Falling: Is It Due To Age Or Health Issues?

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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 😎

❝What are the signs that a senior is falling due to health issues rather than just aging?❞

Superficial answer: having an ear infection can result in a loss of balance, and is not particularly tied to age as a risk factor

More useful answer: first, let’s consider these two true statements:

  • The risks of falling (both the probability and the severity of consequences) increase with age
  • Health issues (in general) tend to increase with age

With this in mind, it’s difficult to disconnect the two, as neither exist in a vacuum, and each is strongly associated with the other.

So the question is easier to answer by first flipping it, to ask:

❝What are the health issues that typically increase with age, that increase the chances of falling?❞

A non-exhaustive list includes:

  • Loss of strength due to sarcopenia (reduced muscle mass)
  • Loss of mobility due to increased stiffness (many causes, most of which worsen with age)
  • Loss of risk-awareness due to diminished senses (for example, not seeing an obstacle until too late)
  • Loss of risk-awareness due to reduced mental focus (cognitive decline producing absent-mindedness)

Note that in the last example there, and to a lesser extent the third one, reminds us that falls also often do not happen in a vacuum. There is (despite how it may sometimes feel!) no actual change in our physical relationship with gravity as we get older; most falls are about falling over things, even if it’s just one’s own feet:

The 4 Bad Habits That Cause The Most Falls While Walking

Disclaimer: sometimes a person may just fall down for no external reason. An example of why this may happen is if a person’s joint (for example an ankle or a knee) has a particular weakness that means it’ll occasionally just buckle and collapse under one’s own weight. This doesn’t even have to be a lot of weight! The weakness could be due to an old injury, or Ehlers-Danlos Syndrome (with its characteristic joint hypermobility symptoms), or something else entirely.

Now, notice how:

  • all of these things can happen at any age
  • all of these things are more likely to happen the older we get
  • none of these things have to happen at any age

That last one’s important to remember! Aging is often viewed as an implacable Behemoth, but the truth is that it is many-faceted and every single one of those facets can be countered, to a greater or lesser degree.

Think of a room full of 80-year-olds, and now imagine that…

  • One has the hearing of a 20-year-old
  • One has the eyesight of a 20-year-old
  • One has the sharp quick mind of a 20-year-old
  • One has the cardiovascular fitness of a 20-year-old

…etc. Now, none of those things in isolation is unthinkable, so remember, there is no magic law of the universe saying we can’t have each of them:

Age & Aging: What Can (And Can’t) We Do About It?

Which means: that goes for the things that increase the risk of falling, too. In other words, we can combat sarcopenia with protein and resistance training, maintain our mobility, look after our sensory organs as best we can, nourish our brain and keep it sharp, etc etc etc:

Train For The Event Of Your Life! (Mobility As A Long-Term “Athletic” Goal For Personal Safety)

Which doesn’t mean: that we will necessarily succeed in all areas. Your writer here, broadly in excellent health, and whose lower body is still a veritable powerhouse in athletic terms, has a right ankle and left knee that will sometimes just buckle (yay, the aforementioned hypermobility).

So, it becomes a priority to pre-empt the consequences of that, for example:

  • being able to fall with minimal impact (this is a matter of knowing how, and can be learned from “soft” martial arts such as aikido), and
  • ensuring the skeleton can take a knock if necessary (keeping a good balance of vitamins, minerals, protein, etc; keeping an eye on bone density).

See also:

Fall Special ← appropriate for the coming season, but it’s about avoiding falling, and reducing the damage of falling if one does fall, including some exercises to try at home.

Take care!

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  • How Healers Heal – by Dr. Shilpi Pradhan

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    First note: the listed author here is in fact the compiler, with the authors being a collection of no fewer than 33 board-certified lifestyle medicine physicians. So, we’re not getting just a single person’s opinions/bias here!

    But what is lifestyle medicine? This book holds the six pillars of lifestyle medicine to be:

    1. Nutrition
    2. Physical activity
    3. Stress management
    4. Restorative sleep
    5. Social connections
    6. Avoidance of risky substances

    …and those things are what we read about throughout the book, both in highly educational mini-lecture form, and sometimes highly personal storytelling.

    It’s not just a “do these things” book, though yes, there’s a large part of that. It also covers wide topics, from COVID to alopecia, burnout to grief, immune disorders to mysterious chest pains (and how such mysteries are unravelled, when taken seriously).

    One of the greatest strengths of this book is that it’s very much “medicine, as it should be”, so that the reader knows how to recognize the difference.

    Bottom line: this book doesn’t fit into a very neat category, but it’s a very worthwhile book to read, and one that could help inform a decision that changes the entire path of your life or that of a loved one.

    Click here to check out How Healers Heal, and learn to recognize the healthcare you deserve!

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  • 21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)

    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.

    Bone density is a concern for a lot of people past a certain age, and it can lead to an endless juggling of vitamin and mineral supplements to try to get the right balance. Sachiaki Takamiya advocates for a natural diet- and exercise-based approach instead, showing good results with his Okinawan-influenced Blue Zones diet and lifestyle.

    As a caveat, he has not gone through menopause, so this video does completely overlook the implications of that. Nevertheless, even if some of us must get our hormones from a bottle these days, this diet and exercise approach is a very good foundation and the advice here is important for all—we can take all the estrogen we need and still have weak bones if our diet and exercise aren’t there as needed.

    From strength to strength

    Sachiaki Takamiya’s bone density wasn’t bad the previous year, but this year it is better, hitting 123.4%. This is important information, because it’s easier to achieve an n% increase (for any given value of n) if your starting point is lower. For example, a 50% increase from 1g is 1.5g (so, 0.5g difference), whereas a 50% increase from 20g is 30g (so, a 10g difference). Since his starting value was high, this makes his 21% rise particularly noteworthy—and mean that a reader with a lower starting value will most likely see even better gains, if implementing this protocol.

    You may be wondering: isn’t a bone mass density of 123.4% about 23.4% more than we want it? And the answer is that the 100% value is taken from an average peak bone mass in young adults, so having it at 100% is fine, and having it a bit higher is still better—it just means he’s outclassing healthy young adults, less likely to break a bone if he falls, etc.

    As for what he ate: he focused on getting calcium and magnesium, as well as vitamins D and K2, all from food sources. Key foods included small fish (sardines, niosi, jaco), nattō, mushrooms, and seaweed (nori, wakame, hijiki). In particular, he emphasizes nattō’s benefits for bones, as well as for the gut, heart, and brain.

    As for his exercise: he did weight-bearing exercise and resistance training—including calisthenics and yoga, as well as sport, and simply walking and running. His weekly routine looked like this:

    • Monday: heart rate zone 2 jogging (45 min)
    • Tuesday: bodyweight HIIT and flexibility (20 min)
    • Wednesday: heart rate zone 2 jogging (60 min)
    • Thursday: bodyweight HIIT and flexibility (40 min)
    • Friday: heart rate zone 2 jogging (45 min)
    • Saturday: bodyweight HIIT and flexibility (20 min)

    …as well as social sports (e.g. tennis, amongst others), and additional activities such as gardening, and cycling for groceries.

    For more on all of the above (this is a very information-dense video), enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Healthy sex drive In Our Fifties

    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.

    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

    Q: What’s a healthy sex drive for someone in their 50s?

    A: If you’re happy with it, it’s healthy! If you’re not, it’s not.

    This means… If you’re not (happy) and thus it’s not (healthy), you have two main options:

    1. Find a way to be happier without changing it (i.e., change your perspective)
    2. Find a way to change your sex drive (presumably: “increase it”, but we don’t like to assume)

    There are hormonal and pharmaceutical remedies that may help (whatever your sex), so do speak with your doctor/pharmacist.

    Additionally, if a boost to sex drive is what’s wanted, then almost anything that is good for your heart will help.

    We wrote about heart health yesterday:

    What Matters Most For Your Heart?

    That was specifically about dietary considerations, so you might also want to check out:

    The Knowledge That Harvard Medical School’s Clinical Instructor Dr. Monique Tello Thinks Everyone Should Have About Heart Health

    Take care!

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  • Metformin For Weight-Loss & More

    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.

    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:

    One of the cheapest diabetes drugs on the market can also slow aging and extend your life span. Here’s how

    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❞

    Source: Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up

    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.❞

    Real World Data: Off-Label Metformin in Patients with Prediabetes is Associated with Improved Cardiovascular Outcomes

    We wondered about the weight loss implications of this, and…

    For weight loss

    The short version is, it works:

    …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:

    Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients

    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!

    Don’t Forget…

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  • How White Is Your Tongue?

    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.

    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

    ❝So its normal to develop a white sort of coating on the tongue, right? It develops when I eat, and is able to (somewhat) easily be brushed off❞

    If (and only if) there is no soreness and the coverage of the whiteness is not extreme, then, yes, that is normal and fine.

    Your mouth has a microbiome, and it’s supposed to have one (helps keep the conditions in your mouth correct, so that food is broken down and/but your gums and teeth aren’t).

    Read more: The oral microbiome: Role of key organisms and complex networks in oral health and disease

    The whiteness you often see on a healthy tongue is, for the most part, bacteria and dead cells—harmless.

    Cleaning the whiteness off with your brush is fine. You can also scrape off with floss is similar if you prefer. Or a tongue-scraper! Those can be especially good for people for whom brushing the tongue is an unpleasant sensation. Or you can just leave it, if it doesn’t bother you.

    By the way, that microbiome is a reason it can be good to go easy on the mouthwash. Moderate use of mouthwash is usually fine, but you don’t want to wipe out your microbiome then have it taken over by unpleasantries that the mouthwash didn’t kill (unpleasantries like C. albicans).

    There are other mouthwash-related considerations too:

    Toothpastes and mouthwashes: which kinds help, and which kinds harm?

    If you start to get soreness, that probably means the papillae (little villi-like things) are inflamed. If there is soreness, and/or the whiteness is extreme, then it could be a fungal infection (usually C. albicans, also called Thrush), in which case, antifungal medications will be needed, which you can probably get over the counter from your pharmacist.

    Do not try to self-treat with antibiotics.

    Antibiotics will make a fungal infection worse (indeed, antibiotic usage is often the reason for getting fungal growth in the first place) by wiping out the bacteria that normally keep it in check.

    Other risk factors include a sugary diet, smoking, and medications that have “dry mouth” as a side effect.

    Read more: Can oral thrush be prevented?

    If you have any symptoms more exciting than the above, then definitely see a doctor.

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Cranberries vs Goji Berries – Which is Healthier?

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    Our Verdict

    When comparing cranberries to goji berries, we picked the cranberries.

    Why?

    Both are great! And your priorities may differ. Here’s how they stack up:

    In terms of macros, goji berries have more protein, carbs, and fiber. This is consistent with them generally being eaten very dried, whereas cranberries are more often eaten fresh or from frozen, or partially rehydrated. In any case, goji berries are the “more food per food” option, so it wins this category. The glycemic indices are both low, by the way, though goji berries are the lower.

    When it comes to vitamins, cranberries have more of vitamins B1, B2, B3, B5, B6, B9, E, K, and choline, while goji berries have more of vitamins A and C. Admittedly it’s a lot more, but still, on strength of overall vitamin coverage, the clear winner here is cranberries.

    We see a similar story when it comes to minerals: cranberries have more copper, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while goji berries have (a lot) more calcium and iron. Again, by strength of overall mineral coverage, the clear winner here is cranberries.

    Cranberries do also have some extra phytochemical benefits, including their prevention/cure status when it comes to UTIs—see our link below for more on that.

    At any rate, enjoy either or both, but those are the strengths and weaknesses of these two berries!

    Want to learn more?

    You might like to read:

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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