Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
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Chronic Obstructive Pulmonary Disease (COPD): More Likely Than You Think
COPD is not so much one disease, as rather a collection of similar (and often overlapping) diseases. The main defining characteristic is that they are progressive lung diseases. Historically the most common have been chronic bronchitis and emphysema, though Long COVID and related Post-COVID conditions appear to have been making inroads.
Lung cancer is generally considered separately, despite being a progressive lung disease, but there is crossover too:
COPD prevalence is increased in lung cancer, independent of age, sex and smoking history
COPD can be quite serious:
“But I don’t smoke”
Great! In fact we imagine our readership probably has disproportionately few smokers compared to the general population, being as we all our interested in our health.
But, it’s estimated that 30,000,000 Americans have COPD, and approximately half don’t know it. Bear in mind, the population of the US is a little over 340,000,000, so that’s a little under 9% of the population.
Click here to see a state-by-state breakdown (how does your state measure up?)
How would I know if I have it?
It typically starts like any mild respiratory illness. Likely shortness of breath, especially after exercise, a mild cough, and a frequent need to clear your throat.
Then it will get worse, as the lungs become more damaged; each of those symptoms might become stronger, as well as chest tightness and a general lack of energy.
Later stages, you guessed it, the same but worse, and—tellingly—weight loss.
The reason for the weight loss is because you are getting less oxygen per breath, making carrying your body around harder work, meaning you burn more calories.
What causes it?
Lots of things, with smoking being up at the top, or being exposed to a lot of second-hand smoke. Working in an environment with a lot of air pollution (for example, working around chemical fumes) can cause it, as can inhaling dust. New Yorkers: yes, that dust too. It can also develop from other respiratory illnesses, and some people even have a genetic predisposition to it:
Alpha-1 antitrypsin deficiency: a commonly overlooked cause of lung disease
Is it treatable?
Treatment varies depending on what form of it you have, and most of the medical interventions are beyond the scope of this article. Suffice it to say, there are medications that can be taken (including bronchodilators taken via an inhaler device), corticosteroids, antibiotics and antivirals of various kinds if appropriate. This is definitely a “see your doctor” item though, because there are is far too much individual variation for us to usefully advise here.
However!
There are habits we can do to a) make COPD less likely and b) make COPD at least a little less bad if we get it.
Avoiding COPD:
- Don’t smoke. Just don’t.
- Avoid second-hand smoke if you can
- Avoid inhaling other chemicals/dust that may be harmful
- Breathe through your nose, not your mouth; it filters the air in a whole bunch of ways
- Seriously, we know it seems like nostril hairs surely can’t do much against tiny particles, but tiny particles are attracted to them and get stuck in mucous and dealt with by our immune system, so it really does make a big difference
Managing COPD:
- Continue the above things, of course
- Exercise regularly, even just light walking helps; we realize it will be difficult
- Maintain a healthy weight if you can
- This means both ways; COPD causes weight loss and that needs to be held in check. But similarly, you don’t want to be carrying excessive weight either; that will tire you even more.
- Look after the rest of your health; everything else will now hit you harder, so even small things need to be taken seriously
- If you can, get someone to help / do your household cleaning for you, ideally while you are not in the room.
Where can I get more help/advice?
As ever, speak to your doctor if you are concerned this may be affecting you. You can also find a lot of resources via the COPD Foundation’s website.
Take care of yourself!
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Treat Your Own Knee – by Robert McKenzie
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He’s a physiotherapist not a doctor, but with 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff.
The book covers recognizing the difference between arthritis, degeneration, or normal wear and tear, before narrowing down what your actual problem is and what can be done about it.
While there are many possible causes of knee pain (and by causes, we mean the first-level cause, such as “bad posture” or “old sports injury” or “inflammatory diet” or “repetitive strain” etc, not second-level causes that are also symptoms, like inflammation), McKenzie’s approach involves customizing his system to your body’s specific problems and needs. That’s what most of the book is about.
The style is direct and to-the-point; there’s no sensationalization here nor a feel of being sold anything. There’s lots of science scattered throughout, but all with the intent of enabling the reader to understand what’s going on with the problems, processes, and solutions, and why/how the things that work, work. Where there are exercises offered they are clearly-described and well-illustrated.
Bottom line: this is not a fancy book but it is an effective one. If you have knee pain, this is a very worthwhile one to read.
Click here to check out Treat Your Own Knee, and treat your own knee!
PS: if you have musculoskeletal problems elsewhere in your body, you might want to check out the rest of his body parts series (back, hip, neck, wrist, ankle, etc) for the one that’s tailored to your specific problem.
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How To Prevent And Reverse Type 2 Diabetes
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Turn back the clock on insulin resistance
This is Dr. Jason Fung. He’s a world-leading expert on intermittent fasting and low carbohydrate approaches to diet. He also co-founded the Intensive Dietary Management Program, later rebranded to the snappier title: The Fasting Method, a program to help people lose weight and reverse type 2 diabetes. Dr. Fung is certified with the Institute for Functional Medicine, for providing functional medicine certification along with educational programs directly accredited by the Accreditation Council for Continuing Medical Education (ACCME).
Why Intermittent Fasting?
Intermittent fasting is a well-established, well-evidenced, healthful practice for most people. In the case of diabetes, it becomes complicated, because if one’s blood sugars are too low during a fasting period, it will need correcting, thus breaking the fast.
Note: this is about preventing and reversing type 2 diabetes. Type 1 is very different, and sadly cannot be prevented or reversed in this fashion.
However, these ideas may still be useful if you have T1D, as you have an even greater need to avoid developing insulin resistance; you obviously don’t want your exogenous insulin to stop working.
Nevertheless, please do confer with your endocrinologist before changing your dietary habits, as they will know your personal physiology and circumstances in ways that we (and Dr. Fung) don’t.
In the case of having type 2 diabetes, again, please still check with your doctor, but the stakes are a lot lower for you, and you will probably be able to fast without incident, depending on your diet itself (more on this later).
Intermittent Fasting can be extra helpful for the body in the case of type 2 diabetes, as it helps give the body a rest from high insulin levels, thus allowing the body to become gradually re-sensitised to insulin.
Why low carbohydrate?
Carbohydrates, especially sugars, especially fructose*, cause excess sugar to be quickly processed by the liver and stored there. When the body’s ability to store glycogen is exceeded, the liver stores energy as fat instead. The resultant fatty liver is a major contributor to insulin resistance, when the liver can’t keep up with the demand; the blood becomes spiked full of unprocessed sugars, and the pancreas must work overtime to produce more and more insulin to deal with that—until the body starts becoming desensitized to insulin. In other words, type 2 diabetes.
There are other factors that affect whether we get type 2 diabetes, for example a genetic predisposition. But, our carb intake is something we can control, so it’s something that Dr. Fung focuses on.
*A word on fructose: actual fruits are usually diabetes-neutral or a net positive due to their fiber and polyphenols.
Fructose as an added ingredient, however, not so much. That stuff zips straight into your veins with nothing to slow it down and nothing to mitigate it.
The advice from Dr. Fung is simple here: cut the carbs. If you are already diabetic and do this with no preparation, you will probably simply suffer hypoglycemia, so instead:
- Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
- Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
- Eat carbs last (preferably whole, unprocessed carbohydrates), and stop eating when 80% full.
Adapting Intermittent Fasting to diabetes
Dr. Fung advocates for starting small, and gradually increasing your fasting period, until, ideally, fasting 16 hours per day. You probably won’t be able to do this immediately, and that’s fine.
You also probably won’t be able to do this, if you don’t also make the dietary adjustments that help to give your liver a break, and thus by knock-on-effect, give your pancreas a break too.
With the dietary adjustments too, however, your insulin production-and-response will start to return to its pre-diabetic state, and finally its healthy state, after which, it’s just a matter of maintenance.
Want to hear more from Dr. Fung?
You may enjoy his blog, and for those who like videos, here is his YouTube channel:
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Staying Healthy and Active After 60
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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: How to be your best self after 60: Self motivation / Avoiding or limiting salt, sugar & alcohol: Alternatives / Ways to sneak in more movements/exercise
…and, from a different subscriber…
Q: Inflammation & over 60 weight loss. Thanks!
Here are some of our greatest hits on those topics:
- Where Nutrition Meets Habits ← focusing on food that’s all three of: healthy + easy + cheap
- How To Keep On Keeping On ← exercise tips for when the motivation wanes
- Keep Inflammation At Bay ← science-based tips and advice
Also, while we’ve recommended a couple of books on stopping (or reducing) drinking, we’ve not done a main feature on that, so we definitely will one of these days!
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Screaming at Screens?
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I Screen, You Screen, We All Screen For…?
Dr. Kathryn Birkenbach is a postdoctoral research fellow in the Department of Neuroscience at Columbia University, and Manager of Research at Early Medical in New York.
Kathryn has things to tell us about kids’ neurological development, and screen time spent with electronic devices including phones, tablets, computers, and TVs.
From the 1960s criticism of “the gogglebox” to the modern-day critiques of “iPad babies” as a watchword of parental neglect, there’s plenty people can say against screen time, but Dr. Birkenbach tells us the that the reality is more nuanced:
Context Is Key
On a positive note”: consistent exposure to age-appropriate educational material results in quicker language acquisition than media that’s purely for entertainment purposes, or not age-appropriate.
Contrary to popular belief, children do not in fact learn by osmosis!
Interaction Is Far More Valuable Than Inaction
Kathryn advises that while adults tend to quite easily grasp things from instructional videos, the same does not go for small children.
This means that a lot of educational programming can be beneficial to small children if and only if there is an adult with them to help translate the visual into the practical!
There’s a story that does the rounds on the Internet: a young boy wanted to train his puppy, but didn’t know how. He asked, and was told “search for puppy training on YouTube”. His parents came back later and found him with his iPad, earnestly showing the training videos to the puppy.
We can laugh at the child’s naïvety, knowing that’s not how it works and the puppy will not learn that way, so why make the same mistake in turn?
❝The phenomenon known as the “video deficit effect” can be overcome, when an on-screen guide interacts with the child or a parent is physically present and draws the child’s attention to relevant information.
In other words, interaction with others appears to enhance the perceived salience of on-screen information, unlocking a child’s ability to learn from a medium which would otherwise offer no real-world benefit.❞
Screens Can Supplement, But Can’t Replace, Live Learning & Play
Sci-fi may show us “education pods” in which children learn all they need to from their screen… but according to our most up-to-date science, Dr. Birkenbach says, that simply would not work at all.
Screen time without adult interactions will typically fail to provide small children any benefit.
There is one thing it’s good at, though… attracting and keeping attention.
Thus, even a mere background presence of a TV show in the room will tend to actively reduce the time a small child spends on other activities, including live learning and exploratory play.
The attention-grabbing abilities of TV shows don’t stop at children, though! Adult caregivers will also tend to engage in fewer interactions with their children… and the interactions will be shorter and of lower quality.
In Summary:
- Young children will tend not to learn from non-interactive screen time
- Interactive screen time, ideally with a caregiver, can be educational
- Interactive screen time, not with a carer, can be beneficial (but a weak substitute)
- Interactive screen time refers to shows such as Dora The Explorer, where Dora directly addresses the viewer and asks questions…But it’s reliant on the child caring to answer!
- It can also mean interactive educational apps, provided the child does consciously interact!
- Randomly pressing things is not conscious interaction! The key here is engaging with it intelligently and thoughtfully
- A screen will take a child’s time and attention away from non-screen things: that’s a genuine measurable loss to their development!
Absolute Bottom Line:
Screens can be of benefit to small children, if and only if the material is:
- Age-Appropriate
- Educational
- Interactive
If it’s missing one of those three, it’ll be of little to no benefit, and can even harm, as it reduces the time spent on more beneficial activities.
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This Is Your Brain on Music – by Dr. Daniel Levitin
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Music has sometimes been touted as having cognitive benefits, by its practice and even by the passive experience of it. But what’s the actual science of it?
Dr. Levitin, an accomplished musician and neuroscientist, explores and explains.
We learn about how music in all likelihood allowed our ancestors to develop speech, something that set us apart (and ahead!) as a species. How music was naturally-selected-for in accordance with its relationship with health. How processing music involves almost every part of the brain. How music pertains specifically to memory. And more.
As a bonus, as well as explaining a lot about our brain, this book offers those of us with limited knowledge of music theory a valuable overview of the seven main dimensions of music, too.
Bottom line: if you’d like to know more about the many-faceted relationship between music and cognitive function, this is a top-tier book about such.
Click here to check out “This Is Your Brain On Music”, and learn more about yours!
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How to Fall Back Asleep After Waking Up in the Middle of the Night
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Dr. Michael Bruce, the Sleep Doctor, addresses a common concern: waking up in the middle of the night and struggling to fall back asleep.
Understanding the Wake-Up
Firstly, why are we waking up during the night?
Waking up between 2 AM and 3 AM is said to be normal, and linked to your core body temperature. As your body core temperature drops, to trigger melatonin release, and then rises again, you get into a lighter stage of sleep. This lighter stage of sleep makes you more prone to waking up.
Note, there are also some medical conditions (such as sleep apnea) that can cause you to wake up during the night.
But, what can we do about it? Aside from constantly shifting sleeping position (Should I be sleeping on my back? On my left? Right?)
Avoid the Clock
The first step is to resist the urge to check the time. It’s easy to be tempted to have a look at the clock, however, doing so can increase anxiety, making it harder to fall back asleep. As Dr. Bruce says, sleep is like love—the less you chase it, the more it comes.
It may be useful to point your alarm clock (if you still have one of those) the opposite direction to your bed.
Embracing Non-Sleep Deep Rest (NSDR)
Whilst this may not help you fall back asleep, it’s worth pointing out that just lying quietly in the dark without moving still offers rejuvenation. This revujenating stage is called Non-Sleep Deep Rest (otherwise known as NSDR)
If you’re not familiar with NSDR, check out our overview of Andrew Huberman’s opinions on NSDR here.
So, you can reassure yourself that whilst you may not be asleep, you are still resting.
Keep Your Heart Rate Down
To fall back asleep, it’s best if your heart rate is below 60 bpm. So, Dr. Bruce advises avoiding void getting up unnecessarily, as moving around can elevate your heart rate.
On a similar vain, he introduces the 4-7-8 breathing technique, which is designed to lower your heart rate. The technique is simple:
- Breathe in for 4 seconds.
- Hold for 7 seconds.
- Exhale for 8 seconds.
Repeat this cycle gently to calm your body and mind.
As per any of our Video Breakdowns, we only try to capture the most important pieces of information in text; the rest can be garnered from the video itself:
Wishing you a thorough night’s rest!
Do you know any other good videos on sleep? Send them to us via email!
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