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Do Try This At Home: The 12-Week Brain Fitness Program
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12 Weeks To Measurably Boost Your Brain
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This is Dr. Majid Fotuhi. From humble beginnings (being smuggled out of Iran in 1980 to avoid death in the war), he went on (after teaching himself English, French, and German, hedging his bets as he didn’t know for sure where life would lead him) to get his MD from Harvard Medical School and his PhD in neuroscience from Johns Hopkins University. Since then, he’s had a decades-long illustrious career in neurology and neurophysiology.
What does he want us to know?
The Brain Fitness Program
This is not, by the way, something he’s selling. Rather, it was a landmark 12-week study in which 127 people aged 60–80, of which 63% female, all with a diagnosis of mild cognitive impairment, underwent an interventional trial—in other words, a 12-week brain fitness course.
After it, 84% of the participants showed statistically significant improvements in cognitive function.
Not only that, but of those who underwent MRI testing before and after (not possible for everyone due to practical limitations), 71% showed either no further deterioration of the hippocampus, or actual growth above the baseline volume of the hippocampus (that’s good, and it means functionally the memory center of the brain has been rejuvenated).
You can read a little more about the study here:
As for what the program consisted of, and what Dr. Fotuhi thus recommends for everyone…
Cognitive stimulation
This is critical, so we’re going to spend most time on this one—the others we can give just a quick note and a pointer.
In the study this came in several forms and had the benefit of neurofeedback technology, but he says we can replicate most of the effects by simply doing something cognitively stimulating. Whatever challenges your brain is good, but for maximum effect, it should involve the language faculties of the brain, since these are what tend to get hit most by age-related cognitive decline, and are also what tends to have the biggest impact on life when lost.
If you lose your keys, that’s an inconvenience, but if you can’t communicate what is distressing you, or understand what someone is explaining to you, that’s many times worse—and that kind of thing is a common reality for many people with dementia.
To keep the lights brightly lit in that part of the brain: language-learning is good, at whatever level suits you personally. In other words: there’s a difference between entry-level Duolingo Spanish, and critically analysing Rumi’s poetry in the original Persian, so go with whatever is challenging and/but accessible for you—just like you wouldn’t go to the gym for the first time and try to deadlift 500lbs, but you also probably wouldn’t do curls with the same 1lb weights every day for 10 years.
In other words: progressive overloading is key, for the brain as well as for muscles. Start easy, but if you’re breezing through everything, it’s time to step it up.
If for some reason you’re really set against the idea of learning another language, though, check out:
Reading As A Cognitive Exercise ← there are specific tips here for ensuring your reading is (and remains) cognitively beneficial
Mediterranean diet
Shocking nobody, this is once again recommended. You might like to check out the brain-healthy “MIND” tweak to it, here:
Four Ways To Upgrade The Mediterranean Diet ← it’s the fourth one
Omega-3 supplementation
Nothing complicated here. The brain needs a healthy balance of these fatty acids to function properly, and most people have an incorrect balance (too little omega-3 for the omega-6 present):
What Omega-3 Fatty Acids Really Do For Us ← scroll to “against cognitive decline”
Increasing fitness
There’s a good rule of thumb: what’s healthy for your heart, is healthy for your brain. This is because, like every other organ in your body, the brain does not function well without good circulation bringing plenty of oxygen and nutrients, which means good cardiovascular health is necessary. The brain is extra sensitive to this because it’s a demanding organ in terms of how much stuff it needs delivering via blood, and also because of the (necessary; we’d die quickly and horribly without it) impediment of the blood-brain barrier, and the possibility of beta-amyloid plaques and similar woes (they will build up if circulation isn’t good).
How To Reduce Your Alzheimer’s Risk ← number two on the list here
Practising mindfulness medication
This is also straightforward, but not to be underestimated or skipped over:
No-Frills, Evidence-Based Mindfulness
Want to step it up? Check out:
Meditation Games That You’ll Actually Enjoy
Lastly…
Dr. Fotuhi wants us to consider looking after our brain the same way we look after our teeth. No, he doesn’t want us to brush our brain, but he does want us to take small measurable actions multiple times per day, every day.
You can’t just spend the day doing nothing but brushing your teeth for the entirety of January the 1st and then expect them to be healthy for the rest of the year; it doesn’t work like that—and it doesn’t work like that for the brain, either.
So, make the habits, and keep them going
Take care!
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Take These To Lower Cholesterol! (Statin Alternatives)
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Dr. Ada Ozoh, a diabetes specialist, took an interest in this upon noting the many-headed beast that is metabolic syndrome means that neither diabetes nor cardiovascular disease exist in a vacuum, and there are some things that can help a lot against both. Here she shares some of her top recommendations:
Statin-free options
Dr. Ozoh recommends:
- Bergamot: lowers LDL (“bad” cholesterol) by about 30% and slightly increases HDL (“good” cholesterol), at 500–1000mg/day, seeing results in 1–6 months
- Berberine: prevents fat absorption and helps burn stored fat, as well as reducing blood sugar levels and blood pressure, at 1,500mg/day
- Silymarin: protects the liver, and lowers cholesterol in type 2 diabetes, at 280–420mg/day
- Phytosterols: lower cholesterol by about 10%; found naturally in many plants, but it takes supplementation to read the needed (for this purpose) dosage of 2g/day
- Red yeast rice: this is white rice fermented with yeast, and it lowers LDL cholesterol by about 25%, seeing results in around 3 months
For more information on all of the above (including more details on the biochemistry, as well as potential issues to be aware of), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Statins: His & Hers? Very Different For Men & Women
- Berberine For Metabolic Health
- Milk Thistle For The Brain, Bones, & More ← this is about silymarin, which is extracted from Silybum marianum, the milk thistle plant
Take care!
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Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money
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One owns a for-profit insurer, a venture capital company, and for-profit hospitals in Italy and Kazakhstan; it has just acquired its fourth for-profit hospital in Ireland. Another owns one of the largest for-profit hospitals in London, is partnering to build a massive training facility for a professional basketball team, and has launched and financed 80 for-profit start-ups. Another partners with a wellness spa where rooms cost $4,000 a night and co-invests with “leading private equity firms.”
Do these sound like charities?
These diversified businesses are, in fact, some of the country’s largest nonprofit hospital systems. And they have somehow managed to keep myriad for-profit enterprises under their nonprofit umbrella — a status that means they pay little or no taxes, float bonds at preferred rates, and gain numerous other financial advantages.
Through legal maneuvering, regulatory neglect, and a large dollop of lobbying, they have remained tax-exempt charities, classified as 501(c)(3)s.
“Hospitals are some of the biggest businesses in the U.S. — nonprofit in name only,” said Martin Gaynor, an economics and public policy professor at Carnegie Mellon University. “They realized they could own for-profit businesses and keep their not-for-profit status. So the parking lot is for-profit; the laundry service is for-profit; they open up for-profit entities in other countries that are expressly for making money. Great work if you can get it.”
Many universities’ most robust income streams come from their technically nonprofit hospitals. At Stanford University, 62% of operating revenue in fiscal 2023 was from health services; at the University of Chicago, patient services brought in 49% of operating revenue in fiscal 2022.
To be sure, many hospitals’ major source of income is still likely to be pricey patient care. Because they are nonprofit and therefore, by definition, can’t show that thing called “profit,” excess earnings are called “operating surpluses.” Meanwhile, some nonprofit hospitals, particularly in rural areas and inner cities, struggle to stay afloat because they depend heavily on lower payments from Medicaid and Medicare and have no alternative income streams.
But investments are making “a bigger and bigger difference” in the bottom line of many big systems, said Ge Bai, a professor of health care accounting at the Johns Hopkins University Bloomberg School of Public Health. Investment income helped Cleveland Clinic overcome the deficit incurred during the pandemic.
When many U.S. hospitals were founded over the past two centuries, mostly by religious groups, they were accorded nonprofit status for doling out free care during an era in which fewer people had insurance and bills were modest. The institutions operated on razor-thin margins. But as more Americans gained insurance and medical treatments became more effective — and more expensive — there was money to be made.
Not-for-profit hospitals merged with one another, pursuing economies of scale, like joint purchasing of linens and surgical supplies. Then, in this century, they also began acquiring parts of the health care systems that had long been for-profit, such as doctors’ groups, as well as imaging and surgery centers. That raised some legal eyebrows — how could a nonprofit simply acquire a for-profit? — but regulators and the IRS let it ride.
And in recent years, partnerships with, and ownership of, profit-making ventures have strayed further and further afield from the purported charitable health care mission in their community.
“When I first encountered it, I was dumbfounded — I said, ‘This not charitable,’” said Michael West, an attorney and senior vice president of the New York Council of Nonprofits. “I’ve long questioned why these institutions get away with it. I just don’t see how it’s compliant with the IRS tax code.” West also pointed out that they don’t act like charities: “I mean, everyone knows someone with an outstanding $15,000 bill they can’t pay.”
Hospitals get their tax breaks for providing “charity care and community benefit.” But how much charity care is enough and, more important, what sort of activities count as “community benefit” and how to value them? IRS guidance released this year remains fuzzy on the issue.
Academics who study the subject have consistently found the value of many hospitals’ good work pales in comparison with the value of their tax breaks. Studies have shown that generally nonprofit and for-profit hospitals spend about the same portion of their expenses on the charity care component.
Here are some things listed as “community benefit” on hospital systems’ 990 tax forms: creating jobs; building energy-efficient facilities; hiring minority- or women-owned contractors; upgrading parks with lighting and comfortable seating; creating healing gardens and spas for patients.
All good works, to be sure, but health care?
What’s more, to justify engaging in for-profit business while maintaining their not-for-profit status, hospitals must connect the business revenue to that mission. Otherwise, they pay an unrelated business income tax.
“Their CEOs — many from the corporate world — spout drivel and turn somersaults to make the case,” said Lawton Burns, a management professor at the University of Pennsylvania’s Wharton School. “They do a lot of profitable stuff — they’re very clever and entrepreneurial.”
The truth is that a number of not-for-profit hospitals have become wealthy diversified business organizations. The most visible manifestation of that is outsize executive compensation at many of the country’s big health systems. Seven of the 10 most highly paid nonprofit CEOs in the United States run hospitals and are paid millions, sometimes tens of millions, of dollars annually. The CEOs of the Gates and Ford foundations make far less, just a bit over $1 million.
When challenged about the generous pay packages — as they often are — hospitals respond that running a hospital is a complicated business, that pharmaceutical and insurance execs make much more. Also, board compensation committees determine the payout, considering salaries at comparable institutions as well as the hospital’s financial performance.
One obvious reason for the regulatory tolerance is that hospital systems are major employers — the largest in many states (including Massachusetts, Pennsylvania, Minnesota, Arizona, and Delaware). They are big-time lobbying forces and major donors in Washington and in state capitals.
But some patients have had enough: In a suit brought by a local school board, a judge last year declared that four Pennsylvania hospitals in the Tower Health system had to pay property taxes because its executive pay was “eye popping” and it demonstrated “profit motives through actions such as charging management fees from its hospitals.”
A 2020 Government Accountability Office report chided the IRS for its lack of vigilance in reviewing nonprofit hospitals’ community benefit and recommended ways to “improve IRS oversight.” A follow-up GAO report to Congress in 2023 said, “IRS officials told us that the agency had not revoked a hospital’s tax-exempt status for failing to provide sufficient community benefits in the previous 10 years” and recommended that Congress lay out more specific standards. The IRS declined to comment for this column.
Attorneys general, who regulate charity at the state level, could also get involved. But, in practice, “there is zero accountability,” West said. “Most nonprofits live in fear of the AG. Not hospitals.”
Today’s big hospital systems do miraculous, lifesaving stuff. But they are not channeling Mother Teresa. Maybe it’s time to end the community benefit charade for those that exploit it, and have these big businesses pay at least some tax. Communities could then use those dollars in ways that directly benefit residents’ health.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Water Water Everywhere, But Which Is Best To Drink?
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Well Well Well…
In Tuesday’s newsletter, we asked you for your (health-related) opinion on drinking water—with the understanding that this may vary from place to place. We got the above-depicted, below-described, set of responses:
- About 65% said “Filtered is best”
- About 20% said “From the mains is best”
- About 8% said “Bottled is best”
- About 3% said “Distilled is best”
- About 3% said “Some other source is best”
Of those who said “some other source is best”, one clarified that their preferred source was well water.
So what does the science say?
Fluoridated water is bad for you: True or False?
False, assuming a normal level of consumption. Rather than take up more space today though, we’ll link to what we previously wrote on this topic:
You may be wondering: but what if my level of consumption is higher than normal?
Let’s quickly look at some stats:
- The maximum permitted safety level varies from place to place, but is (for example) 2mg/l in the US, 1.5mg/l in Canada & the UK.
- The minimum recommended amount also varies from place to place, but is (for example) 0.7mg/l in Canada and the US, and 1mg/l in the UK.
It doesn’t take grabbing a calculator to realize that if you drink twice as much water as someone else, then depending on where you are, water fluoridated to the minimum may give you more than the recommended maximum.
However… Those safety margins are set so much lower than the actual toxicity levels of fluoride, that it doesn’t make a difference.
For example: your writer here takes a medication that has the side effect of causing dryness of the mouth, and consequently she drinks at least 3l of water per day in a climate that could not be described as hot (except perhaps for about 2 weeks of the year). She weighs 72kg (that’s about 158 pounds), and the toxicity of fluoride (for ill symptoms, not death) is 0.2mg/kg. So, she’d need 14.4mg of fluoride, which even if the water fluoridation here were 2mg/l (it’s not; it’s lower here, but let’s go with the highest figure to make a point), would require drinking more than 7l of water faster than the body can process it.
For more about the numbers, check out:
Acute Fluoride Poisoning from a Public Water System
Bottled water is the best: True or False?
False, if we consider “best” to be “healthiest”, which in turn we consider to be “most nutrients, with highest safety”.
Bottled water generally does have higher levels of minerals than most local mains supply water does. That’s good!
But you know what else is generally has? Microplastics and nanoplastics. That’s bad!
We don’t like to be alarmist in tone; it’s not what we’re about here, but the stats on bottled water are simply not good; see:
We Are Such Stuff As Bottles Are Made Of
You may be wondering: “but what about bottled water that comes in glass bottles?”
Indeed, water that comes in glass bottles can be expected to have lower levels of plastic than water that comes in plastic bottles, for obvious reasons.
However, we invite you to consider how likely you believe it to be that the water wasn’t stored in plastic while being processed, shipped and stored, before being portioned into its final store-ready glass bottles for end-consumer use.
Distilled water is the best: True or False?
False, generally, with caveats:
Distilled water is surely the safest water anywhere, because you know that you’ve removed any nasties.
However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals).
Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.
Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.
Here’s an example product on Amazon if you’d like to invest in a water still for such cases.
PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee. So we really don’t recommend distilling your water unless you have a good reason to do so.
Filtered water is the best: True or False?
True for most people in most places.
Let’s put it this way: it can’t logically be worse than whatever source of water you put into it…
Provided you change the filter regularly, of course.
Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.
You may be wondering: can water filters remove microplastics, and can they remove minerals?
The answer in both cases is: sometimes.
- For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
- For minerals, it depends on the filter type. Check out:
The H2O Chronicles | 5 Water Filters That Remove Minerals
One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like
Take care!
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How Too Much Salt May Lead To Organ Failure
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Salt’s Health Risks… More Than Just Heart Disease!
It’s been well-established for a long time that too much salt is bad for cardiovascular health. It can lead to high blood pressure, which in turn can lead to many problems, including heart attacks.
A team of researchers has found that in addition to this, it may be damaging your organs themselves.
This is because high salt levels peel away the surfaces of blood vessels. How does this harm your organs? Because it’s through those walls that nutrients are selectively passed to where they need to be—mostly your organs. So, too much salt can indirectly starve your organs of the nutrients they need to survive. And you absolutely do not want your organs to fail!
❝We’ve identified new biomarkers for diagnosing blood vessel damage, identifying patients at risk of heart attack and stroke, and developing new drug targets for therapy for a range of blood vessel diseases, including heart, kidney and lung diseases as well as dementia❞
~ Newman Sze, Canada Research Chair in Mechanisms of Health and Disease, and lead researcher on this study.
See the evidence for yourself: Endothelial Damage Arising From High Salt Hypertension Is Elucidated by Vascular Bed Systematic Profiling
Diets high in salt are a huge problem in Canada, North America as a whole, and around the world. According to a World Health Organization (WHO) report released March 9, Canadians consume 9.1 grams of salt per day.
Read: WHO global report on sodium intake reduction
You may be wondering: who is eating over 9g of salt per day?
And the answer is: mostly, people who don’t notice how much salt is already in processed foods… don’t see it, and don’t think about it.
Meanwhile, the WHO recommends the average person to consume no more than five grams, or one teaspoon, of salt per day.
Read more: Massive efforts needed to reduce salt intake and protect lives
The American Heart Association, tasked with improving public health with respect to the #1 killer of Americans (it’s also the #1 killer worldwide—but that’s not the AHA’s problem), goes further! It recommends no more than 2.3g per day, and ideally, no more than 1.5g per day.
Some handy rules-of-thumb
Here are sodium-related terms you may see on food packages:
- Salt/Sodium-Free = Less than 5mg of sodium per serving
- Very Low Sodium = 35mg or less per serving
- Low Sodium = 140mg or less per serving
- Reduced Sodium = At least 25% less sodium per serving than the usual sodium level
- Light in Sodium or Lightly Salted = At least 50% less sodium than the regular product
Confused by milligrams? Instead of remembering how many places to move the decimal point (and potentially getting an “out by an order of magnitude error—we’ve all been there!), think of the 1.5g total allowance as being 1500mg.
See also: How much sodium should I eat per day? ← from the American Heart Association
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Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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Procrastination, and how to pay off the to-do list debt
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Procrastination, and how pay off the to-do list debt
Sometimes we procrastinate because we feel overwhelmed by the mountain of things we are supposed to be doing. If you look at your to-do list and it shows 60 overdue items, it’s little wonder if you want to bury your head in the sand!
“What difference does it make if I do one of these things now; I will still have 59 which feels as bad as having 60”
So, treat it like you might a financial debt, and make a repayment plan. Now, instead of 60 overdue items today, you have 1/day for the next 60 days, or 2/day for the next 30 days, or 3/day for the next 20 days, etc. Obviously, you may need to work out whether some are greater temporal priorities and if so, bump those to the top of the list. But don’t sweat the minutiae; your list doesn’t have to be perfectly ordered, just broadly have more urgent things to the top and less urgent things to the bottom.
Note: this repayment plan means having set repayment dates.
Up front, sit down and assign each item a specific calendar date on which you will do that thing.
This is not a deadline! It is your schedule. You’ll not try to do it sooner, and you won’t postpone it for later. You will just do that item on that date.
A productivity app like ToDoist can help with this, but paper is fine too.
What’s important here, psychologically, is that each day you’re looking not at 60 things and doing the top item; you’re just looking at today’s item (only!) and doing it.
Debt Reduction/Cancellation
Much like you might manage a financial debt, you can also look to see if any of your debts could be reduced or cancelled.
We wrote previously about the “Getting Things Done” system. It’s a very good system if you want to do that; if not, no worries, but you might at least want to borrow this one idea….
Sort your items into:
Do / Defer / Delegate / Ditch
- Do: if it can be done in under 2 minutes, do it now.
- Defer: defer the item to a specific calendar date (per the repayment plan idea we just talked about)
- Delegate: could this item be done by someone else? Get it off your plate if you reasonably can.
- Ditch: sometimes, it’s ok to realize “you know what, this isn’t that important to me anymore” and scratch it from the list.
As a last resort, consider declaring bankruptcy
Towards the end of the dot-com boom, there was a fellow who unintentionally got his 5 minutes of viral fame for “declaring email bankruptcy”.
Basically, he publicly declared that his email backlog had got so far out of hand that he would now not reply to emails from before the declaration.
He pledged to keep on top of new emails only from that point onwards; a fresh start.
We can’t comment on whether he then did, but if you need a fresh start, that can be one way to get it!
In closing…
Procrastination is not usually a matter of laziness, it’s usually a matter of overwhelm. Hopefully the above approach will help reframe things, and make things more manageable.
Sometimes procrastination is a matter of perfectionism, and not starting on tasks because we worry we won’t do them well enough, and so we get stuck in a pseudo-preparation rut. If that’s the case, our previous main feature on perfectionism may help:
Don’t Forget…
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Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: