen will take a child’s time and attention away from non-screen things: that’s a genuine measurable loss to their development!
Absolute Bottom Line:
Screens can be of benefit to small children, if and only if the material is:
- Age-Appropriate
- Educational
- Interactive
If it’s missing one of those three, it’ll be of little to no benefit, and can even harm, as it reduces the time spent on more beneficial activities.
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Walk Yourself Happy – by Dr. Julia Bradbury
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Notwithstanding her (honorary) doctorate, Dr. Bradbury is not, in fact, a scientist. But…
- She has a lot of experience walking all around the world, and her walking habit has seen her through all manner of things, from stress and anxiety to cancer and grief and more.
- She does, throughout this book, consult many scientists and other experts (indeed, some we’ve featured here before at 10almonds), so we still get quite a dose of science too.
The writing style of this book is… Compelling. Honestly, the biggest initial barrier to you getting out of the door will be putting this book down first.If you have good self-discipline, you might make it last longer by treating yourself to a chapter per day
Bottom line: you probably don’t need this book to know how to go for a walk, but it will motivate, inspire, and even inform you of how to get the most out of it. Treat yourself!
Click here to check out Walk Yourself Happy, and prepare for a new healthy habit!
Don’t Forget…
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Learn to Age Gracefully
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