An Elegant Defense – by Matt Richtel
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In a way, Richtel got the best and worst of the publication date lottery. This book, which he’d obviously been working on for however long, was published in March 2020. Yes, that March 2020. So, it obviously got a huge boost in sales that launced it to bestseller status, and/but it doesn’t actually discuss COVID at all.
What it does discuss, is—as one might expect—the immune system. Or really, the immune systems, plural, several systems working alongside each other. How we got to have such, how our immune functions work, where all the various immune cells come from and what part they play. What pathogens can do to fight and/or confuse (or even co-opt) our immune response, and what modern medicine can do to counteract the pathogens’ anti-countermeasure countermeasures. And how it can still go wrong.
The “Four Lives” promised in the subtitle are stories, and Richtel explains the immune system through specific people’s specific battles. In particular, a friend of his who had quite a remarkable battle against cancer, which was of course terrible for him, but illustrative for us.
The style of the book is very readably journalistic. The author is a Pulitzer-winning NYT journalist, and not normally a science writer. Here at 10almonds, “we like big bibliographies and we cannot lie”, and we didn’t get to enjoy that in this case. The book contained no bibliography (nor appropriate inline citations, nor equivalent footnotes). Maybe a future addition will include this.
Bottom line: there’s a lot of “science for the lay reader” here. While the lack of references is a big oversight, the book does give a very good overview of what both sides (immune response and pathogenic invasion) bring to the battle of your body.
Click here to check out Elegant Defense, and demystify immunology!
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Chiropractors have been banned again from manipulating babies’ spines. Here’s what the evidence actually says
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Chiropractors in Australia will not be able to perform spinal manipulation on children under the age of two once more, following health concerns from doctors and politicians.
But what is the spinal treatment at the centre of the controversy? Does it work? Is there evidence of harm?
We’re a team of researchers who specialise in evidence-based musculoskeletal health. I (Matt) am a registered chiropractor, Joshua is a registered physiotherapist and Giovanni trained as a physiotherapist.
Here’s what the evidence says.
Dmitry Naumov/Shutterstock Remind me, how did this all come about?
A Melbourne-based chiropractor posted a video on social media in 2018 using a spring-loaded device (known as the Activator) to manipulate the spine of a two-week-old baby suspended upside down by the ankles.
The video sparked widespread concerns among the public, medical associations and politicians. It prompted a ban on the procedure in young children. The Victorian health minister commissioned Safer Care Victoria to conduct an independent review of spinal manipulation techniques on children.
Recently, the Chiropractic Board of Australia reinstated chiropractors’ authorisation to perform spinal manipulation on babies under two years old. But this week, it backflipped, following heavy criticism from medical associations and politicians.
What is spinal manipulation?
Spinal manipulation is a treatment used by chiropractors and other health professionals such as doctors, osteopaths and physiotherapists.
It is an umbrella term that includes popular “back cracking” techniques.
It also includes more gentle forms of treatment, such as massage or joint mobilisations. These involve applying pressure to joints without generating a “cracking” sound.
Does spinal manipulation in babies work?
Several international guidelines for health-care professionals recommend spinal manipulation to treat adults with conditions such as back pain and headache as there is an abundance of evidence on the topic. For example, spinal manipulation for back pain is supported by data from nearly 10,000 adults.
For children, it’s a different story. Safer Care Victoria’s 2019 review of spinal manipulation found very few studies testing whether this treatment was safe and effective in children.
Studies were generally small and were of poor quality. Some of those small, poor-quality studies, suggest spinal manipulation provides a very small benefit for back pain, colic and potentially bedwetting – some common reasons for parents to take their child to see a chiropractor. But overall, the review found the overall body of evidence was very poor.
Spinal manipulation doesn’t seem to help young children with an ear infection. MIA Studio/Shutterstock However, for most other children’s conditions chiropractors treat – such as headache, asthma, otitis media (a type of ear infection), cerebral palsy, hyperactivity and torticollis (“twisted neck”) – there did not appear to be a benefit.
The number of studies investigating the effectiveness of spinal manipulation on babies under two years of age was even smaller.
There was one high-quality study and two small, poor quality studies. These did not show an appreciable benefit of spinal manipulation on colic, otitis media with effusion (known as glue ear) or twisted neck in babies.
Is spinal manipulation on babies safe?
In terms of safety, most studies in the review found serious complications were extremely rare. The review noted one baby or child dying (a report from Germany in 2001 after spinal manipulation by a physiotherapist). The most common complications were mild in nature such as increased crying and soreness.
However, because studies were very small, they cannot tell us anything about the safety of spinal manipulation in a reliable way. Studies that are designed to properly investigate if a treatment is safe typically include thousands of patients. And these studies have not yet been done.
Why do people see chiropractors?
Safer Care Victoria also conducted surveys with more than 20,000 people living in Australia who had taken their children under 12 years old to a chiropractor in the past ten years.
Nearly three-quarters said that was for treatment of a child aged two years or younger.
Nearly all people surveyed reported a positive experience when they took their child to a chiropractor and reported that their child’s condition improved with chiropractic care. Only a small number of people (0.3%) reported a negative experience, and this was mostly related to cost of treatment, lack of improvement in their child’s condition, excessive use of x-rays, and perceived pressure to avoid medications.
Many of the respondents had also consulted their GP or maternity/child health nurse.
What now for spinal manipulation in children?
At the request of state and federal ministers, the Chiropractic Board of Australia confirmed that spinal manipulation on babies under two years old will continue to be banned until it discusses the issue further with health ministers.
Many chiropractors believe this is unfair, especially considering the strong consumer support for chiropractic care outlined in the Safer Care Victoria report, and the rarity of serious reported harms in children.
Others believe that in the absence of evidence of benefit and uncertainty around whether spinal manipulation is safe in children and babies, the precautionary principle should apply and children and babies should not receive spinal manipulation.
Ultimately, high quality research is urgently needed to better understand whether spinal manipulation is beneficial for the range of conditions chiropractors provide it for, and whether the benefit outweighs the extremely small chance of a serious complication.
This will help parents make an informed choice about health care for their child.
Matt Fernandez, Senior lecturer and researcher in chiropractic, CQUniversity Australia; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why STIs Are On The Rise In Older Adults
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Three Little Words
Sexually Transmitted Infections (STIs) are often thought of as something that predominantly plagues younger people… The truth, however, is different:
❝Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over-50s.
These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs.❞
Read more: Managing The Rise In STIs Among Older Adults
That said, there is a gender gap when it comes to the increased risk, for example:
❝A retrospective study from the USA involving 420,790 couples aged 67 to 99 years, found that widowhood was associated with an increased risk of STIs in older men, but not women❞
~ US Dept of Health & Human Services
Source: CDC: | Sexually Transmitted Disease Surveillance
Is abstinence the best preventative, then?
It is inarguably the most effective, but not necessarily the best for everyone.
This is because for most adults, a healthy sex life is an important part of overall wellbeing.
See also: Mythbusting The Big O
Even in this case there is a gender gap in:
- the level of importance placed on frequency of sexual interactions
- what act(s) of sexuality are held to be most important:
❝Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life.
Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101).
Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.❞
Source: Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults
If you have the time to go into it much more deeply, this paper from the Journal of Gerontology is much more comprehensive, looking also at related lifestyle factors, religious/political backgrounds, views on monogamy or non-monogamy (of various kinds), hormonal considerations, the impact of dementia or other long-term disabilities that may affect things, widowhood, and many other elements:
The National Social Life, Health, and Aging Project: An Introduction
What’s the best preventative, then?
Regular health screening for yourself and your partner(s) is an important key to preventative health when it comes to STIs.
You can Google search for a local STI clinic, and worry not, they are invariably discreet and are well-used to everybody coming in. They’re just glad you’re being responsible about things. It’s also not their job to judge your sexual activities, even if it’s something you might have reason to wish to be secretive about, try to be honest there.
Secondly, most of the usual advice about safe sex still goes, even when there’s no risk of pregnancy. For example, if there’s at least one penis involved, then condoms remain the #1 barrier to all manner of potential infections (we know, almost nobody likes condoms, but sometimes the truth isn’t what we want to hear).
Lastly, if there’s at least one vagina involved, then please for the love of all that is holey, do not put anything there that could cause a yeast infection.
What can cause a yeast infection? Pretty much anything with sugar, which includes but is not limited to:
- Most kinds of food that Cosmo-style “liven things up in the bedroom” advice columns might suggest using (including fruit, honey, chocolate sauce, whipped cream, etc)
- Hands that are not clean (watch out for bacteria too)
- A mouth that has recently been eating or drinking anything with sugar in it, and that includes many kinds of alcohol, as well as milk or hot drinks that had milk in
Yeast infections are not nearly so serious as the STIs the other measures are there to avoid, but they’re not fun either, so some sensible policies in that regard are always good!
On a related note, see also: How To Avoid UTIs
Recap on the single most important part of this article:
At all ages, it remains a good health practice—unless one is absolutely celibate—to regularly get oneself and one’s partner(s) checked for STIs.
Take care!
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Dealing With Hearing Loss
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Hearing is important, not only for convenience, but also for cognitive health—as an inability to participate in what for most people is an important part of social life, has been shown to accelerate cognitive decline:
14 Powerful Strategies To Prevent Dementia ← one of them is looking after your hearing
To this end, we’ve written before about ways to retain (or at least slow the loss of) your hearing, here:
But, what if, despite our best efforts, your hearing is declining regardless, or is already impaired in some way?
Working with the hand we’ve been dealt
So, your hearing is bad and/or deteriorating. Assuming you’ve ruled out possibilities of fixing it, the next step is how to manage this new state of affairs.
One thing to seriously consider, sooner than you think you need to, is using hearing aids. This is because they will not only help you in the obvious practical way, but also, they will slow the associated decline of the parts of your brain that process the language you hear:
ACHIEVE study finds hearing aids cut cognitive decline by 48%
…and here’s the paper itself:
Furthermore, hearing aid use can significantly reduce all-cause mortality:
Your ears are not the only organs
Remember, today’s about dealing with hearing loss, not preventing it (for preventing it, see the second link we dropped up top).
With this in mind: do not underestimate the usefulness of learning to lipread.
Lipreading is not a panacea; it has its limitations:
- You can’t lipread an audio-only phonecall, or a podcast, or the radio
- You can’t lipread a video call if the video quality is poor
- You can’t lipread if someone is wearing a mask (as in many healthcare settings)
- You can’t lipread multiple people at once; you have to choose whose mouth to watch (or at least, you will miss the first word(s) each time while switching)
- You can’t lipread during sex if your/their face is somewhere else (may seem like a silly example, but actually communication can be important in sex, and the number of times this writer has had to say “Say again?” in intimate moments is ridiculous)
However, it can also make a huge difference the rest of the time, and can even be a superpower in times/places when other people’s hearing is nullified, such as a noisy environment, or a video call in which someone’s mic isn’t working.
The good news is, it’s really very easy to learn to lipread. There are many valid ways (often involving consciously memorizing mouth-shapes from charts, and then putting them together one by one to build a vocabulary), but this writer recommends a more organic, less effort-intensive approach:
- Choose a video of someone who speaks clearly, and for which video you already know what is being said (such as by using subtitles first, or a transcript, or perhaps the person is delivering a famous speech or reciting a poem that you know well, or it’s your favorite movie that you’ve watched many times).
- Now watch it with the sound off (assuming you do normally have some hearing; if you don’t, then you’re probably ahead of the game here) and just pay close attention to the lips. Do this on repeat; soon you’ll be able to “hear” the sounds as you see them made.
- Now choose a video of someone who speaks clearly, for which video you do not already know what is being said. You’ll probably only get parts of it at first; that’s ok.
- Now learn the rest of what they said in that video (by reading a transcript or such), and use it like you used the first video.
- Now repeat steps 3 and 4 until you are lipreading most people easily unless there is some clear obfuscation preventing you.
This process should not take long, as there are only about 44 phonemes (distinct sounds) in English, and once you’ve learned them, you’re set. If you speak more languages, those same 44 phonemes should cover most of most of them, but if not, just repeat the above process with the next language.
Remember, if you have at least some hearing, then most of the time your lipreading and your hearing are going to be working together, and neither will be as strong without the other—but if necessary, well-practised lipreading can indeed often stand in for hearing when hearing isn’t available.
A note on sign language:
Sign language is great, and cool, and useful. However, it’s only as useful as the people who know it, which means that it’s top-tier in the Deaf community (where people will dodge hearing-related cognitive decline entirely, because their social interaction is predominantly signed rather than spoken), and can be useful with close friends or family members who learn it (or at least learn some), but isn’t as useful in most of the wider world when people don’t know it. But if you do want to learn it, don’t let that hold you back—be the change you want to see!
Most of our readers are American, so here’s a good starting place for American Sign Language ← this is a list of mostly-free resources
Enjoy!
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Peas vs Broad Beans – Which is Healthier?
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Our Verdict
When comparing peas to broad beans, we picked the peas.
Why?
Both are great of course, but…
Looking at the macros to start with, peas have more protein and more fiber. The differences aren’t huge, but they are clear.
In terms of vitamins, peas have more of vitamins A, B1, B2, B3, B5, B6, B9, E, K, and choline (some with very large margins, some with small), while broad beans contain a little more vitamin C (the margin is quite narrow though).
When it comes to minerals, peas have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while broad beans have more sodium. So this category wasn’t close.
Adding up the win from each of the categories makes for a clear triple-win for peas.
Easy-peasy!
Want to learn more?
You might like to read:
Take care!
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Kidney Beans vs Chickpeas – Which is Healthier?
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Our Verdict
When comparing kidney beans to chickpeas, we picked the chickpeas.
Why?
Both are great! But there’s a clear winner here today:
In terms of macros, chickpeas have more protein, carbs, and fiber, making them the more nutrient-dense option in this category.
In the category of vitamins, kidney beans have more of vitamins B1, B3, and K, while chickpeas have more of vitamins A, B2, B5, B6, B7, B9, C, E, and choline, taking the victory again here.
When it comes to minerals, it’s a similar story: kidney beans have more potassium, while chickpeas have more calcium, copper, iron, magnesium, manganese, phosphorus, selenium, and zinc. Another easy win for chickpeas.
Adding up the three wins makes chickpeas the clear overall winner, but of course, as ever, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Coca-Cola vs Diet Coke – Which is Healthier?
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Our Verdict
When comparing Coca-Cola to Diet Coke, we picked the Diet Coke.
Why?
While the Diet Coke is bad, the Coca-Cola has mostly the same problems plus sugar.
The sugar in a can of Coca-Cola is 39g high-fructose corn syrup (the worst kind of sugar yet known to humanity), and of course it’s being delivered in liquid form (the most bioavailable way to get, which in this case, is bad).
To put those 39g into perspective, the daily recommended amount of sugar is 36g for men or 25g for women, according to the AHA.
The sweetener in Diet Coke is aspartame, which has had a lot of health risk accusations made against it, most of which have not stood up to scrutiny, and the main risk it does have is “it mimics sugar too well” and it can increase cravings for sweetness, and therefore higher consumption of sugars in other products. For this reason, the World Health Organization has recommended to simply reduce sugar intake without looking to artificial sweeteners to help.
Nevertheless, aspartame has been found safe (in moderate doses; the upper tolerance level would equate to more than 20 cans of diet coke per day) by food safety agencies ranging from the FDA to the EFSA, based on a large body of science.
Other problems that Diet Coke has are present in Coca-Cola too, such as its acidic nature (bad for tooth enamel) and gassy nature (messes with leptin/ghrelin balance).
Summary: the Diet Coke is relatively less unhealthy, but is still bad in numerous ways, and remains best avoided.
Read more:
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