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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As The Summer Gets Hotter Still…
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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
❝I would love to see an article about heat dehydrated illness….so much of the US is under hot conditions. I had an fainting sweating episode and now trying to recoup from it. What should we do? Drink water,rest…???❞
We have done some of this, but it’s always a good one to revisit! Last summer (N. Hemisphere summer), we wrote this:
Stay Safe From Heat Exhaustion & Heatstroke!
…and this year, it’s getting hotter still (and is already the hottest summer on record), with certainly much of the US seriously affected, as you say. Next year, it will probably be worse again; climate change is getting predictable like that, and likely will continue until fixed. We are but a health science publication, so we can’t fix the world’s climate, but we can reiterate the above advice, and urge everyone to take it seriously.
Note: heat exhaustion and heatstroke kill. Yes, we’re including heat exhaustion in that, because by the time you get heat exhaustion, you’re often not in the best state of mind to take the correct steps to avoid the heatstroke that follows.
To think otherwise would be akin to thinking “falling never killed anyone; it’s only when you stop falling that it’s dangerous”.
This summer, we did also write this more niche article:
…whose advice won’t apply to everyone, but will be helpful to some, and honestly, some of that advice does go for everyone.
One thing we didn’t write about in those articles that we’ll add here:
Humidity is dangerous:
- Dry heat: you sweat, the sweat evaporates, cooling you. As well as losing heat, you’ve also now lost water and salts, which you’ll need to replenish, but your body is operating correctly.
- Humid heat: you sweat, and now you are just sweaty until further notice. It doesn’t evaporate because the surrounding humidity doesn’t provide the physics for that. Not only are you not losing heat through evaporating sweat, but also, if you’re wearing clothes, that’s now an insulating layer you’re wearing.
…so that means, watch the humidity as carefully as you watch the temperature, and when it’s high, get extra serious about finding ways to keep yourself cool (e.g. shade, rest, cooling showers etc if you can, that kind of thing).
Take care!
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Gut Renovation – by Dr. Roshini Raj, with Sheila Buff
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Unless we actually feel something going on down there, gut health is an oft-neglected part of overall health—which is unfortunate, because invisible as it may often be, it affects so much.
Gastroenterologist Dr. Roshini Raj gives us all the need-to-know information, explanations of why things happen the way they do with regard to the gut, and tips, tricks, and hacks to improve matters.
She also does some mythbusting along the way, and advises about what things don’t make a huge difference, including what medications don’t have a lot of evidence for their usefulness.
The style is easy-reading pop-science, with plenty of high-quality medical content.
Reading between the lines, a lot of the book as it stands was probably written by the co-author, Sheila Buff, who is a professional ghostwriter and specializes in working closely with doctors to produce works that are readable and informative to the layperson while still being full of the doctor’s knowledge and expertise. So a reasonable scenario is that Dr. Raj gave her extensive notes, she took it from there, passed it back to her for medical corrections, and they had a little back and forth until it was done. Whatever their setup, the end result was definitely good!
Bottom line: if you’d like a guide to gut health that’s practical and easy to read, while being quite comprehensive and certainly a lot more than “eat probiotics and fiber”, then this book is a fine choice.
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The Cancer Journey – by Dr. Chadi Nabhan
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After a brief introduction of what cancer actually is and what causes it, the layout of the rest of the book is in chronological order of patient experience, that is to say, what to expect during the journey from screening and diagnosis, to one’s first oncology visit (the author being an oncologist himself), how cancer staging works, getting second opinions, and a chapter-by-chapter review of many different treatment options, ranging from surgery and chemotherapy, to radiation and hormonal therapies, and even more modern targeted therapies, immunotherapy, cellular therapies, and yes, complementary and alternative therapies, amongst others we haven’t listed for the sake of brevity.
He doesn’t leave it there though; he also talks managing side effects, monitoring for recurrence, and even caring for the caregiver(s), along with eventual survivorship and that emotional journey, or if it comes down to it, palliative and hospice care.
Finishing on a hopeful note, he also brings attention to novel approaches that are being trialled presently, and the prospects for the near future of cancer care.
The style is very human and readable, notwithstanding that the author has hundreds of peer-reviewed publications to his name, the content here is presented in a much more approachable, less clinical way, while still conveying all the information that needs to be conveyed.
Bottom line: if you or a loved one is facing cancer, this book will be an invaluable resource.
Click here to check out The Cancer Journey, and understand each part of it!
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Mythbusting The Mask Debate
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Mythbusting The Mask Debate
We asked you for your mask policy this respiratory virus season, and got the above-depicted, below-described, set of responses:
- A little under half of you said you will be masking when practical in indoor public places
- A little over a fifth of you said you will mask only if you have respiratory virus symptoms
- A little under a fifth of you said that you will not mask, because you don’t think it helps
- A much smaller minority of you (7%) said you will go with whatever people around you are doing
- An equally small minority of you said that you will not mask, because you’re not concerned about infections
So, what does the science say?
Wearing a mask reduces the transmission of respiratory viruses: True or False?
True…with limitations. The limitations include:
- The type of mask
- A homemade polyester single-sheet is not the same as an N95 respirator, for instance
- How well it is fitted
- It needs to be a physical barrier, so a loose-fitting “going through the motions” fit won’t help
- The condition of the mask
- And if applicable, the replaceable filter in the mask
- What exactly it has to stop
- What kind of virus, what kind of viral load, what kind of environment, is someone coughing/sneezing, etc
More details on these things can be found in the link at the end of today’s main feature, as it’s more than we could fit here!
Note: We’re talking about respiratory viruses in general in this main feature, but most extant up-to-date research is on COVID, so that’s going to appear quite a lot. Remember though, even COVID is not one beast, but many different variants, each with their own properties.
Nevertheless, the scientific consensus is “it does help, but is not a magical amulet”:
- 2021: Effectiveness of Face Masks in Reducing the Spread of COVID-19: A Model-Based Analysis
- 2022: Why Masks are Important during COVID‐19 Pandemic
- 2023: The mitigating effect of masks on the spread of COVID-19
Wearing a mask is actually unhygienic: True or False?
False, assuming your mask is clean when you put it on.
This (the fear of breathing more of one’s own germs in a cyclic fashion) was a point raised by some of those who expressed mask-unfavorable views in response to our poll.
There have been studies testing this, and they mostly say the same thing, “if it’s clean when you put it on, great, if not, then well yes, that can be a problem”:
❝A longer mask usage significantly increased the fungal colony numbers but not the bacterial colony numbers.
Although most identified microbes were non-pathogenic in humans; Staphylococcus epidermidis, Staphylococcus aureus, and Cladosporium, we found several pathogenic microbes; Bacillus cereus, Staphylococcus saprophyticus, Aspergillus, and Microsporum.
We also found no associations of mask-attached microbes with the transportation methods or gargling.
We propose that immunocompromised people should avoid repeated use of masks to prevent microbial infection.❞
Source: Bacterial and fungal isolation from face masks under the COVID-19 pandemic
Wearing a mask can mean we don’t get enough oxygen: True or False?
False, for any masks made-for-purpose (i.e., are by default “breathable”), under normal conditions:
- COVID‐19 pandemic: do surgical masks impact respiratory nasal functions?
- Performance Comparison of Single and Double Masks: Filtration Efficiencies, Breathing Resistance and CO2 Content
However, wearing a mask while engaging in strenuous best-effort cardiovascular exercise, will reduce VO₂max. To be clear, you will still have more than enough oxygen to function; it’s not considered a health hazard. However, it will reduce peak athletic performance:
…so if you are worrying about whether the mask will impede you breathing, ask yourself: am I engaging in an activity that requires my peak athletic performance?
Also: don’t let it get soaked with water, because…
Writer’s anecdote as an additional caveat: in the earliest days of the COVID pandemic, I had a simple cloth mask on, the one-piece polyester kind that we later learned quite useless. The fit wasn’t perfect either, but one day I was caught in heavy rain (I had left it on while going from one store to another while shopping), and suddenly, it fitted perfectly, as being soaked through caused it to cling beautifully to my face.
However, I was now effectively being waterboarded. I will say, it was not pleasant, but also I did not die. I did buy a new mask in the next store, though.
tl;dr = an exception to “no it won’t impede your breathing” is that a mask may indeed impede your breathing if it is made of cloth and literally soaked with water; that is how waterboarding works!
Want up-to-date information?
Most of the studies we cited today were from 2022 or 2023, but you can get up-to-date information and guidance from the World Health Organization, who really do not have any agenda besides actual world health, here:
Coronavirus disease (COVID-19): Masks | Frequently Asked Questions
At the time of writing this newsletter, the above information was last updated yesterday.
Take care!
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Quit Drinking – by Rebecca Dolton
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Many “quit drinking” books focus on tips you’ve heard already—cut down like this, rearrange your habits like that, make yourself accountable like so, add a reward element this way, etc.
Dolton takes a different approach.
She focuses instead on the underlying processes of addiction, so as to not merely understand them to fight them, but also to use them against the addiction itself.
This is not just a social or behavioral analysis, by the way, and goes into some detail into the physiological factors of the addiction—including such things as the little-talked about relationship between addiction and gut flora. Candida albans, found in most if not all humans to some extent, gets really out of control when given certain kinds of sugars (including those from alcohol); it grows, eventually puts roots through the intestinal walls (ouch!) and the more it grows, the more it demands the sugars it craves, so the more you feed it.
Quite a motivator to not listen to such cravings! It’s not even you that wants it, it’s the Candida!
Anyway, that’s just one example; there are many. The point here is that this is a well-researched, well-written book that sets itself apart from many of its genre.
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The Best Kind Of Fiber For Overall Health?
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The Fiber Of Good Health
We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Fiber’s important for many aspects of health, not least of all the heart:
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
As well, of course, as being critical for gut health:
Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)
But is all fiber “prebiotic fiber”, and/or are some better than others?
Beta-glucan
A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:
- pectin
- β-glucan
- wheat dextrin
- resistant starch
- cellulose (control)
As for health metrics, they measured:
- body weight
- adiposity
- indirect calorimetry
- glucose tolerance
- gut microbiota
- metabolites thereof
What they found was…
❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.
All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞
If you’d like to read more, the study itself is here:
If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.
It also acts indirectly as a GLP-1 agonist, by the way:
The right fiber may help you lose weight
You may be wondering: what is β-glucan found in?
It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.
Is it available as a supplement?
More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.
As an aside, cordyceps itself has many other healthful properties too:
Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.
Enjoy!
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