The Knowledge That Harvard Medical School’s Clinical Instructor Dr. Monique Tello Thinks Everyone SHOULD Have About Heart Health
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Anyone (who has not had a double mastectomy, anyway) can get breast cancer.
Breast cancer, if diagnosed early (before it spreads), has a 98% survival rate.
That survival rate drops to 31% if diagnosed after it has spread through the body.
(The US CDC’s breast cancer “stat bite” page has more stats and interactive graphs, so click here to see those charts and get the more detailed low-down on mortality/survival rates with various different situations)
We think that the difference between 98% and 31% survival rates is more than enough reason to give ourselves a monthly self-check at the very least! You’ve probably seen how-to diagrams before, but here are instructions for your convenience:
This graphic created by the Jordan Breast Cancer Program (check them out, as they have lots of resources)
If you don’t have the opportunity to take matters into your own hands right now, rather than just promise yourself “I’ll do that later”, take this free 4-minute Breast Health Assessment from Aurora Healthcare. Again, we think the difference early diagnosis can make to your survival chances make these tests well worth it.
Lest we forget, men can also get breast cancer (the CDC has a page for men too), especially if over 50. But how do you check for breast cancer, when you don’t have breasts in the commonly-understood sense of the word?
So take a moment to do this (yes, really actually do it!), and set a reminder in your calendar to repeat it monthly—there really is no reason not to! Take care of yourself; you’re important.
Pssst! Did you scroll past the diagrams, looking for the online 4-minute test promised by the subtitle? If so, scroll back up; the link is in the middle!
Harvard Medical School’s Clinical Instructor’s Five-Point Plan for Heart Health
Dr. Monique Tello, M.D., M.P.H., is a practicing physician at Massachusetts General Hospital, director of research and academic affairs for the MGH DGM Healthy Lifestyle Program, clinical instructor at Harvard Medical School, and author of the evidence-based lifestyle change guide Healthy Habits for Your Heart.
Here are what she says are the five most important factors to help keep your ticker ticking:
5. Have (at most) a moderate alcohol intake! While there are polyphenols such as resveratrol in red wine that could boost heart health, there’s so little per glass that you may need 100–1000 glasses to get the dosage that provides benefits in mouse studies. If you’re not a mouse, it may not be as beneficial, and Dr. Tello recommends drinking no more than one glass per day of any alcohol. What constitutes a glass? It varies from one kind of drink to another, so here’s a handy guide.
4. Don’t smoke. Best of all to never start. But if you did, quit. Simple as that. There is no healthy amount of smoking. While paradoxically, quitting smoking may of course be stressful to you, the long term gains are considered more than worth it. As with all advice, do consult your own physician for guidance, as individual circumstances may vary, and that may change the best approach for you.
3. Maintain a healthy body weight. While BMI (Body Mass Index) is not a perfect system, it’s a system in popular use, and Dr. Tello recommends keeping a BMI between 18.5 and 24.9.
What’s your BMI? It takes into account your height and weight; here’s a Quick BMI Calculator for your convenience.
2. Keep a healthy level of physical activity—which ideally means at least 30 minutes per day vigorous activity, but obviously if you’re not used to this, take it slowly and build up over time. Even just small lifestyle changes (walking where possible, taking the stairs instead of the elevator where possible, etc) can add up to a big difference.
1. Enjoy a healthy diet. This is the single most important thing, and the best modern scientific consensus holds that the best diet contains plenty of vegetables, fruits and nuts, whole grains, and omega-3 fatty acids, while it avoids processed meats, sugar-sweetened beverages, trans fats (what are trans fats?), and too much sodium.
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Delicious Daily Daal
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You’re not obliged to eat this every day, but you might want to. The reason we called this one this, is because it’s a super simple recipe (don’t be put off by the long ingredients list; it’s mostly spices making it look long) which, after you’ve done it a couple of times, you could practically do it in your sleep quickly and easily.
The name “lentil daal” is a bit like “naan bread”—a redundant tautology repeated more than once unnecessarily, but it helps for international clarity. The dish is usually served with naan, by the way, and rice. We don’t have room for those today, maybe we’ll do them another day; for now, you can just cook rice how you normally do, and buy naan if necessary.
Writer’s note: I love strong flavors; many people don’t. For this reason I’m going to give a “basic” version. Please feel free to multiply the spices if you feel so inclined. Where I give “one teaspoon” of a spice below, I’d use a tablespoon at home. Chili peppers can vary in heat a lot even within the same type, so what I do for any given batch is taste one (raw), judge the heat, and use an appropriate number of peppers accordingly. If you don’t want to do that, I suggest just guessing low (as per the instructions below) and if you find at the end you want more heat, you can always stir in a little hot sauce. I know that sounds heretical, but at the end of the day, the primary goal of cooking is to have the meal you want at the end of it.
You will need
- 1 1/2 cups red lentils
- 1 large onion, chopped
- 1 large bulb garlic, minced
- 1 oz ginger, grated
- 2 hot peppers (e.g. serrano), chopped
- 1 tsp ground cumin
- 1 tsp ground coriander
- 1 tsp ground turmeric
- 1 tsp garam masala (this is also ground, but it doesn’t come any other way)
- 1 tsp chili flakes (omit if you’re not a fan of heat)
- 2 tsp cracked black pepper
- 1 tsp salt ← I wouldn’t recommend multiplying this one unless later, to taste. In fact, instead of 1 tsp salt I use 2 tsp MSG, which has less sodium than 1 tsp salt. But “1 tsp salt” is the “easy to find in the store” version.
- 2 large or 3 small tomatoes, chopped (or 1 can chopped tomatoes)
- 2 shallots, thinly sliced
- 1 tsp cumin seeds
- 1 tsp mustard seeds
- 1 tsp coriander seeds
- 1 tsp black peppercorns
- 1 lime
- 1/2 cup fresh cilantro, or if you have the “that tastes like soap” gene, parsley, chopped
- Coconut oil for cooking (if you don’t like coconut, consider springing for avocado oil—if you use olive oil, it’ll add an olivey taste which changes the dish a lot; not inherently bad, but it feels a lot less like traditional daal; seed oils are less healthy and we don’t recommend them; ghee is a traditional option and not bad in moderation, but not as healthy as the oils we mentioned first)
- Water for cooking the lentils
Method
(we suggest you read everything at least once before doing anything)
1) In a saucepan, boil water and add the lentils; let them simmer while doing the next things.
2) Sauté the onions until translucent. This should only take a few minutes.
3) Add the garlic, ginger, and hot peppers, and keep stirring for another couple of minutes.
4) Add the ground spices (cumin, coriander, turmeric, garam masala) chili flakes, and cracked black pepper, as well as the salt or MSG if using (not both), and stir them in quickly but thoroughly.
For the next step, you may need to transfer to larger pan if your sauté pan isn’t big enough to take the volume; if so, that’s fine, the sauté has done its job and can have a rest now. If your sauté pan is big enough, just carry on in the same pan; this is perfect.
5) Add the lentils with the water you cooked them in (there might not be much water left now, as the lentils will have absorbed a lot of it; this is fine) as well as the chopped tomatoes.
6) Simmer until it has the consistency of a very thick sauce (you can add a splash more water here and there if it seems to need more). In the West it’s common to serve lentils “al dente”, but in the East it’s usual to (for dishes like this) cook them until they start to
7) Add the juice of at least 1/2 of your lime, or the whole lime if you feel so inclined.
8) In a pre-heated skillet, flash-fry the sliced shallots and the seeds (cumin, coriander, mustard, black peppercorns) at the hottest temperature you can muster. Don’t worry if the oil smokes; we’re only going to be at this tadka-making stage for a moment and nothing will stick provided you keep it moving. When the seeds start popping, it’s ready. Add it all to the big pan and stir in.
9) Add the cilantro-or-parsley garnish once you’re ready to serve.
Enjoy!
Learn more
For those interested in some of the science of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- How Much Spice Is Right?
- Tasty Polyphenols
Take care!
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The Intelligence Trap – by David Robson
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We’re including this one under the umbrella of “general wellness”, because it happens that a lot of very intelligent people make stunningly unfortunate choices sometimes, for reasons that may baffle others.
The author outlines for us the various reasons that this happens, and how. From the famous trope of “specialized intelligence in one area”, to the tendency of people who are better at acquiring knowledge and understanding to also be better at acquiring biases along the way, to the hubris of “I am intelligent and therefore right as a matter of principle” thinking, and many other reasons.
Perhaps the greatest value of the book is the focus on how we can avoid these traps, narrow our bias blind spots, and play to our strengths while paying full attention to our weaknesses.
The style is very readable, despite having a lot of complex ideas discussed along the way. This is entirely to be expected of this author, an award-winning science writer.
Bottom line: if you’d like to better understand the array of traps that disproportionately catch out the most intelligent people (and how to spot such), then this is a great book for you.
Click here to check out The Intelligence Trap, and be more wary!
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How To Avoid Carer Burnout (Without Dropping Care)
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How To Avoid Carer Burnout
Sometimes in life we find ourselves in a caregiving role.
Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.
Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.
Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.
But, we are not a philosophy publication, and will henceforth keep to the practicalities.
First: are you the right person?
Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?
It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.
It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.
It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).
So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.
Second: are you out of your depth?
Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.
Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.
So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.
And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.
Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.
Check out: Caregiver Action Network: Organizations Near Me
A very good resource-hub for help, advice, & community
Third: put your own oxygen mask on first
Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.
As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).
One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.
Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.
There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.
In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.
So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.
Lastly: what if it’s you?
If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.
About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.
On the flipside: you don’t have to be strong all the time; nobody should.
Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.
See also: How To Beat Loneliness & Isolation
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An Underrated Tool Against Alzheimer’s
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.
Dementia in general, and Alzheimer’s in particular, affects a lot of people, and probably even more than the stats show, because some (estimated to be: about half) will go undiagnosed and thus unreported:
Alzheimer’s: The Bad News And The Good
At 10almonds, we often talk about brain health, whether from a nutrition standpoint or other lifestyle factors. For nutrition, by the way, check out:
Today we’ll be looking at some new science for an underrated tool:
Bilingualism as protective factor
It’s well-known that bilingualism offers brain benefits, but most people would be hard-pressed to name what, specifically, those brain benefits are.
As doctors Kristina Coulter and Natalie Phillips found in a recent study, one of the measurable benefits may be a defense against generalized (i.e. not necessarily language-related) memory loss Alzheimer’s disease.
Specifically,
❝We used surface-based morphometry methods to measure cortical thickness and volume of language-related and AD-related brain regions. We did not observe evidence of brain reserve in language-related regions.
However, reduced hippocampal volume was observed for monolingual, but not bilingual, older adults with AD. Thus, bilingualism is hypothesized to contribute to reserve in the form of brain maintenance in the context of AD.❞
Read in full: Bilinguals show evidence of brain maintenance in Alzheimer’s disease
This is important, because while language is processed in various parts of the brain beyond the scope of this article, the hippocampi* are where memory is stored.
*usually mentioned in the singular as “hippocampus”, but you have one on each side, unless some terrible accident or incident befell you.
What this means in practical terms: these results suggest that being bilingual means we will retain more of our capacity for memory, even if we get Alzheimer’s disease, than people who are monolingual.
Furthermore, while we’re talking practicality:
❝…our subsample may be characterized as mostly late bilinguals (i.e., learning an L2 after age 5), having moderate self-reported L2 ability, and relatively few participants reporting daily L2 use (33 out of 119)❞
(L2 = second language)
This is important, because it means you don’t have to have grown up speaking multiple languages, you don’t even have to speak it well, and you don’t have to be using your second language(s) on a daily basis, to enjoy benefits. Merely having them in your head appears to be sufficient to trigger the brain to go “oh, we need to boost and maintain the hippocampal volume”.
We would hypothesize that using second language(s) regularly and/or speaking second language(s) well offers additional protection, and the data would support this if it weren’t for the fact that the sample sizes for daily and high-level speakers are a bit small to draw conclusions.
But the important part is: simply knowing another language, including if you literally just learned it later in life, is already protective of hippocampal volume in the context of Alzheimer’s disease.
Here’s a pop-science article about the study, that goes into it in more detail than we have room to here:
Bilingualism linked to greater brain resilience in older adults
Want to learn a new language?
Here are some options where you can get going right away:
If you are thinking “sounds good, but learning a language is too much work”, then that is why we included that third option there. It’s specifically for one language, and that language is Esperanto, arguably the world’s easiest language and specifically designed to be super quick and easy to get good at. Also, it’s free!
Do, kial ne lerni novan lingvon rapide kaj facile? 😉
Want to know more?
For ways to reduce your overall Alzheimer’s risk according to science, check out:
Take care!
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11 Minutes to Pain-Free Hips – by Melinda Wright
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If hips don’t lie, what are yours saying to you? If what they’re saying to you sounds like a cry for help sometimes, this is the book to get you onto a better track.
The hip is the largest joint in your body, and it bears a lot of weight. So it’s little wonder if sometimes they’d like a word with the boss. The question is: what will you do about it? Melinda Wright has suggestions to keep your hips—and you—happy.
She spends the first couple of chapters introducing key concepts, and some anatomy and physiology that’ll be good to know.
Then we’re into resistance stretching, basic hip exercises, all the way through to more advanced stuff. There are very clear photos for each. One thing that stands out about this book is each exercise is not just explained simply and clearly, but also offers “easing oneself in” exercises. After all, we’re not all at the same starting point.
The book finishes off with some more holistic advice about chronic pain management, based on her personal experience with scoliosis, and some dietary tips to reduce joint pain and inflammation too.
All in all, a very helpful book!
Pick up 11 “Minutes to Pain-Free Hips” at Amazon today!
^You will also see options for pain-free back, and pain-free neck, by the same author
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From Strength to Strength – by Dr. Arthur Brooks
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For most professions, there are ways in which performance can be measured, and the average professional peak varies by profession, but averages are usually somewhere in the 30–45 range, with a pressure to peak between 25–35.
With a peak by age 45 or perhaps 50 at the latest (aside from some statistical outliers, of course), what then to expect at age 50+? Not long after that, there’s a reason for mandatory retirement ages in some professions.
Dr. Brooks examines the case for accepting that rather than fighting it, and/but making our weaknesses into our strengths as we go. If our fluid intelligence slows, our accumulated crystal intelligence (some might call it “wisdom“) can make up for it, for example.
But he also champions the idea of looking outside of ourselves; of the importance of growing and fostering connections; giving to those around us and receiving support in turn; not transactionally, but just as a matter of mutualism of the kind found in many other species besides our own. Indeed, Dr. Brooks gives the example of a grove of aspen trees (hence the cover art of this book) that do exactly that.
The style is very accessible in terms of language but with frequent scientific references, so very much a “best of both worlds” in terms of readability and information-density.
Bottom line: if ever you’ve wondered at what age you might outlive your usefulness, this book will do as the subtitle suggests, and help you carve out your new place.
Click here to check out From Strength To Strength, and find yours!
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Learn to Age Gracefully
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