Demystifying Cholesterol
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All About Cholesterol
When it comes to cholesterol, the most common lay understanding (especially under a certain age) is “it’s bad”.
A more informed view (and more common after a certain age) is “LDL cholesterol is bad; HDL cholesterol is good”.
A more nuanced view is “LDL cholesterol is established as significantly associated with (and almost certainly a causal factor of) atherosclerotic cardiovascular disease and related mortality in men; in women it is less strongly associated and may or may not be a causal factor”
You can read more about that here:
Statins: His & Hers? ← we highly recommend reading this, especially if you are a woman and/or considering/taking statins. To be clear, we’re not saying “don’t take statins!”, because they might be the right medical choice for you and we’re not your doctors. But we are saying: here’s something to at least know about and consider.
Beyond HDL & LDL
There is also VLDL cholesterol, which as you might have guessed, stands for “very low-density lipoprotein”. It has a high, unhealthy triglyceride content, and it increases atherosclerotic plaque. In other words, it hardens your arteries more quickly.
The term “hardening the arteries” is an insufficient descriptor of what’s happening though, because while yes it is hardening the arteries, it’s also narrowing them. Because minerals and detritus passing through in the blood (the latter sounds bad, but there is supposed to be detritus passing through in the blood; it’s got to get out of the body somehow, and it’s off to get filtered and excreted) get stuck in the cholesterol (which itself is a waxy substance, by the way) and before you know it, those minerals and other things have become a solid part of the interior of your artery wall, like a little plastering team came and slapped plaster on the inside of the walls, then when it hardened, slapped more plaster on, and so on. Macrophages (normally the body’s best interior clean-up team) can’t eat things much bigger than themselves, so that means they can’t tackle the build-up of plaque.
Impact on the heart
Narrower less flexible arteries means very poor circulation, which means that organs can start having problems, which obviously includes your heart itself as it is not only having to do a harder job to keep the blood circulating through the narrower blood vessels, but also, it is not immune to also being starved of oxygen and nutrients along with the rest of the body when the circulation isn’t good enough. It’s a catch 22.
What if LDL is low and someone is getting heart disease anyway?
That’s often a case of apolipoprotein B, and unlike lipoprotein A, which is bound to LDL so usually* isn’t a problem if LDL is in “safe” ranges, Apo-B can more often cause problems even when LDL is low. Neither of these are tested for in most standard cholesterol tests by the way, so you might have to ask for them.
*Some people, around 1 in 20 people, have hereditary extra risk factors for this.
What to do about it?
Well, get those lipids tests! Including asking for the LpA and Apo-B tests, especially if you have a history of heart disease in your family, or otherwise know you have a genetic risk factor.
With or without extra genetic risks, it’s good to get lipids tests done annually from 40 onwards (earlier, if you have extra risk factors).
See also: Understanding your cholesterol numbers
Wondering whether you have an increased genetic risk or not?
Genetic Testing: Health Benefits & Methods ← we think this is worth doing; it’s a “one-off test tells many useful things”. Usually done from a saliva sample, but some companies arrange a blood draw instead. Cost is usually quite affordable; do shop around, though.
Additionally, talk to your pharmacist to check whether any of your meds have contraindications or interactions you should be aware of in this regard. Pharmacists usually know contraindications/interactions stuff better than doctors, and/but unlike doctors, they don’t have social pressure on them to know everything, which means that if they’re not sure, instead of just guessing and reassuring you in a confident voice, they’ll actually check.
Lastly, shocking nobody, all the usual lifestyle medicine advice applies here, especially get plenty of moderate exercise and eat a good diet, preferably mostly if not entirely plant-based, and go easy on the saturated fat.
Note: while a vegan diet contains zero dietary cholesterol (because plants don’t make it), vegans can still get unhealthy blood lipid levels, because we are animals and—like most animals—our body is perfectly capable of making its own cholesterol (indeed, we do need some cholesterol to function), and it can make its own in the wrong balance, if for example we go too heavy on certain kinds of (yes, even some plant-based) saturated fat.
Read more: Can Saturated Fats Be Healthy? ← see for example how palm oil and coconut oil are both plant-based, and both high in saturated fat, but palm oil’s is heart-unhealthy on balance, while coconut oil’s is heart-healthy on balance (in moderation).
Want to know more about your personal risk?
Try the American College of Cardiology’s ASCVD risk estimator (it’s free)
Take care!
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How often should you really weigh yourself?
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Few topics are more debated in health than the value of the humble bathroom scale. Some experts advocate daily self-weigh-ins to promote accountability for weight management, particularly when we’re following a diet and exercise program to lose weight.
Others suggest ditching self-weigh-ins altogether, arguing they can trigger negative psychological responses and unhealthy behaviours when we don’t like, or understand, the number we see on the scale.
Many, like me, recommend using scales to weigh yourself weekly, even when we’re not trying to lose weight. Here’s why.
1. Weighing weekly helps you manage your weight
Research confirms regular self-weighing is an effective weight loss and management strategy, primarily because it helps increase awareness of our current weight and any changes.
A systematic review of 12 studies found participants who weighed themselves weekly or daily over several months lost 1–3 BMI (body mass index) units more and regained less weight than participants who didn’t weight themselves frequently. The weight-loss benefit was evident with weekly weighing; there was no added benefit with daily weighing.
Self-weigh-ins are an essential tool for weight management as we age. Adults tend to gain weight progressively through middle age. While the average weight gain is typically between 0.5–1kg per year, this modest accumulation of weight can lead to obesity over time. Weekly weighing and keeping track of the results helps avoid unnecessary weight gain.
Tracking our weight can also help identify medical issues early. Dramatic changes in weight can be an early sign of some conditions, including problems with our thyroid, digestion and diabetes.
2. Weekly weighing accounts for normal fluctuations
Our body weight can fluctuate within a single day and across the days of the week. Studies show body weight fluctuates by 0.35% within the week and it’s typically higher after the weekend.
Daily and day-to-day body weight fluctuations have several causes, many linked to our body’s water content. The more common causes include:
The type of food we’ve consumed
When we’ve eaten a dinner higher in carbohydrates, we’ll weigh more the next day. This change is a result of our bodies temporarily carrying more water. We retain 3–4 grams of water per gram of carbohydrate consumed to store the energy we take from carbs.
Our water content also increases when we consume foods higher in salt. Our bodies try to maintain a balance of sodium and water. When the concentration of salt in our bloodstream increases, a mechanism is triggered to restore balance by retaining water to dilute the excess salt.
Our food intake
Whether it’s 30 grams of nuts or 65 grams of lean meat, everything we eat and drink has weight, which increases our body weight temporarily while we digest and metabolise what we’ve consumed.
Our weight also tends to be lower first thing in the morning after our food intake has been restricted overnight and higher in the evening after our daily intake of food and drinks.
Exercise
If we weigh ourselves at the gym after a workout, there’s a good chance we’ll weigh less due to sweat-induced fluid loss. The amount of water lost varies depending on things like our workout intensity and duration, the temperature and humidity, along with our sweat rate and hydration level. On average, we lose 1 litre of sweat during an hour of moderate-intensity exercise.
Hormonal changes
Fluctuations in hormones within your menstrual cycle can also affect fluid balance. Women may experience fluid retention and temporarily gain 0.5–2kg of weight at this time. Specifically, the luteal phase, which represents the second half of a woman’s cycle, results in a shift of fluid from your blood plasma to your cells, and bloating.
Bowel movements
Going to the bathroom can lead to small but immediate weight loss as waste is eliminated from the body. While the amount lost will vary, we generally eliminate around 100 grams of weight through our daily bowel movements.
All of these fluctuations are normal, and they’re not indicative of significant changes in our body fat or muscle mass. However, seeing these fluctuations can lead to unnecessary stress and a fixation with our weight.
3. Weekly weighing avoids scale obsession and weight-loss sabotage
Weighing too frequently can create an obsession with the number on the scales and do more harm than good.
Often, our reaction when we see this number not moving in the direction we want or expect is to further restrict our food intake or embark on fad dieting. Along with not being enjoyable or sustainable, fad diets also ultimately increase our weight gain rather than reversing it.
This was confirmed in a long-term study comparing intentional weight loss among more than 4,000 twins. The researchers found the likelihood of becoming overweight by the age of 25 was significantly greater for a twin who dieted to lose 5kg or more. This suggests frequent dieting makes us more susceptible to weight gain and prone to future weight gain.
So what should you do?
Weighing ourselves weekly gives a more accurate measure of our weight trends over time.
Aim to weigh yourself on the same day, at the same time and in the same environment each week – for example, first thing every Friday morning when you’re getting ready to take a shower, after you’ve gone to the bathroom, but before you’ve drunk or eaten anything.
Use the best quality scales you can afford. Change the batteries regularly and check their accuracy by using a “known” weight – for example, a 10kg weight plate. Place the “known” weight on the scale and check the measurement aligns with the “known” weight.
Remember, the number on the scale is just one part of health and weight management. Focusing solely on it can overshadow other indicators, such as how your clothes fit. It’s also essential to pay equal attention to how we’re feeling, physically and emotionally.
Stop weighing yourself – at any time interval – if it’s triggering anxiety or stress, and get in touch with a health-care professional to discuss this.
At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.
Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Acorns vs Chestnuts – Which is Healthier?
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Our Verdict
When comparing acorns to chestnuts, we picked the acorns.
Why?
In terms of macros, chestnuts are mostly water, so it’s not surprising that acorns have a lot more carbs, fat, protein, and fiber. Thus, unless you have personal reasons for any of those to be a problem, acorns are the better choice, offering a lot more nutritional value.
In the category of vitamins, acorns lead with a lot more of vitamins A, B2, B3, B5, B6, and B9, while chestnuts have more of vitamins B1 and C. However, that vitamin C is useless to us, because it is destroyed in the cooking process (by boiling or roasting), and both of these nuts can be harmful if consumed raw, so that cooking does need to be done. That leaves acorns with a 6:1 lead.
When it comes to minerals, things are more even; acorns have more copper, magnesium, manganese, and zinc, while chestnuts have more calcium, iron, phosphorus, and potassium. Thus, a 4:4 tie (and yes, the margins of difference are approximately equal too).
We mentioned “both of these nuts can be harmful if consumed raw”, so a note on that: it’s because, while both contain an assortment of beneficial phytochemicals, they also both contain tannins that, if consumed raw, chelate with iron, essentially taking it out of our diet and potentially creating an iron deficiency. Cooking tannins stops this from being an issue, and the same cooking process renders the tannins actively beneficial to the health, for their antioxidant powers.
You may have heard that acorns are poisonous; that’s not strictly speaking true, except insofar as anything could be deemed poisonous in excess (including such things as water, and oxygen). Rather, it’s simply the above-described matter of the uncooked tannins and iron chelation. Even then, you’re unlikely to suffer ill effects unless you consume them raw in a fair quantity. While acorns have fallen from popular favor sufficient that one doesn’t see them in supermarkets, the fact is they’ve been enjoyed as an important traditional part of the diet by various indigenous peoples of N. America for centuries*, and provided they are cooked first, they are a good healthy food for most people.
*(going so far as to cultivate natural oak savannah areas, by burning out young oaks to leave the old ones to flourish without competition, to maximize acorn production, and then store dried acorns in bulk sufficient to cover the next year or so in case of a bad harvest later—so these was not just an incidental food, but very important “our life may depend on this” food. Much like grain in many places—and yes, acorns can be ground into flour and used to make bread etc too)
Do note: they are both still tree nuts though, so if you have a tree nut allergy, these ones aren’t for you.
Otherwise, enjoy both; just cook them first!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Behind Book Recommendations
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It’s Q&A Day!
Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!
So, no question/request to big or small; they’ll just get sorted accordingly
Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!
Q: What’s the process behind the books you recommend? You seem to have a limitless stream of recommendations
We do our best!
The books we recommend are books that…
- are on Amazon—it makes things tidy, consistent, and accessible. And if you end up buying one of the books, we get a small affiliate commission*.
- we have read—we would say “obviously”, but you might be surprised how many people write about books without having read them.
- pertain in at least large part to health and/or productivity.
- are written by humans—bookish people (and especially Kindle Unlimited users) may have noticed lately that there are a lot of low quality AI-written books flooding the market, sometimes with paid 5-star reviews to bolster them. It’s frustrating, but we can tell the difference and screen those out.
- are of a certain level of quality. They don’t have to be “top 5 desert-island books”, because well, there’s one every day and the days keep coming. But they do have to genuinely deliver the value that we describe, and merit a sincere recommendation.
- are varied—we try to not give a run of “samey” books one after another. We will sometimes review a book that covers a topic another previously-reviewed book did, but it must have something about it that makes it different. It may be a different angle or a different writing style, but it needs something to set it apart.
*this is from Amazon and isn’t product-specific, so this is not affecting our choice of what books to review at all—just that they will be books that are available on Amazon.
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Wouldn’t It Be Nice To Have Regenerative Superpowers?
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The Best-Laid Schemes of Mice and Medical Researchers…
This is Dr. Ellen Heber-Katz. She’s an internationally-renowned immunologist and regeneration biologist, but her perhaps greatest discovery was accidental.
Unlike in Robert Burns’ famous poem, this one has a happy ending!
But it did involve the best-laid schemes of mice and medical researchers, and how they did indeed “gang gagly“ (or in the English translation, “go awry”).
How it started…
Back in 1995, she was conducting autoimmune research, and doing a mouse study. Her post-doc assistant was assigned to punch holes in the ears of mice that had received an experimental treatment, to distinguish them from the control group.
However, when the mice were later checked, none of them had holes (nor even any indication there ever had been holes punched)—the experiment was ruined, though the post-doc swore she did her job correctly.
So, they had to start from scratch in the new year, but again, a second batch of mice repeated the trick. No holes, no wounds, no scarring, not disruption to their fur, no damage to the cartilage that had been punched through.
In a turn of events worthy of a superhero origin story, they discovered that their laboratory-made autoimmune disease had accidentally given the mice super-healing powers of regeneration.
In the animal kingdom, this is akin to a salamander growing a new tail, but it’s not something usually found in mammals.
Read: A New Murine Model for Mammalian Wound Repair and Regeneration
How it’s going…
Dr. Heber-Katz and colleagues took another 20 years of work to isolate hypoxia-inducible factor-1a (HIF-1a) as a critical molecule that, if blocked, would eliminate the regenerative response.
Further, a drug (which they went on to patent), 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), chemically induced this regenerative power:
See: Drug-induced regeneration in adult mice
Another 5 years later, they found that this same drug can be used to stimulate the regrowth of bones, too:
And now…
The research is continuing. Here’s the latest, a little over a month ago:
Epithelial–mesenchymal transition: an organizing principle of mammalian regeneration
Regrowing nerves has also been added into the list of things the drug can do.
What about humans?
Superpowered mice are all very well and good, but when can we expect this in humans?
The next step is testing the drug in larger animals, which she hopes to do next year, followed eventually by studies in humans.
Read the latest:
Regrowing nerves and healing without scars? A scientist’s career-long quest comes closer to fruition
Very promising!
Don’t Forget…
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Stop Self-Sabotage – by Dr. Judy Ho
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A lot of books of this genre identify one particular kind of self-sabotage, for example, they might pick one out of:
- Bad habits
- Limiting self-beliefs
- Poor goal-setting
- Procrastination
…etc, slap a quick fix on whatever they chose to focus on, and call it a day. Not so with Dr. Ho!
Here we have a much more comprehensive approach to tackling the problem of unintentional self-sabotage. With a multi-vector method, of which all angles can be improved simultaneously, it becomes much less like “whack-a-mole”… And much more like everything actually getting into order and staying that way.
The main approach here is CBT, but far beyond what most pop-psychology CBT books go for, with more techniques and resources.
On which note…
There are many great exercises that Dr. Ho recommends we do while reading… So you might want to get a nice notebook alongside this book if you don’t already have one! And what is more inspiring of optimism than a new notebook?
Bottom line: this is a great, well-organized guide to pruning the “why am I still doing this to myself?” aspects out of your life for a much more intentional, purposeful, effective way of living.
Click here to check it out on Amazon today, and stop sabotaging yourself!
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Healthy sex drive In Our Fifties
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
Q: What’s a healthy sex drive for someone in their 50s?
A: If you’re happy with it, it’s healthy! If you’re not, it’s not.
This means… If you’re not (happy) and thus it’s not (healthy), you have two main options:
- Find a way to be happier without changing it (i.e., change your perspective)
- Find a way to change your sex drive (presumably: “increase it”, but we don’t like to assume)
There are hormonal and pharmaceutical remedies that may help (whatever your sex), so do speak with your doctor/pharmacist.
Additionally, if a boost to sex drive is what’s wanted, then almost anything that is good for your heart will help.
We wrote about heart health yesterday:
What Matters Most For Your Heart?
That was specifically about dietary considerations, so you might also want to check out:
Take care!
Don’t Forget…
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Learn to Age Gracefully
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