The Brain As A Work-In-Progress
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And The Brain Goes Marching On!
In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:
- About 64% of people said “Never”
- About 16% of people said “25 years”
- About 9% of people said “65 years”
- About 5% of people said “13 years”
- About 3% of people said “18 years”
- About 3% of people said “45 years”
Some thoughts, before we get into the science:
An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:
- “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
- When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages
Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!
Why we picked those ages
We picked those ages as poll options for reasons people might be drawn to them:
- 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
- 18 years: age of legal majority in N. America and many other places
- 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
- 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
- 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research
Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!
Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.
So, what does the science say?
Our brains are never finished developing: True or False?
True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.
Glossary:
- Neurogenesis: the process of creating new brain cells
- Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs
We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.
For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:
How To Grow New Brain Cells (At Any Age)
Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.
Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:
Our brains are still developing up to the age of 25: True or False?
True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.
A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:
❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞
Source: Structural Magnetic Resonance Imaging of the Adolescent Brain
There are several things to note here:
- The above statement is talking about the physical size of the brain growing
- Nowhere does he say “and stops developing at 25”
However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.
This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.
The study didn’t misrepresent this, by the way, but the popular press did!
Another 2012 study looked at various metrics of brain development, and found:
- Synapse overproduction into the teens
- Cortex pruning into the late 20s
- Prefrontal pruning into middle age at least (they stopped looking)
- Myelination beyond middle age (they stopped looking)
Source: Experience and the developing prefrontal cortex ← check out figure 1, and make sure you’re looking at the human data not the rat data
So how’s the most recent research looking?
Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:
Brain charts for the human lifespan ← check out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!
Want to know how not to get caught out by science being misrepresented by the popular press? Check out:
How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)
Take care!
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Health Benefits Of Cranberries (But: You’d Better Watch Out)
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Health Benefits Of Cranberries (But: You’d Better Watch Out)
Quick clarification first: today we’re going to be talking about cranberries. Not “cranberry juice drink” that is loaded with sugar, nor “cranberry jelly” or similar that is more added sugar than it is cranberry.
We’re going to keep this short today, because “eat berries” is probably something you know already, but there are some things you should be aware of!
The benefits
Cranberries, even more than most berries, are full of polyphenols and flavonoids that do “those three things that usually come together”: antioxidant properties, anti-inflammatory properties, and anti-cancer properties
Unsurprisingly, this also means they’re good for the immune system and thus quite a boon in flu season:
They’re also good for heart health:
Quick Tip: we’re giving you one study for each of these things for brevity, but if you click through on any of our PubMed study links, you’ll (almost) always see a heading “Similar articles” heading beneath it, which will (almost) always show you plenty more.
Perhaps the most popular reason people take cranberry supplements, though, is their effectiveness at prevention of urinary tract infections:
Indeed, their effectiveness is such that researchers have considered them a putative alternative to antibiotics, particularly in individuals with recurrent UTIs:
Is it safe?
Cranberries are generally considered a very healthful food. However, there are two known possible exceptions:
If you are taking warfarin, it is possible that cranberry consumption may cause additional anti-clotting effects that you don’t want.
If you are at increased risk of kidney stones, the science is currently unclear as to whether this will help or hinder:
- Influence of cranberry juice on the urinary risk factors for calcium oxalate kidney stone formation ← this one concluded “Cranberry juice has antilithogenic properties and, as such, deserves consideration as a conservative therapeutic protocol in managing calcium oxalate urolithiasis”
- Dietary supplementation with cranberry concentrate tablets may increase the risk of nephrolithiasis ← this one, as you can see, concluded the opposite
- Safety of Cranberry: Evaluation of Evidence of Kidney Stone Formation and Botanical Drug-Interactions ← this one acknowledges “contradictory data regarding the role of cranberry in kidney stone formation”
Where can I get some?
You can probably buy fresh, frozen, or dried cranberries from wherever you normally do your grocery shopping.
However, if you prefer to take it in supplement form, then here’s an example product on Amazon
Enjoy!
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Pneumonia: Prevention Is Better Than Cure
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Pneumonia: What We Can & Can’t Do About It
Pneumonia is a significant killer of persons over the age of 65, with the risk increasing with age after that, rising very sharply around the age of 85:
While pneumonia is treatable, especially in young healthy adults, the risks get more severe in the older age brackets, and it’s often the case that someone goes into hospital with one thing, then develops pneumonia, which the person was already not in good physical shape to fight, because of whatever hospitalized them in the first place:
American Lung Association | Pneumonia Treatment and Recovery
Other risk factors besides age
There are a lot of things that can increase our risk factor for pneumonia; they mainly fall into the following categories:
- Autoimmune diseases
- Other diseases of the immune system (e.g. HIV)
- Medication-mediated immunosuppression (e.g. after an organ transplant)
- Chronic lung diseases (e.g. asthma, COPD, Long Covid, emphysema, etc)
- Other serious health conditions ← we know this one’s broad, but it encompasses such things as diabetes, heart disease, and cancer
See also:
Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
Things we can do about it
When it comes to risks, we can’t do much about our age and some of the other above factors, but there are other things we can do to reduce our risk, including:
- Get vaccinated against pneumonia if you are over 65 and/or have one of the aforementioned risk factors. This is not perfect (it only reduces the risk for certain kinds of infection) and may not be advisable for everyone (like most vaccines, it can put the body through its paces a bit after taking it), so speak with your own doctor about this, of course.
- See also: Vaccine Mythbusting
- Avoid contagion. While pneumonia itself is not spread person-to-person, it is caused by bacteria or viruses (there are numerous kinds) that are opportunistic and often become a secondary infection when the immune system is already busy with the first one. So, if possible avoid being in confined spaces with many people, and do wash your hands regularly (as a lot of germs are transferred that way and can get into the respiratory tract because you touched your face or such).
- See also: The Truth About Handwashing
- If you have a cold, or flu, or other respiratory infection, take it seriously, rest well, drink fluids, get good immune-boosting nutrients. There’s no such thing as “just a cold”; not anymore.
- Look after your general health too—health doesn’t exist in a vacuum, and nor does disease. Every part of us affects every other part of us, so anything that can be in good order, you want to be in good order.
This last one, by the way? It’s an important reminder that while some diseases (such as some of the respiratory infections that can precede pneumonia) are seasonal, good health isn’t.
We need to take care of our health as best we can every day along the way, because we never know when something could change.
Want to do more?
Check out: Seven Things To Do For Good Lung Health!
Take care!
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What Are “Adaptogens” Anyway? (And Other Questions Answered)
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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 tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞
(this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)
How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.
Did anyone else have this problem? Let us know! (You can reply to this email, or use the handy feedback widget at the bototm)
❝I may have missed it, but how much black pepper provides benefits?❞
So, for any new subscribers joining us today, this is about two recent main features:
As for a daily dosage of black pepper, it varies depending on the benefit you’re looking for, but:
- 5–20mg of piperine is the dosage range used in most scientific studies we looked at
- 10mg is a very common dosage found in many popular supplements
- That’s the mass of piperine though, so if taking it as actual black pepper rather than as an extract, ½ teaspoon is considered sufficient to enjoy benefits.
❝I loved the health benefits of pepper. I do not like pepper. Where can I get it as a supplement?❞
You can simply buy whole black peppercorns and take a few with water as though they were tablets. Your stomach acid will do the rest. Black pepper is also good for digestion, so taking it with a meal is best.
You can buy piperine (black pepper extract) by itself as a supplement in powder form, but if you don’t like black pepper, you will probably not like this powder either. We couldn’t find it readily in capsule form.
You can buy piperine (black pepper extract) as an adjunct to other supplements, with perhaps the most common/popular being turmeric capsules that also contain 10mg (or more) piperine per capsule. Shop around if you like, but here’s one that has 15mg piperine* per capsule, for example.
*They call it “Bioperine®” but that is literally just piperine. Same goes if you see “Absorbagen™”, it’s still just piperine.
❝What do you mean when you say that something is adaptogenic?❞
Simple version: it means it helps the body adapt to stress, by adjusting the body’s natural responses. Thus, adaptogenic supplements can be contrasted with tranquilizing drugs that mask stress by brute force, for example.
Technical version: adaptogenic activity refers to improving physiological stress resilience, such as by moderating and modulating hypothalamic–pituitary–adrenal axis signaling, and/or by regulating levels of endogenic compounds involved in the cellular stress response.
Read more (technical version):
Read more (simple version):
European Medicines Agency’s Reflection Paper On The Adaptogenic Concept
Enjoy!
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This Is Your Brain on Music – by Dr. Daniel Levitin
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Music has sometimes been touted as having cognitive benefits, by its practice and even by the passive experience of it. But what’s the actual science of it?
Dr. Levitin, an accomplished musician and neuroscientist, explores and explains.
We learn about how music in all likelihood allowed our ancestors to develop speech, something that set us apart (and ahead!) as a species. How music was naturally-selected-for in accordance with its relationship with health. How processing music involves almost every part of the brain. How music pertains specifically to memory. And more.
As a bonus, as well as explaining a lot about our brain, this book offers those of us with limited knowledge of music theory a valuable overview of the seven main dimensions of music, too.
Bottom line: if you’d like to know more about the many-faceted relationship between music and cognitive function, this is a top-tier book about such.
Click here to check out “This Is Your Brain On Music”, and learn more about yours!
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Fully Present – by Dr. Susan Smalley and Diana Winston
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“The Science and the Art of…” tends to be a bit of a fuzzy obfuscation, but in this case, it’s accurate, especially in this presentation. The authors are, indeed, a scientist and an artist—and both practitioners, meeting in the middle.
As such, we get the clinical insights of a researcher and professor of psychiatry, and the grounded-yet-spiritual insights of an erstwhile Buddhist nun.
While the book is pop psychology in essence, the format is much more that of a textbook than a self-help book. Will it be useful for helping yourself anyway, though? Yes, absolutely, if you apply the information contained within.
Don’t be fooled into thinking that a textbook format makes it dry, though—the writing is very compelling, and you’ll find yourself turning pages eagerly. There’s no time like the present, after all!
Bottom line: if you find the scientific evidence-base for the usefulness of mindfulness appealing, but find a lot of guides a little fluffy, this one is perfectly balanced—and very well written, too.
Click here to check out Fully Present, bring yourself into the moment, always!
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Elon Musk says ‘disc replacement’ worked for him. But evidence this surgery helps chronic pain is lacking
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Last week in a post on X, owner of the platform Elon Musk recommended people look into disc replacement if they’re experiencing severe neck or back pain.
According to a biography of the billionaire, he’s had chronic back and neck pain since he tried to “judo throw” a 350-pound sumo wrestler in 2013 at a Japanese-themed party for his 42nd birthday, and blew out a disc at the base of his neck.
In comments following the post, Musk said the surgery was a “gamechanger” and reduced his pain significantly.
Musk’s original post has so far had more than 50 million views and generated controversy. So what is disc replacement surgery and what does the evidence tells us about its benefits and harms?
What’s involved in a disc replacement?
Disc replacement is a type of surgery in which one or more spinal discs (a cushion between the spine bones, also known as vertebrae) are removed and replaced with an artificial disc to retain movement between the vertebrae. Artificial discs are made of metal or a combination of metal and plastic.
Disc replacement may be performed for a number of reasons, including slipped discs in the neck, as appears to be the case for Musk.
Disc replacement is major surgery. It requires general anaesthesia and the operation usually takes 2–4 hours. Most people stay in hospital for 2–7 days. After surgery patients can walk but need to avoid things like strenuous exercise and driving for 3–6 weeks. People may be required to wear a neck collar (following neck surgery) or a back brace (following back surgery) for about 6 weeks.
Costs vary depending on whether you have surgery in the public or private health system, if you have private health insurance, and your level of coverage if you do. In Australia, even if you have health insurance, a disc replacement surgery may leave you more than A$12,000 out of pocket.
Disc replacement surgery is not performed as much as other spinal surgeries (for example, spinal fusion) but its use is increasing.
In New South Wales for example, rates of privately-funded disc replacement increased six-fold from 6.2 per million people in 2010–11 to 38.4 per million in 2019–20.
What are the benefits and harms?
People considering surgery will typically weigh that option against not having surgery. But there has been very little research comparing disc replacement surgery with non-surgical treatments.
Clinical trials are the best way to determine if a treatment is effective. You first want to show that a new treatment is better than doing nothing before you start comparisons with other treatments. For surgical procedures, the next step might be to compare the procedure to non-surgical alternatives.
Unfortunately, these crucial first research steps have largely been skipped for disc replacement surgery for both neck and back pain. As a result, there’s a great deal of uncertainty about the treatment.
There are no clinical trials we know of investigating whether disc replacement is effective for neck pain compared to nothing or compared to non-surgical treatments.
For low back pain, the only clinical trial that has been conducted to our knowledge comparing disc replacement to a non-surgical alternative found disc replacement surgery was slightly more effective than an intensive rehabilitation program after two years and eight years.
Complications are not uncommon, and can include disclocation of the artificial disc, fracture (break) of the artificial disc, and infection.
In the clinical trial mentioned above, 26 of the 77 surgical patients had a complication within two years of follow up, including one person who underwent revision surgery that damaged an artery leading to a leg needing to be amputated. Revision surgery means a re-do to the primary surgery if something needs fixing.
Are there effective alternatives?
The first thing to consider is whether you need surgery. Seeking a second opinion may help you feel more informed about your options.
Many surgeons see disc replacement as an alternative to spinal fusion, and this choice is often presented to patients. Indeed, the research evidence used to support disc replacement mainly comes from studies that compare disc replacement to spinal fusion. These studies show people with neck pain may recover and return to work faster after disc replacement compared to spinal fusion and that people with back pain may get slightly better pain relief with disc replacement than with spinal fusion.
However, spinal fusion is similarly not well supported by evidence comparing it to non-surgical alternatives and, like disc replacement, it’s also expensive and associated with considerable risks of harm.
Fortunately for patients, there are new, non-surgical treatments for neck and back pain that evidence is showing are effective – and are far cheaper than surgery. These include treatments that address both physical and psychological factors that contribute to a person’s pain, such as cognitive functional therapy.
While Musk reported a good immediate outcome with disc replacement surgery, given the evidence – or lack thereof – we advise caution when considering this surgery. And if you’re presented with the choice between disc replacement and spinal fusion, you might want to consider a third alternative: not having surgery at all.
Giovanni E Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Christopher Maher, Professor, Sydney School of Public Health, University of Sydney; Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney, and Joshua Zadro, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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