Track Your Blood Sugars For Better Personalized Health
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There Will Be Blood
Are you counting steps? Counting calories? Monitoring your sleep? Heart rate zones? These all have their merits:
- Steps: One More Resource Against Osteoporosis!
- Calories: Is Cutting Calories The Key To Healthy Long Life?
- Sleep: A Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
- Heart Rate Zones: Heart Rate Zones, Oxalates, & More
About calories: this writer (it’s me, hi) opines that intermittent fasting has the same benefits as caloric restriction, without the hassle of counting, and is therefore superior. I also personally find fasting psychologically more pleasant. However, our goal here is to be informative, not prescriptive, and some people may have reasons to prefer CR to IF!
Examples that come to mind include ease of adherence in the case of diabetes management, especially Type 1, or if one’s schedule (and/or one’s “medications that need to be taken with food” schedule) does not suit IF.
And now for the blood…
A rising trend in health enthusiasts presently is the use of Continuous Glucose Monitors (CGMs), which do exactly what is sounds like they do: they continually monitor glucose. Specifically, the amount of it in your blood.
Of course, these have been in use in diabetes management for years; the technology is not new, but the application of the technology is.
A good example of what benefits a non-diabetic person can gain from the use of a CGM is Jessie Inchauspé, the food scientist of “Glucose Revolution” and “The Glucose Goddess Method” fame.
By wearing a CGM, she was able to notice what things did and didn’t spike her blood sugars, and found that a lot of the things were not stuff that people knew/advised about!
For example, much of diabetes management (including avoiding diabetes in the first place) is based around paying attention to carbs and little else, but she found that it made a huge difference what she ate (or didn’t) with the carbs. By taking many notes over the course of her daily life, she was eventually able to isolate these patterns, showed her working-out in The Glucose Revolution (there’s a lot of science in that book), and distilled that information into bite-size (heh) advice such as:
10 Ways To Balance Blood Sugars
That’s great, but since people like Inchauspé have done the work, I don’t have to, right?
You indeed don’t have to! But you can still benefit from it. For example, fastidious as her work was, it’s a sample size of one. If you’re not a slim white 32-year-old French woman, there may be some factors that are different for you.
All this to say: glucose responses, much like nutrition in general, are not a one-size-fits-all affair.
With a CGM, you can start building up your own picture of what your responses to various foods are like, rather than merely what they “should” be like.
This, by the way, is also one of the main aims of personalized health company ZOE, which crowdsourced a lot of scientific data about personalized metabolic responses to standardized meals:
Not knowing these things can be dangerous
We don’t like to scaremonger here, but we do like to point out potential dangers, and in this case, blindly following standardized diet advice, if your physiology is not standard, can have harmful effects, see for example:
Diabetic-level glucose spikes seen in non-diabetic people
Where can I get a CGM?
We don’t sell them, and neither does Amazon, but you can check out some options here:
The 4 Best CGM Devices For Measuring Blood Sugar in 2024
…and if your doctor is not obliging with a prescription, note that the device that came out top in the above comparisons, will be available OTC soon:
The First OTC Continuous Glucose Monitor Will Be Available Summer 2024
Take care!
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The Whole-Body Approach to Osteoporosis – by Keith McCormick
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You probably already know to get enough calcium and vitamin D, and do some resistance training. What does this book offer beyond that advice?
It’s pretty comprehensive, as it turns out. It covers the above, plus the wide range of medications available, what supplements help or harm or just don’t have enough evidence either way yet, things like that.
Amongst the most important offerings are the signs and symptoms that can help monitor your bone health (things you can do at home! Like examinations of your fingernails, hair, skin, tongue, and so forth, that will reveal information about your internal biochemical make-up), as well as what lab tests to ask for. Which is important, as osteoporosis is one of those things whereby we often don’t learn something is wrong until it’s too late.
The author is a chiropractor, which doesn’t always have a reputation as the most robustly science-based of physical therapy options, but he…
- doesn’t talk about chiropractic
- did confer with a flock of experts (osteopaths, nutritionists, etc) to inform/check his work
- does refer consistently to good science, and explains it well
- includes 16 pages of academic references, and yes, they are very reputable publications
Bottom line: this one really does give what the subtitle promises: a whole body approach to avoiding (or reversing) osteoporosis.
Click here to check out The Whole Body Approach To Osteoporosis; sooner is better than later!
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Solitary Fitness – by Charles Bronson
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Sometimes it can seem that every new diet and/or exercise regime you want to try will change your life, if just you first max out your credit card on restocking your kitchen and refurbishing your home gym, not to mention buying all the best supplements, enjoying the latest medical gadgets, and so on and so forth.
And often… Most of those things genuinely are good! And it’s great that such things are becoming more accessible and available.
But… Wouldn’t it be nice to know how to have excellent strength and fitness without any of that, even if just as a “bare bones” protocol to fall back on? That’s what Manson provides in this book.
The writing style is casual and friendly; Manson is not exactly an academic, but he knows his stuff when it comes to what works. And a good general rule of thumb is: if it’s something that he can do in his jail cell, we can surely do it in the comfort of our homes.
Bottom line: if you want functional strength and fitness with zero gimmicks, this is the book for you (as an aside, it’s also simply an interesting and recommendable read, sociologically speaking, but that’s another matter entirely).
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Why it’s a bad idea to mix alcohol with some medications
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Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.
But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.
When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.
How alcohol and medicines interact
The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to convulsions. Too much inhibition and you will experience effects like sedation and depression.
Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.
With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.
Medications can interact with alcohol to produce different or increased effects. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those effects can be compounded.
Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can increase the drug’s effect on the heart, increasing your heart rate and the risk of a heart attack.
Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.
Alcohol can increase the break-down of certain medicines, such as opioids, cannabis, seizures, and even ritalin. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with paracetamol.
At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.
Who is at most risk?
The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.
Older people do not break down medicines as quickly as younger people, and are often on more than one medication.
Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.
Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.
What drugs can’t you mix with alcohol?
You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.
The most common alcohol-interacting prescription medicines are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.
It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.
Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.
If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney; Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney; Kellie Charles, Associate Professor in Pharmacology, University of Sydney, and Tina Hinton, Associate Professor of Pharmacology, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians
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Our ageing population brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).
Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are living with dual sensory impairment.
Combined vision and hearing loss describes any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is increasingly common as people get older.
The experience can make older people feel isolated and unable to participate in important conversations, including about their health.
Causes and conditions
Conditions related to hearing and vision impairment often increase as we age – but many of these changes are subtle.
Hearing loss can start as early as our 50s and often accompany other age-related visual changes, such as age-related macular degeneration.
Other age-related conditions are frequently prioritised by patients, doctors or carers, such as diabetes or heart disease. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our research told us
I don’t see too good or hear too well. It’s just part of old age.
An invisible disability
Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts social activities and communication, making it difficult for older adults to manage.
It is underdiagnosed, underrecognised and sometimes misattributed (for example, to cognitive impairment or decline). However, there is also growing evidence of links between dementia and dual sensory loss. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, feel happy and be safe.
A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:
There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.
Isolated yet more dependent on others
Global trends show a worrying conundrum. Older people with dual sensory impairment become more socially isolated, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.
One aspect of this is how effectively they can comprehend and communicate in a health-care setting. Recent research shows doctors and nurses in hospitals aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, researchers note. It facilitates:
- shorter hospital stays
- fewer re-admissions
- reduced emergency room visits
- better treatment adherence and medical follow up
- less unnecessary diagnostic testing
- improved health-care outcomes.
‘Too hard’
Globally, there is a better understanding of how important it is to maintain active social lives as people age. But this is difficult for older adults with dual sensory loss. One person told us
I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.
Again, these experiences increase reliance on family. But caring in this context is tough and largely hidden. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring frustration, social isolation and depression for carers too. One spouse told us:
He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.
So, what can we do?
Dual sensory impairment is a growing problem with potentially devastating impacts.
It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.
We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to navigate health care.
Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.
Moira Dunsmore, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, University of Sydney; Annmaree Watharow, Lived Experience Research Fellow, Centre for Disability Research and Policy, University of Sydney, and Emily Kecman, Postdoctoral research fellow, Department of Linguistics, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Retinoids: Retinol vs Retinal vs Retinoic Acid vs..?
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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 😎
❝I’m confused about retinol, retinal, retinoin, retinoids, etc, and of course every product claims to be the best, what’s the actual science on it?❞
Before we get into these skincare products, let’s first note that for most people, what’s best for the skin is good sleep and hydration, a plants-centric whole foods diet, and good stress management:
See for example: Of Brains And Breakouts: The Brain Skin Doctor
However, the world of potions and lotions can be an alluring one, and there is some merit there too. So, in a nutshell:
- Retinoids are the overall class of chemicals, and not a specific type
- Retinoic acid is the strongest form of this chemical and is prescription-controlled in most places
- “Retinoin” is probably tretinoin (all-trans retinoic acid) with the “t” having falling off; we can only find it being used as a product name, not an actual substance
- Retinal, when it’s not an adjective referring to the retina (the part of the eye that receives refocussed light) and is instead a noun, is a less potent retinoid than the prescription-only kinds, but still stronger than retinol
- Retinol is a much less potent form, and is the most widely found in skincare products
- Retinoic acid is the strongest form of this chemical and is prescription-controlled in most places
All of them work the same way; it is only how serious they are about it that differs.
The mechanism of action is that they speed up the turnover (shedding cycle) of skin, so that cells are replaced sooner. As with any non-cancerous human tissue, this means that the tissue itself (in this case, your skin) will be biologically younger than if it had been replaced later.
The downside, of course, of this is that—while trying to make your skin healthier and more beautiful—the first thing that will happen is skin shedding. Depending on the retinoid type, dose, and the health of your skin to start with, this may mean anything from needing to exfoliate in the morning, to having to go to hospital with what looks like the world’s worst sunburn. For this reason, it is recommended to start with weaker products and lower doses, and work up carefully.
A note on doses: the recommended doses for these products are always truly tiny, like “use a pea-sized amount of this 0.05% serum on your face”. Take them seriously until you’re absolutely sure from experience that your skin can handle more.
Also, a tip: wear gloves when you apply any of the above products. This is because your fingers are also covered in skin, and if you don’t use gloves, then half the product that you intended for your face will be absorbed into your fingers instead.
You can learn more about the science of retinoids here, in our article about tretinoin, the usually prescription-only form of retinoic acid:
Tretinoin: Undo The Sun’s Damage To Your Skin
Want to try some?
We don’t sell it, but here for your convenience is an example product of retinal (stronger than retinol) on Amazon 😎
Take care!
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- Retinoids are the overall class of chemicals, and not a specific type