
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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Invigorating Sabzi Khordan
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Have you ever looked at the nutritional values and phytochemical properties of herbs, and thought “well that’s all well and good, but we only use a tiny amount”? Sabzi khordan is a herb-centric traditional Levantine sharing platter served most commonly as an appetizer, and it is indeed appetizing! Never again will “start your meal with a green salad to ensure a gentle blood sugar curve” seem like a chore:
You will need
- Large bunch of parsley
- Small bunch of tarragon leaves
- Small bunch of basil leaves
- Small bunch of mint
- Small bunch of sorrel leaves
- 7 oz block of feta cheese (if vegan, a plant-based substitution is fine in culinary terms, but won’t have the same gut-healthy benefits, as plant-based cheeses are not fermented)
- 9 oz labneh-stuffed vine leaves in olive oil (if vegan, same deal as the above, except it’s harder to find plant-based substitutes for labneh (strained yogurt cheese), so you might want to use our Plant-Based Healthy Cream Cheese recipe instead and make your own)
- 2 tbsp za’atar (you can make your own by blending dried hyssop, dried sumac berries, sesame seeds, dried thyme, and salt—but if you haven’t had za’atar before, we recommend first buying some like the one that we linked, so that next time you know what you’re aiming for)
- 3 tbsp extra virgin olive oil
- 10 radishes
- 6 scallions
- 9 oz walnuts, soaked in water overnight and drained
- 1 cucumber, cut into batons
- Warm flatbreads (you can use our Healthy Homemade Flatbreads recipe)
Method
(we suggest you read everything at least once before doing anything)
1) Arrange the feta, labneh, za’atar, and olive oil in separate little serving dishes.
2) Arrange everything else around them on a platter.
3) Serve! You may be thinking: did we really need a recipe to tell us “put the things on a plate”? The answer here is that this one today was shared mostly as a matter of inspiration, because when was the last time you thought to serve herbs as the star of the dish? Plus, it’s an excuse to try za’atar, not something so commonly seen outside of the Levant.
An alternative presentation
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Herbs for Evidence-Based Health & Healing
- Making Friends With Your Gut (You Can Thank Us Later)
- 10 Ways To Balance Blood Sugars
Take care!
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The Kindness Method – by Shahroo Izadi
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Shahroo Izadi here covers everything from alcohol addiction to procrastination to weight loss. It’s a catch-all handbook for changing your habits—in general, and/or in whatever area of your life you most feel you want or need to.
She herself went from yo-yo dieting to a stable healthy lifestyle, and wants to share with us how she did it. So she took what worked for her, organized and dilstilled it, and named it “the kindness method”, which…
- promotes positivity not in a “head in the sand” sense but rather: you have strengths, let’s find them and use them
- offers many exploratory exercises to help you figure out what’s actually going to be best for you
- plans support in advance—you’re going to be your own greatest ally here
Basically it’s about:
- being kind to yourself rather than setting yourself up to fail, and “judging a fish by how well it can climb a tree”
- being kind to yourself by being compassionate towards your past self and moving on with lessons learned
- being kind to yourself by getting things in order for your future self, because you need to treat your future self like a loved one
In fact, why not buy a copy of this book as a gift for your future self?
Click Here To Order Your Copy of “The Kindness Method” on Amazon Today!
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Dry Needling for Meralgia Paresthetica?
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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
❝Could you address dry needling, who should administer it, and could it be a remedy for meralgia paresthetica? If not, could you speak to home-based remedies for meralgia paresthetica? Thank you?❞
We’ll need to take a main feature some time to answer this one fully, but we will say some quick things here:
- Dry needling, much like acupuncture, has been found to help with pain relief.
- Meralgia paresthetica, being a neuropathy, may benefit from some things that benefit people with peripheral neuropathy, such as lion’s mane mushroom. There is definitely not research to support this hypothesis yet though (so far as we could find anyway; there is plenty to support lion’s mane helping with nerve regeneration in general, but nothing specific for meralgia paresthetica).
Some previous articles you might enjoy meanwhile:
- Pinpointing The Usefulness Of Acupuncture
- Science-Based Alternative Pain Relief
- Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
- What Does Lion’s Mane Actually Do, Anyway?
Take care!
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ADHD 2.0 – by Dr. Edward Hallowell & Dr. John Ratey
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A lot of ADHD literature is based on the assumption that the reader is a 30-something parent of a child with ADHD. This book, on the other hand, addresses all ages, and includes just as readily the likelihood that the person with ADHD is the reader, and/or the reader’s partner.
The authors cover such topics as:
- ADHD mythbusting, before moving on to…
- The problems of ADHD, and the benefits that those exact same traits can bring too
- How to leverage those traits to get fewer of the problems and more of the benefits
- The role of diet beyond the obvious, including supplementation
- The role of specific exercises (especially HIIT, and balance exercises) in benefiting the ADHD brain
- The role of medications—and arguments for and gainst such
The writing style is… Thematic, let’s say. The authors have ADHD and it shows. So, expect comprehensive deep-dives from whenever their hyperfocus mode kicked in, and expect no stones left unturned. That said, it is very readable, and well-indexed too, for ease of finding specific sub-topics.
Bottom line: if you are already very familiar with ADHD, you may not learn much, and might reasonably skip this one. However, if you’re new to the topic, this book is a great—and practical—primer.
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Red Cabbage vs Cauliflower – Which is Healthier?
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Our Verdict
When comparing red cabbage to cauliflower, we picked the cabbage.
Why?
In terms of macros, there’s no meaningful difference between them; they’re both mostly water with just enough fiber to hold them together, a small amount of carbs, and an even more trivial amount of protein. So, a tie on macros.
Looking at the vitamins, red cabbage has more of vitamins A, B1, B2, B6, C, E, and K, while cauliflower has more of vitamins B3, B5, B9, and choline. So, a 7:4 win for red cabbage.
In the category of minerals, red cabbage has more calcium, manganese, and iron, while cauliflower has more copper, phosphorus, and potassium. The margins of difference are comparable too, thus, a 3:3 tie on minerals.
It’s always worth taking a look at polyphenols for plants like these, but in this case, once again, there’s not much to set one above the other. However, it’s good to note also that despite them both being Brassica oleracea (same species, different cultivar), there isn’t much overlap in their polyphenol content, meaning they complement each other very well. In particular, red cabbage is a source of luteolin and quercetin, while cauliflower is a source of gallic acid and caffeic acid, for example.
Adding up the three ties and the one win for red cabbage, gives the cabbage the victory today—but do enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
21 Most Beneficial Polyphenols & What Foods Have Them
Enjoy!
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Climate Change Threatens the Mental Well-Being of Youths. Here’s How To Help Them Cope.
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We’ve all read the stories and seen the images: The life-threatening heat waves. The wildfires of unprecedented ferocity. The record-breaking storms washing away entire neighborhoods. The melting glaciers, the rising sea levels, the coastal flooding.
As California wildfires stretch into the colder months and hurricane survivors sort through the ruins left by floodwaters, let’s talk about an underreported victim of climate change: the emotional well-being of young people.
A nascent but growing body of research shows that a large proportion of adolescents and young adults, in the United States and abroad, feel anxious and worried about the impact of an unstable climate in their lives today and in the future.
Abby Rafeek, 14, is disquieted by the ravages of climate change, both near her home and far away. “It’s definitely affecting my life, because it’s causing stress thinking about the future and how, if we’re not addressing the problem now as a society, our planet is going to get worse,” says Abby, a high school student who lives in Gardena, California, a city of 58,000 about 15 miles south of downtown Los Angeles.
She says wildfires are a particular worry for her. “That’s closer to where I live, so it’s a bigger problem for me personally, and it also causes a lot of damage to the surrounding areas,” she says. “And also, the air gets messed up.”
In April, Abby took a survey on climate change for kids ages 12-17 during a visit to the emergency room at Children’s Hospital of Orange County.
Rammy Assaf, a pediatric emergency physician at the hospital, adapted the survey from one developed five years ago for adults. He administered his version last year to over 800 kids ages 12-17 and their caregivers. He says initial results show climate change is a serious cause of concern for the emotional security and well-being of young people.
Assaf has followed up with the kids to ask more open-ended questions, including whether they believe climate change will be solved in their lifetimes; how they feel when they read about extreme climate events; what they think about the future of the planet; and with whom they are able to discuss their concerns.
“When asked about their outlook for the future, the first words they will use are helpless, powerless, hopeless,” Assaf says. “These are very strong emotions.”
Assaf says he would like to see questions about climate change included in mental health screenings at pediatricians’ offices and in other settings where children get medical care. The American Academy of Pediatrics recommends that counseling on climate change be incorporated into the clinical practice of pediatricians and into medical school curriculums, but not with specific regard to mental health screening.
Assaf says anxiety about climate change intersects with the broader mental health crisis among youth, which has been marked by a rise in depression, loneliness, and suicide over the past decade, though there are recent signs it may be improving slightly.
A 2022 Harris Poll of 1,500 U.S. teenagers found that 89% of them regularly think about the environment, “with the majority feeling more worried than hopeful.” In addition, 69% said they feared they and their families would be affected by climate change in the near future. And 82% said they expected to have to make key life decisions — including where to live and whether to have children — based on the state of the environment.
And the impact is clearly not limited to the U.S. A 2021 survey of 10,000 16- to 25-year-olds across 10 countries found “59% were very or extremely worried and 84% were at least moderately worried” about climate change.
Susan Clayton, chair of the psychology department at the College of Wooster in Ohio, says climate change anxiety may be more pronounced among younger people than adults. “Older adults didn’t grow up being as aware of climate change or thinking about it very much, so there’s still a barrier to get over to accept it’s a real thing,” says Clayton, who co-created the adult climate change survey that Assaf adapted for younger people.
By contrast, “adolescents grew up with it as a real thing,” Clayton says. “Knowing you have the bulk of your life ahead of you gives you a very different view of what your life will be like.” She adds that younger people in particular feel betrayed by their government, which they don’t think is taking the problem seriously enough, and “this feeling of betrayal is associated with greater anxiety about the climate.”
Abby believes climate change is not being addressed with sufficient resolve. “I think if we figure out how to live on Mars and explore the deep sea, we could definitely figure out how to live here in a healthy environment,” she says.
If you are a parent whose children show signs of climate anxiety, you can help.
Louise Chawla, professor emerita in the environmental design program at the University of Colorado-Boulder, says the most important thing is to listen in an open-ended way. “Let there be space for kids to express their emotions. Just listen to them and let them know it’s safe to express these emotions,” says Chawla, who co-founded the nonprofit Growing Up Boulder, which works with the city’s schools to encourage kids to engage civically, including to help shape their local environment.
Chawla and others recommend family activities that reinforce a commitment to the environment. They can be as simple as walking or biking and participating in cleanup or recycling efforts. Also, encourage your children to join activities and advocacy efforts sponsored by environmental, civic, or religious organizations.
Working with others can help alleviate stress and feelings of powerlessness by reassuring kids they are not alone and that they can be proactive.
Worries about climate change should be seen as a learning opportunity that might even lead some kids to their life’s path, says Vickie Mays, professor of psychology and health policy at UCLA, who teaches a class on climate change and mental health — one of eight similar courses offered recently at UC campuses.
“We should get out of this habit of ‘everything’s a mental health problem,’” Mays says, “and understand that often a challenge, a stress, a worry can be turned into advocacy, activism, or a reach for new knowledge to change the situation.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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