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 😎

❝Thank you for the video about what to do if you have a heart attack alone, what about what to do if you have a stroke alone?❞

(for anyone who missed that video, here it is)

That’s a good question, especially as stroke risk is rising in the industrialized world in general, and the US in particular.

However, let’s start with the caveat that if you are having a stroke, there’s a good chance you will forget what we are about to say, what with the immediate effects it has on the brain. That said…

The general advice when it comes to looking after someone else who is experiencing a stroke, is, “don’t”.

In other words, call emergency services, and don’t do anything else, e.g:

• don’t give them anything to eat or drink
• don’t give them any medications
• don’t let them go to sleep
• don’t let them talk you out of calling emergency services
• don’t let them drive themselves to hospital
• don’t drive them to hospital yourself either*

*This is for two reasons:

1. an ambulance crew has skills and resources that you don’t, and can begin treatment en-route, and also,
2. not all hospitals have appropriate resources to treat stroke, so the ambulance crew will know to drive to one that does, instead of driving to a random hospital and hoping for the best

So, flipping this for if it’s you having the stroke, and you’re cognizant enough to remember this:

• do call an ambulance; stay on the line and don’t do anything else unless instructed by the emergency services.

In order to do that, of course it’s important to recognize the symptoms; you probably know these but just in case, the mnemonic is “FAST”:

• Face: is there weakness on one side of their face?
• Arms: if they raise both arms, does one drift downwards?
• Speech: if they speak, is their speech slurred or otherwise unusual?
• Time: to call emergency services

It’s great to not get caught out by surprise, so you might also want to check out:

6 Signs Of Stroke (One Month In Advance)

Take care!

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 😎

❝Could you do a this or that of which. Is worse, smoking cigarettes or having a sweet tooth? Also, perhaps have us evaluate one part of newsletter at a time, rather than overall. I especially appreciate your book reviews and often find them through my library system.❞

We’re glad you enjoy the book reviews! We certainly enjoy reading many books to write about them for you.

As for the idea having readers evaluate one part of the newsletter at a time, rather than overall, there is a technical limitation that embedded polls are very large, data-wise, so if we were to do a poll for each section, the email would then get clipped by gmail and other email providers. However, you are always more than welcome to do as you’ve done, and include comments about what section(s) you took the most value from.

Now, onto your main question/request: as it doesn’t quite fit the usual format for our This vs That section, we’ve opted to do it as a main feature here 🙂

So, let’s get into it…

Not a zero-sum game

First, let’s be clear that for most people there is no pressing reason that this should be an either/or decision. There is nothing inherent to quitting either one that makes the other loom larger.

However, that said, if you’re (speaking generally here, and not making any presumptions about the asker) currently smoking regularly and partaking of a lot of added sugar, then you may be wondering which you should prioritize quitting first—as it is indeed generally recommended to only try to quit one thing at a time.

Indeed, we wrote previously, as a guideline for “what to do in one what order”:

Not sure where to start? We suggest this order of priorities, unless you have a major health condition that makes something else a higher priority:

1. If you smoke, stop
2. If you drink, reduce, or ideally stop
3. Improve your diet

About that diet…

Worry less about what to exclude, and instead focus on adding more variety of fruit/veg.

See also: Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)

That said, if you’re looking for things to cut, sugar is a top candidate (and red meat is in clear second place albeit some way below)

That’s truncated from a larger list, but those were the top items.

You can read the rest in full, here: The Best Few Interventions For The Best Health: These Top 5 Things Make The Biggest Difference

The flipside of this “you can quit both” reality is that the inverse is also true: much like how having one disease makes it more likely we will get another, unhealthy habits tend to come in clusters too, as each will weaken our resolve with regard to the others. Thus, there is a sort of “comorbidity of habits” that occurs.

The good news is: the same can be said for healthy habits, so they (just like unhealthy habits) can support each other, stack, and compound. This means that while it may seem harder to quit two bad habits than one, in actual fact, the more bad habits you quit, the more it’ll become easy to quit the others. And similarly, the more good habits you adopt, the more it’ll become easy to adopt others.

See also: How To Really Pick Up (And Keep!) Those Habits

So, let’s keep that in mind, while we then look at the cases against smoking, and sugar:

The case against smoking

This is perhaps one of the easiest cases to make in the entirety of the health science world, and the only difficult part is knowing where to start, when there’s so much.

The World Health Organization leads with these key facts, on its tobacco fact sheet:

• Tobacco kills up to half of its users who don’t quit.
• Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke.
• Around 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.
• In 2020, 22.3% of the world’s population used tobacco: 36.7% of men and 7.8% of women.
• To address the tobacco epidemic, WHO Member States adopted the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2003. Currently 182 countries are Parties to this treaty.
• The WHO MPOWER measures are in line with the WHO FCTC and have been shown to save lives and reduce costs from averted healthcare expenditure.

Source: World Health Organization | Tobacco

Now, some of those are just interesting sociological considerations (well, they are of practical use to the WHO whose job it is to offer global health policy guidelines, but for us at 10almonds, with the more modest goal of helping individual people lead their best healthy lives, there’s not so much that we can do with the Framework Convention on Tobacco Control, for example), but for the individual smoker, the first two are really very serious, so let’s take a closer look:

❝Tobacco kills up to half of its users who don’t quit.❞

A bold claim, backed up by at least three very large, very compelling studies:

• Mortality in relation to smoking: 50 years’ observations on male British doctors
• Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence
• Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries

❝Tobacco kills more than 8 million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke.❞

The WHO’s cited source for this was gatekept in a way we couldn’t access (and so probably most of our readers can’t either), but take a look at what the CDC has to say for the US alone (bearing in mind the US’s population of a little over 300,000,000, which is just 3.75% of the global population of a little over 8,000,000,000):

❝smoking causes more than 480,000 deaths [in the US] annually, with an estimated 41,000 deaths from secondhand smoke exposure, and it can reduce a person’s life expectancy by 10 years. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90%❞

If we now remember that third bullet point, that said “Around 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.”, then we can imagine the numbers are worse for many other countries, including large-population countries that have a lower median income than the US, such as India and Brazil.

Source for the CDC comment: Tobacco-Related Mortality

See also: AAMC | Smoking is still the leading cause of preventable death in the U.S.

We only have so much room here, but if that’s not enough…

More than 100 reasons to quit tobacco

The case against sugar

We reviewed an interesting book about this:

The Case Against Sugar – by Gary Taubes

But suffice it to say, added sugar is a big health problem; not in the same league as tobacco, but it’s big, because of how it messes with our metabolism (and when our metabolism goes wrong, everything else goes wrong):

From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?

The epidemiology of sugar consumption and related mortality is harder to give clear stats about than smoking, because there’s not a clear yes/no indicator, and cause and effect are harder to establish when the waters are so muddied by other factors. But for comparison, we’ll note that compared to the 480,000 deaths caused by tobacco in the US annually, the total death to diabetes (which is not necessarily “caused by sugar consumption”, but there’s at least an obvious link when it comes to type 2 diabetes and refined carbohydrates) was 101,209 deaths due to diabetes in 2022:

National Center for Health Statistics | Diabetes

Now, superficially, that looks like “ok, so smoking is just under 5x more deadly”, but it’s important to remember that almost everyone eats added sugar, whereas a minority of people smoke, and those are mortality per total US population figures, not mortality per user of the substance in question. So in fact, smoking is, proportionally to how many people smoke, many times more deadly than diabetes, which currently ranks 8th in the “top causes of death” list.

Note: we recognize that you did say “having a sweet tooth” rather than “consuming added sugar”, but it’s worth noting that artificial sweeteners are not a get-out-of-illness-free card either:

The Problem With Sweeteners

Let’s get back to sugar though, as while it’s a very different beast than tobacco, it is arguably addictive also, by multiple mechanisms of addiction:

The Not-So-Sweet Science Of Sugar Addiction

That said, those mechanisms of addiction are not necessarily as strong as some others, so in the category of what’s easy or hard to quit, this is on the easier end of things—not that that means it’s easy, just, quitting many drugs is harder. In any case, it can be done:

When It’s More Than “Just” Cravings: Beat Food Addictions!

In summary

Neither are good for the health, but tobacco is orders of magnitude worse, and should be the priority to quit, unless your doctor(s) tell you otherwise because of your personal situation, and even then, try to get multiple opinions to be sure.

Take care!