Do You Have A Personalized Health Plan? (Here’s How)
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“Good health” is quite a broad umbrella, and while we all have a general idea of what “healthy” looks like, it’s easy to focus on some areas and overlook others.
Of course, how much one does this will still depend on one’s level of interest in health, which can change over the course of life, and (barring serious midlife health-related curveballs such as a cancer diagnosis or something) often looks like an inverse bell curve:
- As small kids, we probably barely thought about health
- As teenagers, we probably had a narrow view of health (often related to whatever is considered sexually attractive at the time)
- In our 20s, may have a bit of a health kick in which we learn and apply a lot… Which often then gets to later take a bit of a back seat to work responsibilities and so forth
- This is commonly followed by a few decades of just trying to make it to Friday by any means necessary (definite risk factor for substance abuse of various kinds), double if we have kids, triple if we have work, kids, and are also solely responsible for managing the household.
- Then just as suddenly as it is predictably, we are ambushed when approaching retirement age by a cluster of age-related increased health risks that we now get to do our best to mitigate—the focus here is “not dying early”. A lot of health education occurs at this time.
- Finally, upon retirement, we actually get the time to truly focus on our health again, and now it’s easier to learn about all aspects of health, even if now there’s a need to juggle many health issues all at once, most of which affect the others.
See also: How Likely Are You To Live To 100? ← in which we can also see a graph of 10almonds subscribers’ ages, consistent with the above
So, let’s recap, and personalize our health plan
There are often things we wish we could have focused on sooner, so now’s the time to figure out what future-you in your next decade (or later!) is going to thank you for having done now.
So, while 20-year-old us might have been focusing on fat levels or athletic performance, how much does that really help us now? (With apologies to any readers in their 20s, but also, with the bonus for you: now’s the perfect time to plan ahead!)
At 10almonds, while we cover very many health topics, we often especially focus on:
- Brain health
- Heart health
- Gut health
…because they affect everything else so much. We’ve listed them there in the order they appear in the body, but in fact it can be useful to view them upside down, because:
- Gut health is critical for good metabolic health (a happy efficient gut allows us to process nutrients, including energy, efficiently)
- Metabolic health is critical for good heart health (a nicely ticking metabolism will not strain our heart)
- Heart health is critical for good brain health (a strong heart will nourish the brain with well-oxygenated blood and the nutrients it also carries)
So, this isn’t a catch-22 at all! There is a clear starting point:
“How do I do the other bits, though?”
We have you covered here: Your Health Audit, From Head To Toe
“Wait, where’s the personalization?”
This comes once you’ve got those above things in order.
Hopefully you know what particular health risks you have—as in, particular to you.
First, you will have any current diagnoses, and a plan for treating those. Many chronic illnesses can be reversed or at least lessened with lifestyle changes, in particular, if we reduce chronic inflammation, which is implicated in countless chronic illnesses, and exacerbates most of the rest.
So: How to Prevent (or Reduce) Inflammation
The same goes for any heightened risks you have as a result of those current diagnoses.
Next, you will have any genetic health risks—so here’s where genetic testing is a good one-shot tool, to get a lot of information all in one go.
Learn more: The Real Benefit Of Genetic Testing
…and then, of course, take appropriate steps to avoid suffering the things of which you are at increased genetic risk.
Finally, you will have any personal concerns or goals—in other words, what do you want to still be able to do, later in life? It’s easy to say “everything”, but what’s most important?
This writer’s example: I want to remain mobile, free from pain, and sharp of mind.
That doesn’t mean I’ll neglect the rest of my health, but it does mean that I will regularly weigh my choices against whether they are consistent with those three things.
As for how to plan for that?
Check out: Train For The Event Of Your Life! ← this one is mostly about the mobility aspect; staying free from pain is in large part a matter of avoiding inflammation which we already discussed, and staying sharp of mind relies on the gut-heart-brain pipeline we also covered.
You can also, of course, personalize your diet per which areas of health are the most important for you:
Four Ways To Upgrade The Mediterranean (most anti-inflammatory, gut-healthiest, heart-healthiest, brain-healthiest)
Take care!
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The 6 Dimensions Of Sleep (And Why They Matter)
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How Good Is Your Sleep, Really?
This is Dr. Marie-Pierre St-Onge, Director of Columbia University’s Center of Excellence for Sleep and Circadian Research.
The focus of Dr. St-Onge’s research is the study of the impact of lifestyle, especially sleep and diet, on cardio-metabolic risk factors.
She conducts clinical research combining her expertise on sleep, nutrition, and energy regulation.
What kind of things do her studies look at?
Her work focuses on questions about…
- The role of circadian rhythms (including sleep duration and timing)
- Meal timing and eating patterns
…and their impact on cardio-metabolic risk.
What does she want us to know?
First things first, when not to worry:
❝Getting a bad night’s sleep once in a while isn’t anything to worry about. That’s what we would describe as transient insomnia. Chronic insomnia occurs when you spend three months or more without regular sleep, and that is when I would start to be concerned.❞
But… as prevention is (as ever) better than cure, she also advises that we do pay attention to our sleep! And, as for how to do that…
The Six Dimensions of Sleep
One useful definition of overall sleep health is the RU-Sated framework, which assesses six key dimensions of sleep that have been consistently associated with better health outcomes. These are:
- regularity
- satisfaction with sleep
- alertness during waking hours
- timing of sleep
- efficiency of sleep
- duration of sleep
You’ll notice that some of these things you can only really know if you use a sleep-monitoring app. She does recommend the use of those, and so do we!
We reviewed and compared some of the most popular sleep-monitoring apps! You can check them out here: Time For Some Pillow Talk
You also might like…
We’re not all the same with regard to when is the best time for us to sleep, so:
Use This Sleep Cycle Calculator To Figure Out the Optimal Time for You To Go to Bed and Wake Up
AROUND THE WEB
What’s happening in the health world…
- Aspirin may make your breathing worse
- Taking naps for more than 30 minutes may raise your metabolic disease risk
- How to ease back into exercise after surgery
- Study provides evidence that breathing exercises may reduce your Alzheimer’s risk
- No one in movies knows how to swallow a pill
More to come tomorrow!
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Why do I need to get up during the night to wee? Is this normal?
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It can be normal to wake up once or even twice during the night to wee, especially as we get older.
One in three adults over 30 makes at least two trips to the bathroom every night.
Waking up from sleep to urinate on a regular basis is called nocturia. It’s one of the most commonly reported bothersome urinary symptoms (others include urgency and poor stream).
So what causes nocturia, and how can it affect wellbeing?
A range of causes
Nocturia can be caused by a variety of medical conditions, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an overactive bladder, or gastrointestinal issues. Other causes include pregnancy, medications and consumption of alcohol or caffeine before bed.
While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or insomnia, can also cause nocturia.
When we sleep, an antidiuretic hormone is released that slows down the rate at which our kidneys produce urine. If we lie awake at night, less of this hormone is released, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.
Stress, anxiety and watching television late into the night are common causes of insomnia.
Sometimes we need to get up late at night to pee.
Christian MoroEffects of nocturia on daily functioning
The recommended amount of sleep for adults is between seven and nine hours per night. The more times you have to get up in the night to go to the bathroom, the more this impacts sleep quantity and quality.
Decreased sleep can result in increased tiredness during the day, poor concentration, forgetfulness, changes in mood and impaired work performance.
If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.
In more severe cases, nocturia has been compared to having a similar impact on quality of life as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.
Nocturia not only upsets sleep, but also increases the risk of falls from moving around in the dark to go to the bathroom.
Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.
Can you have a ‘small bladder’?
It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is smaller relative to your other organs.
If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.
If you find you are going to the bathroom quite a lot during the day and evening (more than eight times in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.
If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.
There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.
A happy and healthy bladder
Here are some tips to maintain a happy and healthy bladder, and reduce the risk you’ll be up at night:
- make your sleep environment comfortable, with a suitable mattress and sheets to suit the temperature
- get to bed early, and limit screens, or activites before bed
- limit foods and drinks that irritate the bladder, such as coffee or alcohol, especially before bedtime
- sit in a relaxed position when urinating, and allow time for the bladder to completely empty
- practice pelvic floor muscle exercises
- drink an adequate amount of fluids during the day, and avoid becoming dehydrated
- maintain a healthy lifestyle, eat nutritious foods and do not do anything harmful to the body such as smoking or using illicit drugs
- review your medications, as the time you take some pharmaceuticals may affect urine production or sleep
- if you have swollen legs, raise them a few hours before bedtime to let the fluid drain.
Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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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
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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Semaglutide for Weight Loss?
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Semaglutide for weight loss?
Semaglutide is the new kid on the weight-loss block, but it’s looking promising (with some caveats!).
Most popularly by brand names Ozempic and Wegovy, it was first trialled to help diabetics*, and is now sought-after by the rest of the population too. So far, only Wegovy is FDA-approved for weight loss. It contains more semaglutide than Ozempic, and was developed specifically for weight loss, rather than for diabetes.
*Specifically: diabetics with type 2 diabetes. Because it works by helping the pancreas to make insulin, it’s of no help whatsoever to T1D folks, sadly. If you’re T1D and reading this though, today’s book of the day is for you!
First things first: does it work as marketed for diabetes?
It does! At a cost: a very common side effect is gastrointestinal problems—same as for tirzepatide, which (like semaglutide) is a GLP-1 agonist, meaning it works the same way. Here’s how they measure up:
- Head-to-head study: Effects of subcutaneous tirzepatide versus placebo or semaglutide on pancreatic islet function and insulin sensitivity in adults with type 2 diabetes
- Head-to-head systematic review: Semaglutide for the treatment of type 2 Diabetes Mellitus: A systematic review and network meta-analysis of safety and efficacy outcomes
As you can see, both of them work wonders for pancreatic function and insulin sensitivity!
And, both of them were quite unpleasant for around 20% of participants:
❝Tirzepatide, oral and SC semaglutide has a favourable efficacy in treating T2DM. Gastrointestinal adverse events were highly recorded in tirzepatide, oral and SC semaglutide groups.❞
What about for weight loss, if not diabetic?
It works just the same! With just the same likelihood of gastro-intestinal unpleasantries, though. There’s a very good study that was done with 1,961 overweight adults; here it is:
Once-Weekly Semaglutide in Adults with Overweight or Obesity
The most interesting things here are the positive results and the side effects:
❝The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo, for an estimated treatment difference of −12.4 percentage points (95% confidence interval [CI], −13.4 to −11.5; P<0.001).❞
In other words: if you take this, you’re almost certainly going to get something like 6x better weight loss results than doing the same thing without it.
❝Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%])❞
~ ibid.
In other words: you have about a 3% chance of having unpleasant enough side effects that you don’t want to continue treatment (contrast this with the 20%ish chance of unpleasant side effects of any extent)!
Any other downsides we should know about?
If you stop taking it, weight regain is likely. For example, a participant in one of the above-mentioned studies who lost 22% of her body weight with the drug’s help, says:
❝Now that I am no longer taking the drug, unfortunately, my weight is returning to what it used to be. It felt effortless losing weight while on the trial, but now it has gone back to feeling like a constant battle with food. I hope that, if the drug can be approved for people like me, my [doctor] will be able to prescribe the drug for me in the future.❞
~ Jan, a trial participant at UCLH
Is it injection-only, or is there an oral option?
An oral option exists, but (so far) is on the market only in the form of Rybelsus, another (slightly older) drug containing semaglutide, and it’s (so far) only FDA-approved for diabetes, not for weight loss. See:
A new era for oral peptides: SNAC and the development of oral semaglutide for the treatment of type 2 diabetes ← for the science
FDA approves first oral GLP-1 treatment for type 2 diabetes ← For the FDA statement
Where can I get these?
Availability and prescribing regulations vary by country (because the FDA’s authority stops at the US borders), but here is the website for each of them if you’d like to learn more / consider if they might help you:
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Young Mind Young Body – by Sue Ziang
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This is a very “healthy mind in a healthy body” book, consistent with the author’s status as a holistic health coach. Sometimes that produces a bit of a catch-22 regarding where to start, but for Ziang, the clear answer is to start with the mind, and specifically, one’s perception of one’s own age.
She advocates for building a young mind in a young body, and yes, that’s mind-building much like body-building. This does not mean any kind of wilful self-delusion, but rather, choosing the things that we do get to choose along the way.
The bridge between mind and body, for Ziang, is meditation—which is reasonable, as it’s very much mind-stuff and also very much neurological and has a very real-world impact on the body’s broader health, even simply by such mechanisms as changing breathing, heart rate, neurotransmitter levels, endocrine functions, and the like.
When it comes to the more physical aspects of health, her dietary advice is completely in line with what we write here at 10almonds. Hydrate well, eat more plants, especially beans and greens and whole grains, get good fats in, enjoy spices, practice mindful eating, skip the refined carbohydrates, be mindful of bio-individuality (e.g. one’s own personal dietary quirks that stem from physiology; some of us react differently to this kind of food or that for genetic reasons, and that’s not something to be overlooked).
In the category of exercise, she’s simply about moving more, which while not comprehensive, is not bad advice either.
Bottom line: if you’re looking for an “in” to holistic health and wondering where to start, this book is a fine and very readable option.
Click here to check out “Young Mind Young Body”, and transform yours!
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5 Ways To Beat Afternoon Energy Slumps
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This is Nisha Vora, of Rainbow Plant Life fame. After graduating from Harvard Law School, she realized she hated being a lawyer, and pivoted completely to become what she now is 12 years later, a chef and health coach.
Here are her tips for boosting energy through the day:
Caffeine timing
If you don’t do caffeine at all, no need to change that, but if you do, Vora advises that midday is the best time for it, with a very good rationale:
- of course it should not be too late in the day, because the elimination half-life of caffeine (4–8 hours to eliminate just half of the caffeine, depending on genes, call it 6 hours as an average though honestly for most people it will either be 4 or 8, not 6) is such that it can easily interfere with sleep for most people
- because caffeine is an adenosine blocker, not an adenosine inhibitor, taking caffeine in the morning means either there’s no adenosine to block, or it’ll just “save” that adenosine for later, i.e. when the caffeine is eliminated, then the adenosine will kick in, meaning that your morning sleepiness has now been deferred to the afternoon, rather than eliminated.
Another reminder that caffeine is the “payday loan” of energy. So, midday it is. No morning sleepiness to defer, and yet also not so late as to interfere with sleep.
See also: Calculate (And Enjoy) The Perfect Night’s Sleep
Simplify what can be simplified
This one’s not from a physiological basis, but rather, that a lot of the time most of us have much of our energy being taken by constant task-switching (what gets called multitasking, but as our brain is a single processor, it really means switching rapidly between different kinds of cognition, which is not efficient). In order to avoid that energy drain, try to streamline things and make a particular effort to not only single-task, but to do so without distractions.
Counterpoint: if you have unmedicated ADHD, then chances are you’ll do better with a single small distraction chosen by you, than trying to go without distractions, because your brain will find distractions anyway, so you might as well choose one (for many people it is background music, or a podcast or TV show that one doesn’t may attention to but it’s there) as a matter of harm reduction, and that way you’ll do better at focusing on your primary task than if your brain were reaching out for every and any possible distraction.
Manage your blood sugars
In particular, she advocates for avoiding sugary breakfasts, opting instead for protein, fat, and fiber-rich options. For more in this regard, see:
10 Ways To Balance Your Blood Sugars
Walk after meals
You don’t have to don hiking boots and “I am just going outside and may be some time“; rather, even a 2–5 minute walk after a meal helps regulate digestion and glucose levels, avoiding postprandial energy slumps.
So,
- if you have a treadmill, after eating is a great time to use it for a few minutes
- if you have stairs, now’s a great time to go up and down them a few times
One last technique for when everything else fails
We’ll quote her directly on this one:
❝Despite my best efforts, soemtimes I just have one of those days. Maybe I didn’t sleep well or I’m distracted by my never ending thoughts. If I need to be productive or energized on those days, I will do something that I absolutely hate:
I will take a cold shower.
And I hate it because I’m already always cold all the time, so why would I want to get a cold shower?
Well, it’s because cold water immersion has been shown to dramatically boost your dopamine levels, which gives you more energy and motivation.
In the moment though, it’s mostly painful and I hate everything and everyone around me.
But I know that if I can suffer through two minutes of a cold shower, I will feel so refreshed.❞
There are more benefits than just that, though, see:
A Cold Shower A Day Keeps The Doctor Away?
Want more from Nisha Vora?
We reviewed one of her books a while back:
The Vegan Instant Pot Cookbook – by Nisha Vora
Enjoy!
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