Far less well-known than Coronary Artery Disease, it can still result in loss of life and limb (not in that order). Fortunately, there are ways to be on your guard:

What it is

Peripheral Artery Disease (PAD) is the same thing as Coronary Artery Disease (CAD), just, in the periphery—which by definition means “outside of the heart and brain”, but in practice, it starts with the extremities. And of the extremities, it tends to start with the feet and legs, for the simple reason that if someone’s circulation is sluggish, then because of gravity, that’s where’s going to get blocked first.

In both CAD and PAD, the usual root cause is atherosclerosis, that is to say, the build-up of fatty material inside the arteries, usually commensurate to LDL (“bad”) cholesterol, especially in men (high LDL is still a predictor of cardiovascular disease in women though, just more modestly so, at least pre-menopause or in cases of treated menopause whereby HRT has returned hormones to pre-menopause levels).

See also: Demystifying Cholesterol

And for that about sex differences: His & Hers: The Hidden Complexities of Statins and Cardiovascular Disease (CVD)

Why it is

This one’s straightforward, as it’s the same things as any kind of cardiovascular disease: high blood pressure, high cholesterol, older age, obesity, smoking, drinking, diabetes, and genetic factors (so, a risk factor is: family history of heart disease).

However, while those are the main causes and/or risk factors, it absolutely can still strike other people, so it’s as well to be watch out for…

What to look out for

Many people first notice signs and symptoms that turn out to be PAD when they experience pain or numbness in the foot or feet, and/or a discoloration of the feet (especially toes), and slow wound healing.

At that stage, chances are you will need to go urgently to a specialist, and surgery is a likely necessity. With a little luck, it’ll be a minimally-invasive surgery to unblock an artery; failing that, an amputation will be in order.

At that stage, under 50% will be alive 5 years from diagnosis:

Cardiovascular and all-cause mortality in patients with intermittent claudication and critical limb ischaemia

You probably want to avoid those. Good news is, you can, by catching it earlier!

What to look out for before that

The most common test for PAD is one you can do at home, but enlisting a nurse to do it for you will help ensure accurate readings. It’s called the Ankle-Brachial Index (ABI) test, and it involves comparing the blood pressure in your ankle with the blood pressure in your arm, and expressing them as a ratio.

Here’s how to do it (instructions and a video demonstration if you want it):

Do Try This At Home: ABI Test For Clogged Arteries

If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

• A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
• Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
• High ABI scores (above 1.4) may indicate artery hardening

Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy.

For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

There are other tests that clinicians can do for you, but you can’t do at home unless you have an MRI machine, a CT scanner, an x-ray machine, a doppler-and-ultrasound machine, etc. We’ll not go into those in detail here, but ask your doctor about them if you’re concerned.

What to do about it

In the mid-to-late stages of the disease, the options are medication and surgery, respectively, but your doctor will advise about those in that eventuality.

In the early stages of the disease, the first-line recommend treatment is exercise, of which, especially walking:

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment

Given that this more often happens when someone hasn’t been walking so much, it can be a walk-rest-walk approach at first (a treadmill on a low setting can be very useful for this):

See also: Exercise Comparison Head-to-Head: Treadmill vs Road

Take care!

How To Grow New Brain Cells (At Any Age)

It was long believed that brain growth could not occur later in life, due to expending our innate stock of pluripotent stem cells. However, this was mostly based on rodent studies.

Rodent studies are often used for brain research, because it’s difficult to find human volunteers willing to have their brains sliced thinly (so that the cells can be viewed under a microscope) at the end of the study.

However, neurobiologist Dr. Maura Boldrini led a team that did a lot of research by means of autopsies on the hippocampi of (previously) healthy individuals ranging in age from 14 to 79.

What she found is that while indeed the younger subjects did predictably have more young brain cells (neural progenitors and immature neurons), even the oldest subject, at the age of 79, had been producing new brain cells up until death.

Read her landmark study: Human Hippocampal Neurogenesis Persists throughout Aging

There was briefly a flurry of news articles about a study by Dr. Shawn Sorrels that refuted this, however, it later came to light that Dr. Sorrels had accidentally destroyed his own evidence during the cell-fixing process—these things happen; it’s just unfortunate the mistake was not picked up until after publication.

A later study by a Dr. Elena Moreno-Jiménez fixed this flaw by using a shorter fixation time for the cell samples they wanted to look at, and found that there were tens of thousands of newly-made brain cells in samples from adults ranging from 43 to 87.

Now, there was still a difference: the samples from the youngest adult had 30% more newly-made braincells than the 87-year-old, but given that previous science thought brain cell generation stopped in childhood, the fact that an 87-year-old was generating new brain cells 30% less quickly than a 43-year-old is hardly much of a criticism!

As an aside: samples from patients with Alzheimer’s also had a 30% reduction in new braincell generation, compared to samples from patients of the same age without Alzheimer’s. But again… Even patients with Alzheimer’s were still growing some new brain cells.

Read it for yourself: Adult hippocampal neurogenesis is abundant in neurologically healthy subjects and drops sharply in patients with Alzheimer’s disease

Practical advice based on this information

Since we can do neurogenesis at any age, but the rate does drop with age (and drops sharply in the case of Alzheimer’s disease), we need to:

Feed your brain. The brain is the most calorie-consuming organ we have, by far, and it’s also made mostly of fat* and water. So, get plenty of healthy fats, and get plenty of water.

*Fun fact: while depictions in fiction (and/or chemically preserved brains) may lead many to believe the brain has a rubbery consistency, the untreated brain being made of mostly fat and water gives it more of a blancmange-like consistency in reality. That thing is delicate and spatters easily. There’s a reason it’s kept cushioned inside the strongest structure of our body, far more protected than anything in our torso.

Exercise. Specifically, exercise that gets your blood pumping. This (as our earlier-featured video today referenced) is one of the biggest things we can do to boost Brain-Derived Neurotrophic Factor, or BDNF.

Here be science: Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection

However, that’s not the only way to increase BDNF; another is to enjoy a diet rich in polyphenols. These can be found in, for example, berries, tea, coffee, and chocolate. Technically those last two are also botanically berries, but given how we usually consume them, and given how rich they are in polyphenols, they merit a special mention.

See for example: Effects of nutritional interventions on BDNF concentrations in humans: a systematic review

Some supplements can help neuron (re)growth too, so if you haven’t already, you might want to check out our previous main feature on lion’s mane mushroom, a supplement which does exactly that.

For those who like videos, you may also enjoy this TED talk by neuroscientist Dr. Sandrine Thuret:

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