Hypertension: Factors Far More Relevant Than Salt
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Hypertension: Factors Far More Relevant Than Salt
Firstly, what is high blood pressure vs normal, and what do those blood pressure readings mean?
Rather than take up undue space here, we’ll just quickly link to…
Blood Pressure Readings Explained (With A Colorful Chart)
More details of specifics, at:
Hypotension | Normal | Elevated | Stage 1 | Stage 2 | Danger zone
Keeping Blood Pressure Down
As with most health-related things (and in fact, much of life in general), prevention is better than cure.
People usually know “limit salt” and “manage stress”, but there’s a lot more to it!
Salt isn’t as big a factor as you probably think
That doesn’t mean go crazy on the salt, as it can cause a lot of other problems, including organ failure. But it does mean that you can’t skip the salt and assume your blood pressure will take care of itself.
This paper, for example, considers “high” sodium consumption to be more than 5g per day, and urinary excretion under 3g per day is considered to represent a low sodium dietary intake:
Sodium Intake and Hypertension
Meanwhile, health organizations often recommend to keep sodium intake to under 2g or under 1.5g
Top tip: if you replace your table salt with “reduced sodium” salt, this is usually sodium chloride (regular table salt) cut with potassium chloride, which is almost as “salty” tastewise, but obviously contains less sodium. Not only that, but potassium actually helps the body eliminate sodium, too.
The rest of what you eat is important too
The Mediterranean Diet is as great for this as it is for most health conditions.
If you sometimes see the DASH diet mentioned, that stands for “Dietary Approaches to Stop Hypertension”, and is basically the Mediterranean Diet with a few tweaks.
What are the tweaks?
- Beans went down a bit in priority
- Red meat got removed entirely instead of “limit to a tiny amount”
- Olive oil was deprioritized, and/but vegetable oil is at the bottom of the list (i.e., use sparingly)
You can check out the details here, with an overview and examples:
DASH Eating Plan—Description, Charts, and Recipes
Don’t drink or smoke
And no, a glass of red a day will not help your heart. Alcohol does make us feel relaxed, but that is because of what it does to our brain, not what it does to our heart.
In reality, even a single drink will increase blood pressure. Yes, really:
And smoking? It’s so bad that even second-hand smoke increases blood pressure:
Get those Zs in
Sleep is a commonly underestimated/forgotten part of health, precisely because in a way, we’re not there for it when it happens. We sleep through it! But it is important, including to protect against hypertension:
Short- and long-term health consequences of sleep disruption
Move your body!
Moving your body often is far more important for your heart than running marathons or bench-pressing your spouse.
Those 150 minutes “moderate exercise” (e.g. walking) per week are important, and can be for example:
- 22 minutes per day, 7 days per week
- 25 minutes per day, 6 days per week
- 30 minutes per day, 5 days per week
- 75 minutes per day, 2 days per week
If you’d like to know more about the science and evidence for this, as well as practical suggestions, you can download the complete second edition of the Physical Activity Guidelines for Americans here (it’s free, and no sign-up required!)
If you prefer a bite-size summary, then here’s their own:
Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans
PS: Want a blood pressure monitor? We don’t sell them (or anything else), but for your convenience, here’s a good one you might want to consider.
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What Are The “Bright Lines” Of Bright Line Eating?
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This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.
We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.
What does she want us to know?
Bright Line Eating’s general goal
Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.
You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):
When BMI Doesn’t Quite Measure Up
Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.
What are these “bright lines”?
Bright Line Eating comes with 4 rules:
- No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
- No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
- No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
- Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).
You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”
The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.
You will note that this is completely in opposition to the expert opinion we hosted last week:
What Flexible Dieting Really Means
Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”
Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?
But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:
Where does the psychology come in?
Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.
So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.
You may be wondering: ”doesn’t sticking to what we decided still require willpower?”
And… Potentially. But the key here is shutting down self-negotiation.
Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.
In short, there are lots of opportunities to rationalize the decision to eat the cake.
With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.
So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.
Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:
Bright Line Eating | Research Publications
Counterpoint: pick your own “bright lines”
Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.
So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:
Bright Lines as Guidelines for Weight Loss
The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.
Want to know more from Dr. Thompson?
You might like her book, which we reviewed a while ago:
Bright Line Eating – by Dr. Susan Peirce Thompson
Enjoy!
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Eat Real Food and Love It – by Kari McCloskey
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Half the battle of healthy eating is enjoying it—because once you do, it’s no longer a battle!
So that’s what this book focuses on. The author, a Registered Nutritionist, does indeed dispense nutritional advice, as you might expect, but also bids us pay attention to what nature’s foods do for us, and notice what less healthy foods take from us. She goes through these category by category, quite comprehensively, before moving on to the more “active” parts of the book.
There’s a lot about training our senses, and about taking a holistic approach to eating, as well as renewing not just our relationship with food, but also various other parts of our life that are inextricably linked to it (from sleep and exercise, to social considerations, and medical issues that healthier eating will help us to avoid or at least tame).
The style is… Joyful. Much like this reviewer, the author loves food, and it shows. She also (again much like this reviewer) cares deeply about the impact food has on her, and (for a third time: like this reviewer!) wants to share that joy and care with the reader. The priority is readability and helpfulness; scientific references are still provided wherever appropriate, though.
Bottom line: if you’d like to improve your eating but it seems like a chore, this book can help turn it into an excitingly enjoyable journey instead.
Click here to check out Eat Real Food And Love It, and eat real food and love it!
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What Most People Don’t Know About Hearing Aids
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Dr. Juliëtte Sterkens, a doctor of audiology, makes things clearer in this TEDx talk:
The sound of the future
Half of all adults experience hearing loss by the age of 75, and by 85, that goes up to two thirds. Untreated hearing loss leads to depression, social isolation, cognitive decline, and even an increased fall risk.
It’s not just about reduced volume though; Dr. Sterkens points out that for many (like this writer!) it’s more a matter of unequal pitch perception and difficulty in speech clarity. Most hearing aids just amplify sound, and don’t fully restore clarity, especially beyond a short range.
However, technology keeps marching forwards there have been improvements in the move from analog to digital, and today’s bluetooth-enabled hearing aids often do a lot better, especially in the case of things like TV transmitters and clip-on microphones.
Out and about, you might see signs sometimes saying “Hearing Loop Enabled”, and those transmit sound directly to telecoil-equipped hearing aids—venues with public address systems are legally required to provide hearing accommodations like this. Many hearing aids include telecoils, but users often aren’t informed or don’t have them activated, which is unfortunate, because telecoils improve hearing dramatically in loop-enabled venues.
Dr. Sterkens makes a plea for us to, as applicable,
- Activate telecoils and insist on them in new hearing aids.
- Advocate for assistive listening systems in public venues.
- Use available resources like the Hearing Loss Association of America for tools and information.
- Familiarize ourselves with accessibility laws and report non-compliance.
- Aim to make the world more accessible for people with hearing loss through advocacy, technology, and awareness.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Berberine For Metabolic Health
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Is Berberine Nature’s Ozempic/Wegovy?
Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.
It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).
Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:
- Reduced fasting blood sugar levels
- Improved insulin sensitivity
- Reduced LDL and triglycerides
- Increased HDL levels
So, what does the science say?
It’s (mostly!) not nature’s Wegovy/Ozempic
It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.
Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.
Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.
In less arcane words: it boosts some enzymes and inhibits others.
Each of these boosts/inhibitions has a positive effect on metabolic health.
However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.
See: Effects of Berberine on the Gastrointestinal Microbiota
Does it work for weight loss?
Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.
- Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity ← Wegovy and Ozempic are both brand names of semaglutide
- The effect of berberine supplementation on obesity parameters: A systematic review and meta-analysis of randomized controlled trials ← a good recent research review giving clear data on many factors
- Lipid-lowering effect of berberine in human subjects and rats ← this is an older study, 2012, but it gives 3-month weight loss percentages rather than discrete values in the abstract, so it’s easier to compare to the semaglutide study without grabbing a calculator
❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.
However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)
Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞
(click through to read in full)
Is it safe?
It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.
Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.
Where can I get it?
As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.
Enjoy!
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Honeydew vs Cantaloupe – Which is Healthier?
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Our Verdict
When comparing honeydew to cantaloupe, we picked the cantaloupe.
Why?
In terms of macros, there’s not a lot between them—they’re both mostly water. Nominally, honeydew has more carbs while cantaloupe has more fiber and protein, but the differences are very small. So, a very slight win for cantaloupe.
Looking at vitamins: honeydew has slightly more of vitamins B5 and B6 (so, the vitamins that are in pretty much everything), while cantaloupe has a more of vitamins A, B1, B2, B3, C, and E (especially notably 67x more vitamin A, whence its color). A more convincing win for cantaloupe.
The minerals category is even more polarized: honeydew has more selenium (and for what it’s worth, more sodium too, though that’s not usually a plus for most of us in the industrialized world), while cantaloupe has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An overwhelming win for cantaloupe.
No surprises: adding up the slight win for cantaloupe, the convincing win for cantaloupe, and the overwhelming win for cantaloupe, makes cantaloupe the overall best pick here.
Enjoy!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Teen Daily Delivery Requested
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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 thoroughly enjoy your daily delivery. I’d love to see one for teens too!
That’s great to hear! The average age of our subscribers is generally rather older, but it’s good to know there’s an interest in topics for younger people. We’ll bear that in mind, and see what we can do to cater to that without alienating our older readers!
That said: it’s never too soon to be learning about stuff that affects us when we’re older—there are lifestyle factors at 20 that affect Alzheimer’s risk at 60, for example (e.g. drinking—excessive drinking at 20* is correlated to higher Alzheimer’s risk at 60).
*This one may be less of an issue for our US readers, since the US doesn’t have nearly as much of a culture of drinking under 21 as some places. Compare for example with general European practices of drinking moderately from the mid-teens, or the (happily, diminishing—but historically notable) British practice of drinking heavily from the mid-teens.
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