Blood and Water
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Q&A with the 10almonds Team
Q: I really loved the information about macular degeneration! I was wondering if you have any other advice about looking after eye health?
A: We may well do a full feature on it sometime! Meanwhile, some top tips include:
- Eat your greens (as you know from this last Tuesday’s edition of 10almonds)!
- Exercise! Generally. We’re not talking about eye exercises here, we’re talking about exercises that will support:
- Healthy heart rate
- Healthy blood pressure
- Healthy blood oxygenation
- Healthy blood sugar levels
- Healthy blood flow in general (so keep hydrated too! There’s a reason phlebotomists ask you to be well-hydrated before they take blood)
Eye health is a good indicator for a lot of other things, and that’s because whether or not the eyes are the window to your soul, they’re definitely the window to what your blood’s like, and that affects (and is affected by) so many other things.
- On that note, don’t smoke!
- Protect your eyes physically, too. This means:
- UV-blocking sunglasses when appropriate
- Protective eye-wear when appropriate
You think safety glasses are for laboratories and construction sites, then you go and do comparable tasks in your home? Your eyes are just as damageable in your kitchen or garden as they would be in a lab or workshop.
Some bits and bobs that can help:
- Safety sunglasses! Because a thing can do two jobs (useful in the garden now the days are brightening up!)
- Pulse oximeter! Check your own heart rate, pulse strength, and blood oxygenation at home!
- Blood pressure monitor! Because it’s so important for a lot of things and you really should have one.
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The Insider’s Guide To Making Hospital As Comfortable As Possible
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Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
This is Dr. Chris Bonney. He’s an anesthesiologist. If you have a surgery, he wants you to go in feeling calm, and make a quick recovery afterwards, with minimal suffering in between.
Being a patient in a hospital is a bit like being a passenger in an airplane:
- Almost nobody enjoys the thing itself, but we very much want to get to the other side of the experience.
- We have limited freedoms and comforts, and small things can make a big difference between misery and tolerability.
- There are professionals present to look after us, but they are busy and have a lot of other people to tend to too.
So why is it that there are so many resources available full of “tips for travelers” and so few “tips for hospital patients”?
Especially given the relative risks of each, and likelihood, or even near-certainty of coming to at least some harm… One would think “tips for patients” would be more in demand!
Tips for surgery patients, from an insider expert
First, he advises us: empower yourself.
Empowering yourself in this context means:
- Relax—doctors really want you to feel better, quickly. They’re on your side.
- Research—knowledge is power, so research the procedure (and its risks!). Dr. Bonney, himself an anesthesiologist, particularly recommends you learn what specific anesthetic will be used (there are many, and they’re all a bit different!), and what effects (and/or after-effects) that may have.
- Reframe—you’re not just a patient; you’re a customer/client. Many people suffer from MDeity syndrome, and view doctors as authority figures, rather than what they are: service providers.
- Request—if something would make you feel better, ask for it. If it’s information, they will be not only obliged, but also enthusiastic, to give it. If it’s something else, they’ll oblige if they can, and the worst case scenario is something won’t be possible, but you won’t know if you don’t ask.
Next up, help them to help you
There are various ways you can be a useful member of your own care team:
- Go into surgery as healthy as you can. If there’s ever a time to get a little fitter, eat a little healthier, prioritize good quality sleep more, the time approaching your surgery is the time to do this.
- This will help to minimize complications and maximize recovery.
- Take with you any meds you’re taking, or at least have an up-to-date list of what you’re taking. Dr. Bonney has very many times had patients tell him such things as “Well, let me see. I have two little pink ones and a little white one…” and when asked what they’re for they tell him “I have no idea, you’d need to ask my doctor”.
- Help them to help you; have your meds with you, or at least a comprehensive list (including: medication name, dosage, frequency, any special instructions)
- Don’t stop taking your meds unless told to do so. Many people have heard that one should stop taking meds before a surgery, and sometimes that’s true, but often it isn’t. Keep taking them, unless told otherwise.
- If unsure, ask your surgical team in advance (not your own doctor, who will not be as familiar with what will or won’t interfere with a surgery).
Do any preparatory organization well in advance
Consider the following:
- What do you need to take with you? Medications, clothes, toiletries, phone charger, entertainment, headphones, paperwork, cash for the vending machine?
- Will the surgeons need to shave anywhere, and if so, might you prefer doing some other form of depilation (e.g. waxing etc) yourself in advance?
- Is your list of medications ready?
- Who will take you to the hospital and who will bring you back?
- Who will stay with you for the first 24 hours after you’re sent home?
- Is someone available to look after your kids/pets/plants etc?
Be aware of how you do (and don’t) need to fast before surgery
The American Society of Anesthesiologists gives the following fasting guidelines:
- Non-food liquids: fast for at least 2 hours before surgery
- Food liquids or light snacks: fast for at least 6 hours before surgery
- Fried foods, fatty foods, meat: fast for at least 8 hours before surgery
(see the above link for more details)
Dr. Bonney notes that many times he’s had patients who’ve had the worst thirst, or caffeine headache, because of abstaining unnecessarily for the day of the surgery.
Unless told otherwise by your surgical team, you can have black coffee/tea up until two hours before your surgery, and you can and should have water up until two hours before surgery.
Hydration is good for you and you will feel the difference!
Want to know more?
Dr. Bonney has his own website and blog, where he offers lots of advice, including for specific conditions and specific surgeries, with advice for before/during/after your hospital stay.
He also has a book with many more tips like those we shared today:
Calm For Surgery: Supertips For A Smooth Recovery
Take good care of yourself!
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Natto vs Tofu – Which is Healthier?
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Our Verdict
When comparing nattō to tofu, we picked the nattō.
Why?
In other words, in the comparison of fermented soy to fermented soy, we picked the fermented soy. But the relevant difference here is that nattō is fermented whole soybeans, while tofu is fermented soy milk of which the coagulated curds are then compressed into a block—meaning that the nattō is the one that has “more food per food”.
Looking at the macros, it’s therefore no surprise that nattō has a lot more fiber to go with its higher carb count; it also has slightly more protein. You may be wondering what tofu has more of, and the answer is: water.
In terms of vitamins, nattō has more of vitamins B2, B4, B6, C, E, K, and choline, while tofu has more of vitamins A, B3, and B9. So, a 7:3 win for nattō, even before considering that that vitamin C content of nattō is 65x more than what tofu has.
When it comes to minerals, nattō has more copper, iron, magnesium, manganese, potassium, and zinc, while tofu has more calcium, phosphorus, and selenium. So, a 6:3 win for nattō, and yes, the margins of difference are comparable (being 2–3x more for most of these minerals).
In short, both of these foods are great, but nattō is better.
Want to learn more?
You might like to read:
21% Stronger Bones in a Year at 62? Yes, It’s Possible (No Calcium Supplements Needed!)
Take care!
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Cabbage vs Cauliflower – Which is Healthier?
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Our Verdict
When comparing cabbage to cauliflower, we picked the cauliflower.
Why?
First, let’s note: these are two different cultivars of the same species (Brassica oleracea) and/but as usual (we say, as there are a lot of cultivars of Brassica oleracea, and we’ve done a fair few pairings of them before) there are still nutritional differences to consider, such as…
In terms of macros, cabbage has very slightly more carbs and fiber, while cauliflower has very slightly more protein. However, the numbers are all so close (and the glycemic index equal), such that we’re going to call the macros category a tie.
In the category of vitamins, cabbage has more of vitamins A, B1, E, and K, while cauliflower has more of vitamins B2, B3, B5, B6, B7, B9, C, and choline. Superficially, this is a clear 8:4 win for cauliflower; it’s worth noting though that the differences in amounts are mostly small, so this isn’t as big a win as it looks like. Still a win for cauliflower, though.
When it comes to minerals, it’s a similar story: cabbage has a little more calcium, iron, and manganese, while cauliflower has a little more copper, magnesium, phosphorus, potassium, and zinc. This time a 6:3 win for cauliflower, and again, the margins are small so there’s really not as much between them as it looks like. Still a win for cauliflower, though.
In short: enjoy either or both (diversity is good), but the most nutritionally dense is cauliflower, even if cabbage isn’t far behind it.
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Just One Thing – by Dr. Michael Mosley
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This is a collection of easy-to-implement changes that have good science behind them to show how they can benefit us. Some things are obvious (e.g: drink water); others, less so (e.g: sing, to reduce inflammation).
The book is divided thematically into times of the day, though in many cases it’s not a hard rule that a thing needs to be done at a certain time. Others are, like a cold shower in the morning and hot bath before bed—you might not want to switch those around!
The style is very pop-science, and does not have in-line citations for claims, but it does have a bibliography in the bag organized by each “one thing”, e.g. it might say “get some houseplants” and then list a number of references supporting that, with links to the studies showing how that helps. For those with the paper version, don’t worry, you can copy the URL from the book into your browser and see it that way. In any case, there are 2–6 scientific references for each claim, which is very respectable for a pop-sci book.
Bottom line: if you’re looking for evidence-based “one little thing” changes that can make a big difference, this book has lots!
Click here to check out Just One Thing, and improve your life!
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Semaglutide for Weight Loss?
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Semaglutide for weight loss?
Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).
Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.
*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!
First things first: does it work as marketed for diabetes?
It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:
- Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
- Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes
As you can see, both of them work wonders for pancreatic function and insulin sensitivity!
And, both of them were quite unpleasant for around 20% of participants:
❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞
What about for weight loss, if not diabetic?
It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:
Once-Weekly Semaglutide in Adults with Overweight or Obesity
The most interesting things here are the positive results and the side effects:
❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞
In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.
❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞
~ ibid.
In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!
Any other downsides we should know about?
If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:
❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞
~ Jan, a trial participant at UCLH
Is it injection-only, or is there an oral option?
An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:
A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science
FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement
Where can I get these?
Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:
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The Physical Exercises That Build Your Brain
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Jim Kwik: from broken brain to brain coach
Image from Kwik Learning This is Jim Kwik. He suffered a traumatic brain injury as a small child, and later taught himself to read and write by reading comic books. He became fascinated with the process of learning, and in his late 20s he set up Kwik Learning, to teach accelerated learning in classrooms and companies, which he continued until 2009 when he launched his online learning platform. His courses have now been enjoyed by people in 195 countries.
So, since accelerated learning is his thing, you might wonder…
What does he have to share that we can benefit from in the next five minutes?
Three brain exercises to improve memory and concentration
A lot of problems we have with working memory are a case of executive dysfunction, but there are tricks we can use to get our brains into gear and make them cumulatively stronger:
First exercise
You can strengthen your corpus callosum (the little bridge between the two hemispheres of the brain) by performing a simple kinesiological exercise, such as alternating touching your left elbow to your right knee, and touching your right elbow to your left knee.
Do it for about a minute, but the goal here is not a cardio exercise, it’s accuracy!
You want to touch your elbow and opposite knee to each other as precisely as possible each time. Not missing slightly off to the side, not falling slightly short, not hitting it too hard.
Second exercise
Put your hands out in front of you, as though you’re about to type at a keyboard. Now, turn your hands palm-upwards. Now back to where they were. Now palm-upwards again. Got it? Good.
That’s not the exercise, the exercise is:
You’re now going to do the same thing, but do it twice as quickly with one hand than the other. So they’ll still be flipping to the same basic “beat”, put it in musical terms, the tempo on one hand will now be twice that of the other. When you get the hang of that, switch hands and do the other side.
This is again about the corpus callosum, but it’s now adding an extra level of challenge because of holding the two rhythms separately, which is also working the frontal lobe of the cerebral cortex.
The pre-frontal cortex in particular is incredibly important to executive function, self-discipline, and being able to “do” delayed gratification. So this exercise is really important!
Third exercise
This one works the same features of the brain, but most people find it harder. So, consider it a level-up on the previous:
Imagine there’s a bicycle wheel in front of you (as though the bike is facing you at chest-height). Turn the wheel towards you with your hands, one on each side.
Now, do the same thing, but each of your hands is going in the opposite direction. So one is turning the wheel towards you; the other is turning it away from you.
Now, do the same thing, but one hand goes twice as quickly as the other.
Switch sides.
Why is this harder for most people than the previous? Because the previous involved processing discrete (distinct from each other) movements while this one involves analog continuous movements.
It’s like reading an analog clock vs a digital clock, but while using both halves of your brain, your corpus callosum, your pre-frontal cortex, and the motor cortex too.
Want to learn more?
You might enjoy his book, which as well as offering exercises like the above, also offers a lot about learning strategies, memory processes, and generally building a quicker more efficient brain:
Limitless: Upgrade Your Brain, Learn Anything Faster, and Unlock Your Exceptional Life
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