What Would a Second Trump Presidency Look Like for Health Care?

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On the presidential campaign trail, former President Donald Trump is, once again, promising to repeal and replace the Affordable Care Act — a nebulous goal that became one of his administration’s splashiest policy failures.

“We’re going to fight for much better health care than Obamacare. Obamacare is a catastrophe,” Trump said at a campaign stop in Iowa on Jan. 6.

The perplexing revival of one of Trump’s most politically damaging crusades comes at a time when the Obama-era health law is even more popular and widely used than it was in 2017, when Trump and congressional Republicans proved unable to pass their own plan to replace it. That failed effort was a big part of why Republicans lost control of the House of Representatives in the 2018 midterms.

Despite repeated promises, Trump never presented his own Obamacare replacement. And much of what Trump’s administration actually accomplished in health care has been reversed by the Biden administration.

Still, Trump secured some significant policy changes that remain in place today, including efforts to bring more transparency to prices charged by hospitals and paid by health insurers.

Trying to predict Trump’s priorities in a second term is even more difficult given that he frequently changes his positions on issues, sometimes multiple times.

The Trump campaign did not respond to a request for comment.

Perhaps Trump’s biggest achievement is something he rarely talks about on the campaign trail. His administration’s “Operation Warp Speed” managed to create, test, and bring to market a covid-19 vaccine in less than a year, far faster than even the most optimistic predictions.

Many of Trump’s supporters, though, don’t support — and some even vehemently oppose — covid vaccines.

Here is a recap of Trump’s health care record:

Public Health

Trump’s pandemic response dominates his overall record on health care.

More than 400,000 Americans died from covid over Trump’s last year in office. His travel bans and other efforts to prevent the global spread of the virus were ineffective, his administration was slower than other countries’ governments to develop a diagnostic test, and he publicly clashed with his own government’s health officials over the response.

Ahead of the 2020 election, Trump resumed large rallies and other public campaign events that many public health experts regarded as reckless in the face of a highly contagious, deadly virus. He personally flouted public health guidance after contracting covid himself and ending up hospitalized.

At the same time, despite what many saw as a politicization of public health by the White House, Trump signed a massive covid relief bill (after first threatening to veto it). He also presided over some of the largest boosts for the National Institutes of Health’s budget since the turn of the century. And the mRNA-based vaccines Operation Warp Speed helped develop were an astounding scientific breakthrough credited with helping save millions of lives while laying the groundwork for future shots to fight other diseases including cancer.

Abortion

Trump’s biggest contribution to abortion policy was indirect: He appointed three Supreme Court justices, who were instrumental in overturning the constitutional right to an abortion.

During his 2024 campaign, Trump has been all over the place on the red-hot issue. Since the Supreme Court overturned Roe v. Wade in 2022, Trump has bemoaned the issue as politically bad for Republicans; criticized one of his rivals, Florida Gov. Ron DeSantis, for signing a six-week abortion ban; and vowed to broker a compromise with “both sides” on abortion, promising that “for the first time in 52 years, you’ll have an issue that we can put behind us.”

He has so far avoided spelling out how he’d do that, or whether he’d support a national abortion ban after any number of weeks.

More recently, however, Trump appears to have mended fences over his criticism of Florida’s six-week ban and more with key abortion opponents, whose support helped him get elected in 2016 — and whom he repaid with a long list of policy changes during his presidency.

Among the anti-abortion actions taken by the Trump administration were a reinstatement of the “Mexico City Policy” that bars giving federal funds to international organizations that support abortion rights; a regulation to bar Planned Parenthood and other organizations that provide abortions from the federal family planning program, Title X; regulatory changes designed to make it easier for health care providers and employers to decline to participate in activities that violate their religious and moral beliefs; and other changes that made it harder for NIH scientists to conduct research using fetal tissue from elective abortions.

All of those policies have since been overturned by the Biden administration.

Health Insurance

Unlike Trump’s policies on reproductive health, many of his administration’s moves related to health insurance still stand.

For example, in 2020, Trump signed into law the No Surprises Act, a bipartisan measure aimed at protecting patients from unexpected medical bills stemming from payment disputes between health care providers and insurers. The bill was included in the $900 billion covid relief package he opposed before signing, though Trump had expressed support for ending surprise medical bills.

His administration also pushed — over the vehement objections of health industry officials — price transparency regulations that require hospitals to post prices and insurers to provide estimated costs for procedures. Those requirements also remain in place, although hospitals in particular have been slow to comply.

Medicaid

While first-time candidate Trump vowed not to cut popular entitlement programs like Medicare, Medicaid, and Social Security, his administration did not stick to that promise. The Affordable Care Act repeal legislation Trump supported in 2017 would have imposed major cuts to Medicaid, and his Department of Health and Human Services later encouraged states to require Medicaid recipients to prove they work in order to receive health insurance.

Drug Prices

One of the issues the Trump administration was most active on was reducing the price of prescription drugs for consumers — a top priority for both Democratic and Republican voters. But many of those proposals were blocked by the courts.

One Trump-era plan that never took effect would have pegged the price of some expensive drugs covered by Medicare to prices in other countries. Another would have required drug companies to include prices in their television advertisements.

A regulation allowing states to import cheaper drugs from Canada did take effect, in November 2020. However, it took until January 2024 for the FDA, under Trump’s successor, to approve the first importation plan, from Florida. Canada has said it won’t allow exports that risk causing drug shortages in that country, leaving unclear whether the policy is workable.

Trump also signed into law measures allowing pharmacists to disclose to patients when the cash price of a drug is lower than the cost using their insurance. Previously pharmacists could be barred from doing so under their contracts with insurers and pharmacy benefit managers.

Veterans’ Health

Trump is credited by some advocates for overhauling Department of Veterans Affairs health care. However, while he did sign a major bill allowing veterans to obtain care outside VA facilities, White House officials also tried to scuttle passage of the spending needed to pay for the initiative.

Medical Freedom

Trump scored a big win for the libertarian wing of the Republican Party when he signed into law the “Right to Try Act,” intended to make it easier for patients with terminal diseases to access drugs or treatments not yet approved by the FDA.

But it is not clear how many patients have managed to obtain treatment using the law because it is aimed at the FDA, which has traditionally granted requests for “compassionate use” of not-yet-approved drugs anyway. The stumbling block, which the law does not address, is getting drug companies to release doses of medicines that are still being tested and may be in short supply.

Trump said in a Jan. 10 Fox News town hall that the law had “saved thousands and thousands” of lives. There’s no evidence for the claim.

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.

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  • How do science journalists decide whether a psychology study is worth covering?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Complex research papers and data flood academic journals daily, and science journalists play a pivotal role in disseminating that information to the public. This can be a daunting task, requiring a keen understanding of the subject matter and the ability to translate dense academic language into narratives that resonate with the general public.

    Several resources and tip sheets, including the Know Your Research section here at The Journalist’s Resource, aim to help journalists hone their skills in reporting on academic research.

    But what factors do science journalists look for to decide whether a social science research study is trustworthy and newsworthy? That’s the question researchers at the University of California, Davis, and the University of Melbourne in Australia examine in a recent study, “How Do Science Journalists Evaluate Psychology Research?” published in September in Advances in Methods and Practices in Psychological Science.

    Their online survey of 181 mostly U.S.-based science journalists looked at how and whether they were influenced by four factors in fictitious research summaries: the sample size (number of participants in the study), sample representativeness (whether the participants in the study were from a convenience sample or a more representative sample), the statistical significance level of the result (just barely statistically significant or well below the significance threshold), and the prestige of a researcher’s university.

    The researchers found that sample size was the only factor that had a robust influence on journalists’ ratings of how trustworthy and newsworthy a study finding was.

    University prestige had no effect, while the effects of sample representativeness and statistical significance were inconclusive.

    But there’s nuance to the findings, the authors note.

    “I don’t want people to think that science journalists aren’t paying attention to other things, and are only paying attention to sample size,” says Julia Bottesini, an independent researcher, a recent Ph.D. graduate from the Psychology Department at UC Davis, and the first author of the study.

    Overall, the results show that “these journalists are doing a very decent job” vetting research findings, Bottesini says.

    Also, the findings from the study are not generalizable to all science journalists or other fields of research, the authors note.

    “Instead, our conclusions should be circumscribed to U.S.-based science journalists who are at least somewhat familiar with the statistical and replication challenges facing science,” they write. (Over the past decade a series of projects have found that the results of many studies in psychology and other fields can’t be reproduced, leading to what has been called a ‘replication crisis.’)

    “This [study] is just one tiny brick in the wall and I hope other people get excited about this topic and do more research on it,” Bottesini says.

    More on the study’s findings

    The study’s findings can be useful for researchers who want to better understand how science journalists read their research and what kind of intervention — such as teaching journalists about statistics — can help journalists better understand research papers.

    “As an academic, I take away the idea that journalists are a great population to try to study because they’re doing something really important and it’s important to know more about what they’re doing,” says Ellen Peters, director of Center for Science Communication Research at the School of Journalism and Communication at the University of Oregon. Peters, who was not involved in the study, is also a psychologist who studies human judgment and decision-making.

    Peters says the study was “overall terrific.” She adds that understanding how journalists do their work “is an incredibly important thing to do because journalists are who reach the majority of the U.S. with science news, so understanding how they’re reading some of our scientific studies and then choosing whether to write about them or not is important.”

    The study, conducted between December 2020 and March 2021, is based on an online survey of journalists who said they at least sometimes covered science or other topics related to health, medicine, psychology, social sciences, or well-being. They were offered a $25 Amazon gift card as compensation.

    Among the participants, 77% were women, 19% were men, 3% were nonbinary and 1% preferred not to say. About 62% said they had studied physical or natural sciences at the undergraduate level, and 24% at the graduate level. Also, 48% reported having a journalism degree. The study did not include the journalists’ news reporting experience level.

    Participants were recruited through the professional network of Christie Aschwanden, an independent journalist and consultant on the study, which could be a source of bias, the authors note.

    “Although the size of the sample we obtained (N = 181) suggests we were able to collect a range of perspectives, we suspect this sample is biased by an ‘Aschwanden effect’: that science journalists in the same professional network as C. Aschwanden will be more familiar with issues related to the replication crisis in psychology and subsequent methodological reform, a topic C. Aschwanden has covered extensively in her work,” they write.

    Participants were randomly presented with eight of 22 one-paragraph fictitious social and personality psychology research summaries with fictitious authors. The summaries are posted on Open Science Framework, a free and open-source project management tool for researchers by the Center for Open Science, with a mission to increase openness, integrity and reproducibility of research.

    For instance, one of the vignettes reads:

    “Scientists at Harvard University announced today the results of a study exploring whether introspection can improve cooperation. 550 undergraduates at the university were randomly assigned to either do a breathing exercise or reflect on a series of questions designed to promote introspective thoughts for 5 minutes. Participants then engaged in a cooperative decision-making game, where cooperation resulted in better outcomes. People who spent time on introspection performed significantly better at these cooperative games (t (548) = 3.21, p = 0.001). ‘Introspection seems to promote better cooperation between people,’ says Dr. Quinn, the lead author on the paper.”

    In addition to answering multiple-choice survey questions, participants were given the opportunity to answer open-ended questions, such as “What characteristics do you [typically] consider when evaluating the trustworthiness of a scientific finding?”

    Bottesini says those responses illuminated how science journalists analyze a research study. Participants often mentioned the prestige of the journal in which it was published or whether the study had been peer-reviewed. Many also seemed to value experimental research designs over observational studies.

    Considering statistical significance

    When it came to considering p-values, “some answers suggested that journalists do take statistical significance into account, but only very few included explanations that suggested they made any distinction between higher or lower p values; instead, most mentions of p values suggest journalists focused on whether the key result was statistically significant,” the authors write.

    Also, many participants mentioned that it was very important to talk to outside experts or researchers in the same field to get a better understanding of the finding and whether it could be trusted, the authors write.

    “Journalists also expressed that it was important to understand who funded the study and whether the researchers or funders had any conflicts of interest,” they write.

    Participants also “indicated that making claims that were calibrated to the evidence was also important and expressed misgivings about studies for which the conclusions do not follow from the evidence,” the authors write.

    In response to the open-ended question, “What characteristics do you [typically] consider when evaluating the trustworthiness of a scientific finding?” some journalists wrote they checked whether the study was overstating conclusions or claims. Below are some of their written responses:

    • “Is the researcher adamant that this study of 40 college kids is representative? If so, that’s a red flag.”
    • “Whether authors make sweeping generalizations based on the study or take a more measured approach to sharing and promoting it.”
    • “Another major point for me is how ‘certain’ the scientists appear to be when commenting on their findings. If a researcher makes claims which I consider to be over-the-top about the validity or impact of their findings, I often won’t cover.”
    • “I also look at the difference between what an experiment actually shows versus the conclusion researchers draw from it — if there’s a big gap, that’s a huge red flag.”

    Peters says the study’s findings show that “not only are journalists smart, but they have also gone out of their way to get educated about things that should matter.”

    What other research shows about science journalists

    A 2023 study, published in the International Journal of Communication, based on an online survey of 82 U.S. science journalists, aims to understand what they know and think about open-access research, including peer-reviewed journals and articles that don’t have a paywall, and preprints. Data was collected between October 2021 and February 2022. Preprints are scientific studies that have yet to be peer-reviewed and are shared on open repositories such as medRxiv and bioRxiv. The study finds that its respondents “are aware of OA and related issues and make conscious decisions around which OA scholarly articles they use as sources.”

    A 2021 study, published in the Journal of Science Communication, looks at the impact of the COVID-19 pandemic on the work of science journalists. Based on an online survey of 633 science journalists from 77 countries, it finds that the pandemic somewhat brought scientists and science journalists closer together. “For most respondents, scientists were more available and more talkative,” the authors write. The pandemic has also provided an opportunity to explain the scientific process to the public, and remind them that “science is not a finished enterprise,” the authors write.

    More than a decade ago, a 2008 study, published in PLOS Medicine, and based on an analysis of 500 health news stories, found that “journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms,” when reporting on research studies. Giving time to journalists to research and understand the studies, giving them space for publication and broadcasting of the stories, and training them in understanding academic research are some of the solutions to fill the gaps, writes Gary Schwitzer, the study author.

    Advice for journalists

    We asked Bottesini, Peters, Aschwanden and Tamar Wilner, a postdoctoral fellow at the University of Texas, who was not involved in the study, to share advice for journalists who cover research studies. Wilner is conducting a study on how journalism research informs the practice of journalism. Here are their tips:

    1. Examine the study before reporting it.

    Does the study claim match the evidence? “One thing that makes me trust the paper more is if their interpretation of the findings is very calibrated to the kind of evidence that they have,” says Bottesini. In other words, if the study makes a claim in its results that’s far-fetched, the authors should present a lot of evidence to back that claim.

    Not all surprising results are newsworthy. If you come across a surprising finding from a single study, Peters advises you to step back and remember Carl Sagan’s quote: “Extraordinary claims require extraordinary evidence.”

    How transparent are the authors about their data? For instance, are the authors posting information such as their data and the computer codes they use to analyze the data on platforms such as Open Science Framework, AsPredicted, or The Dataverse Project? Some researchers ‘preregister’ their studies, which means they share how they’re planning to analyze the data before they see them. “Transparency doesn’t automatically mean that a study is trustworthy,” but it gives others the chance to double-check the findings, Bottesini says.

    Look at the study design. Is it an experimental study or an observational study? Observational studies can show correlations but not causation.

    “Observational studies can be very important for suggesting hypotheses and pointing us towards relationships and associations,” Aschwanden says.

    Experimental studies can provide stronger evidence toward a cause, but journalists must still be cautious when reporting the results, she advises. “If we end up implying causality, then once it’s published and people see it, it can really take hold,” she says.

    Know the difference between preprints and peer-reviewed, published studies. Peer-reviewed papers tend to be of higher quality than those that are not peer-reviewed. Read our tip sheet on the difference between preprints and journal articles.

    Beware of predatory journals. Predatory journals are journals that “claim to be legitimate scholarly journals, but misrepresent their publishing practices,” according to a 2020 journal article, published in the journal Toxicologic Pathology,Predatory Journals: What They Are and How to Avoid Them.”

    2. Zoom in on data.

    Read the methods section of the study. The methods section of the study usually appears after the introduction and background section. “To me, the methods section is almost the most important part of any scientific paper,” says Aschwanden. “It’s amazing to me how often you read the design and the methods section, and anyone can see that it’s a flawed design. So just giving things a gut-level check can be really important.”

    What’s the sample size? Not all good studies have large numbers of participants but pay attention to the claims a study makes with a small sample size. “If you have a small sample, you calibrate your claims to the things you can tell about those people and don’t make big claims based on a little bit of evidence,” says Bottesini.

    But also remember that factors such as sample size and p-value are not “as clear cut as some journalists might assume,” says Wilner.

    How representative of a population is the study sample? “If the study has a non-representative sample of, say, undergraduate students, and they’re making claims about the general population, that’s kind of a red flag,” says Bottesini. Aschwanden points to the acronym WEIRD, which stands for “Western, Educated, Industrialized, Rich, and Democratic,” and is used to highlight a lack of diversity in a sample. Studies based on such samples may not be generalizable to the entire population, she says.

    Look at the p-value. Statistical significance is both confusing and controversial, but it’s important to consider. Read our tip sheet, “5 Things Journalists Need to Know About Statistical Significance,” to better understand it.

    3. Talk to scientists not involved in the study.

    If you’re not sure about the quality of a study, ask for help. “Talk to someone who is an expert in study design or statistics to make sure that [the study authors] use the appropriate statistics and that methods they use are appropriate because it’s amazing to me how often they’re not,” says Aschwanden.

    Get an opinion from an outside expert. It’s always a good idea to present the study to other researchers in the field, who have no conflicts of interest and are not involved in the research you’re covering and get their opinion. “Don’t take scientists at their word. Look into it. Ask other scientists, preferably the ones who don’t have a conflict of interest with the research,” says Bottesini.

    4. Remember that a single study is simply one piece of a growing body of evidence.

    “I have a general rule that a single study doesn’t tell us very much; it just gives us proof of concept,” says Peters. “It gives us interesting ideas. It should be retested. We need an accumulation of evidence.”

    Aschwanden says as a practice, she tries to avoid reporting stories about individual studies, with some exceptions such as very large, randomized controlled studies that have been underway for a long time and have a large number of participants. “I don’t want to say you never want to write a single-study story, but it always needs to be placed in the context of the rest of the evidence that we have available,” she says.

    Wilner advises journalists to spend some time looking at the scope of research on the study’s specific topic and learn how it has been written about and studied up to that point.

    “We would want science journalists to be reporting balance of evidence, and not focusing unduly on the findings that are just in front of them in a most recent study,” Wilner says. “And that’s a very difficult thing to as journalists to do because they’re being asked to make their article very newsy, so it’s a difficult balancing act, but we can try and push journalists to do more of that.”

    5. Remind readers that science is always changing.

    “Science is always two steps forward, one step back,” says Peters. Give the public a notion of uncertainty, she advises. “This is what we know today. It may change tomorrow, but this is the best science that we know of today.”

    Aschwanden echoes the sentiment. “All scientific results are provisional, and we need to keep that in mind,” she says. “It doesn’t mean that we can’t know anything, but it’s very important that we don’t overstate things.”

    Authors of a study published in PNAS in January analyzed more than 14,000 psychology papers and found that replication success rates differ widely by psychology subfields. That study also found that papers that could not be replicated received more initial press coverage than those that could. 

    The authors note that the media “plays a significant role in creating the public’s image of science and democratizing knowledge, but it is often incentivized to report on counterintuitive and eye-catching results.”

    Ideally, the news media would have a positive relationship with replication success rates in psychology, the authors of the PNAS study write. “Contrary to this ideal, however, we found a negative association between media coverage of a paper and the paper’s likelihood of replication success,” they write. “Therefore, deciding a paper’s merit based on its media coverage is unwise. It would be valuable for the media to remind the audience that new and novel scientific results are only food for thought before future replication confirms their robustness.”

    Additional reading

    Uncovering the Research Behaviors of Reporters: A Conceptual Framework for Information Literacy in Journalism
    Katerine E. Boss, et al. Journalism & Mass Communication Educator, October 2022.

    The Problem with Psychological Research in the Media
    Steven Stosny. Psychology Today, September 2022.

    Critically Evaluating Claims
    Megha Satyanarayana, The Open Notebook, January 2022.

    How Should Journalists Report a Scientific Study?
    Charles Binkley and Subramaniam Vincent. Markkula Center for Applied Ethics at Santa Clara University, September 2020.

    What Journalists Get Wrong About Social Science: Full Responses
    Brian Resnick. Vox, January 2016.

    From The Journalist’s Resource

    8 Ways Journalists Can Access Academic Research for Free

    5 Things Journalists Need to Know About Statistical Significance

    5 Common Research Designs: A Quick Primer for Journalists

    5 Tips for Using PubPeer to Investigate Scientific Research Errors and Misconduct

    Percent Change versus Percentage-Point Change: What’s the Difference? 4 Tips for Avoiding Math Errors

    What’s Standard Deviation? 4 Things Journalists Need to Know

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • New News From The Centenarian Blue Zones

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    From Blue To Green…

    We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

    This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

    In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

    • Lifespan: how long we live
    • Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

    Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

    You may be wondering… How much good will this do me? And, we do have an answer for that:

    When All’s Said And Done, How Likely Are You To Live To 100?

    Now that we’re all caught-up…

    The news from the Blues

    A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

    Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

    1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
    2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
    3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
    4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

    See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

    And showing that yes, even parks in cities make a significant difference:

    The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

    Want to know more?

    You can read the study in full here:

    A systematic review of diet and medication use among centenarians and near-centenarians worldwide

    Take care!

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  • Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. William Li is well-known for his advocacy of “eating to beat disease”, and/but today he has advice for us about not eating to beat disease. In moderation, of course, thus: intermittent fasting.

    The easy way

    Dr. Li explains the benefits of intermittent fasting; how it improves the metabolism and gives the body a chance to do much-needed maintainance, including burning off any excess fat we had hanging around.

    However, rather than calling for us to do anything unduly Spartan, he points out that it’s already very natural for us to fast while sleeping, so we only need to add a couple of hours before and after sleeping (assuming an 8 hour sleep), to make it to a 12-hour fast for close to zero effort and probably no discomfort.

    And yes, he argues that a 12-hour fast is beneficial, and even if 16 hours would be better, we do not need to beat ourselves up about getting to 16; what is more important is sustainability of the practice.

    Dr. Li advocates for flexibility in fasting, and that it should be done by what manner is easiest, rather than trying to stick to something religiously (of course, if you do fast for religious reasons, that is another matter, and/but beyond the scope of this today).

    For more information on each of these, as well as examples and tips, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Walnut, Apricot, & Sage Nut Roast

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s important to have at least one good nut roast recipe in your repertoire. It’s something that’s very good for making a good dish out of odds and ends that are in your house, and done well, it’s not only filling and nutritious, but a tasty treat too. Done badly, everyone knows the results can be unfortunate… Making this the perfect way to show off your skills!

    You will need

    • 1 cup walnuts
    • ½ cup almonds
    • ¼ cup whole mixed seeds (chia, pumpkin, & poppy are great)
    • ¼ cup ground flax (also called flax meal)
    • 1 medium onion, finely chopped
    • 1 large carrot, grated
    • 4 oz dried apricots, chopped
    • 3 oz mushrooms, chopped
    • 1 oz dried goji berries
    • ½ bulb garlic, crushed
    • 2 tbsp fresh sage, chopped
    • 1 tbsp nutritional yeast
    • 2 tsp dried rosemary
    • 2 tsp dried thyme
    • 2 tsp black pepper, coarse ground
    • 1 tsp yeast extract (even if you don’t like it; trust us; it will work) dissolved in ¼ cup hot water
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉ / 180℃, and line a 2 lb loaf tin with baking paper.

    2) Heat some oil in a skillet over a moderate heat, and fry the onion for a few minutes until translucent. Add the garlic, carrot, and mushrooms, cooking for another 5 minutes, stirring well. Set aside to cool a little once done.

    3) Process the nuts in a food processor, pulsing until they are well-chopped but not so much that they turn into flour.

    4) Combine the nuts, vegetables, and all the other ingredients in a big bowl, and mix thoroughly. If it doesn’t have enough structural integrity to be thick and sticky and somewhat standing up by itself if you shape it, add more ground flax. If it is too dry, add a little water but be sparing.

    5) Spoon the mixture into the loaf tin, press down well (or else it will break upon removal), cover with foil and bake for 30 minutes. Remove the foil, and bake for a further 15 minutes, until firm and golden. When done, allow it to rest in the tin for a further 15 minutes, before turning it out.

    6) Serve, as part of a roast dinner (roast potatoes, vegetables, gravy, etc).

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Why You’re Tired & How To Fix It

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    This is Sadia Badiei. A dietician by academic and professional background, she’s nowadays hung up her lab coat for a chef’s jacket, and is best known for her “Pick Up Limes” brand. Today, we’ll be taking her advice on managing energy levels with what’s on our plates!

    Quick note: our usual medical/legal disclaimer applies, and this article cannot diagnose you from afar, and thus neither can it make any certain prescription; this is for educational purposes, and aimed at being applicable to most of our readers.

    There are many possible things that can cause chronic fatigue, and not all of them can be fixed by diet. Your doctor will have access to tests and such that we, being a humble health science publication, do not.

    You may recognize her; we’ve featured her videos occasionally, mostly recently:

    Pick Up A Zest For Life: 10 Lessons For A Healthy Mind & Body

    But, what does she want us to know about living life with more energy?

    It starts with balance

    Badiei makes the case that we should strive for a nutritionally-balanced diet; that may not come as much of a revelation, but what does that look like for a vegan (Badiei advocates for plant-based eating)?

    She recommends that our diet consist of:

    • About 50% fruits and vegetables
    • About 25% grains and starches
    • About 25% proteins
    • Modest amounts of fats
    • A little of well-chosen dairy substitutions
    • Finally, a few judicious supplements to top it off

    That does add up to more than 100%, but 1) we did say “About n%” and 2) this is not a bad thing to note, actually, since Badiei advocates (as we do) for focussing more on what we add into our diet, rather than what we take out.

    Breaking it down a little further, she recommends making sure to get “the foundational seven”, which is a little like “Dr. Greger’s Daily Dozen”, but in this case it’s counted on a per-food-type basis.

    Thus, she recommends:

    1. Dark green leafy vegetables
    2. Assorted other non-starchy vegetables (your choice what kind)
    3. Fruit, of any kinds (unlike Dr. Greger separating berries)
    4. Grains and starches (so for example, potatoes are lumped in with rice here, botanically very different, but often fulfil a similar culinary role)
    5. Nuts and seeds
    6. Legumes
    7. Fortified dairy alternatives

    For full details including how much of each, and “what counts”, etc, see:

    Pick Up Limes | The Nourish Method

    Time your carbs

    Slow-release carbohydrates, those with the most fiber, are best most of the time, giving us more sustained fuel, keeping us energized for longer after meals—even if we would rather sleep:

    She cites: Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep

    Quick-release carbohydrates, those with what’s generally considered a less favorable carb:fiber ratio, are best if we’re going to eat nearer to bedtime. We know, eating before bed is often considered a bit of a no-no, but Badiei bids us indulge if we so desire, as the quicker-absorbed carbohydrates support tryptophan reaching our brain more efficiently, and thus promote sleep onset.

    See also: Should You Go Light Or Heavy On Carbs?

    About that fat

    We mentioned (or rather, Badiei’s citation mentioned) saturated fat. It is indeed linked with difficulty falling asleep, and/but omega-3 fatty acids, on the other hand, promote better sleep.

    She cites: The relationship between sleep duration, sleep quality and dietary intake in adults

    While you’re enjoying those nuts and seeds (for the omega-3 fatty acids), you might also note that several also star in Badiei’s list of plant-based foods that are rich in tryptophan, such as soy, cashews, pumpkin seeds, sunflower seeds, beans, green vegetables, and mushrooms.

    Micronutrients

    Badiei’s focus here is on B-vitamins, iron, magnesium, selenium, and zinc. We imagine most of our readers here are taking steps to ensure to get a full daily coverage of vitamins and minerals anyway, but you might want to read what she has to say about iron on a plant-based diet, because the numbers may be different than you think.

    The reason for this is that while animal products contain mostly heme iron, which is easier to absorb but associated with a risk increase in some diseases, plant-based foods usually* contain only non-heme iron, which is healthier but not as bioavailable, so if eating only plants, we need more of it:

    Pick Up Limes | Iron on a Plant-Based Diet

    *If you eat a carnivorous plant, guess what, it’ll have heme iron in it, tangling that food web.

    “What if I know I have chronic fatigue for non-dietary reasons?”

    Well, that sucks, and we’re not going to pretend the above will magically fix it. However, there are still things that can at least relatively improve your experience:

    Eat To Beat Chronic Fatigue! Yes, Even When Fatigued Chronically

    (it’s a good guide to being able to consistently eat healthily when your energy levels are consistently at minimal, meaning that a lot of common advice becomes unusable)

    Take care!

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  • How Metformin Slows Aging

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Metformin And How It Slows Down Aging

    That’s a bold claim for a title, but the scientific consensus is clear, and this Research Review Monday we’re going to take a look at exactly that!

    Metformin is a common diabetes-management drug, used to lower blood sugar levels in people who either don’t have enough insulin or the insulin isn’t being recognized well enough by the body.

    However, it also slows aging, which is a quality it’s also been studied for for more than a decade. We’ll look at some of the more recent research, though. Let’s kick off with an initial broad statement, from the paper “The Use of Metformin to Increase the Human Healthspan”, as part of the “Advances in Experimental Medicine and Biology” series:

    In recent years, more attention has been paid to the possibility of using metformin as an anti-aging drug. It was shown to significantly increase the lifespan in some model organisms and delay the onset of age-associated declines. Growing amounts of evidence from clinical trials suggest that metformin can effectively reduce the risk of many age-related diseases and conditions, including cardiometabolic disorders, neurodegeneration, chronic inflammation and frailty.

    ~ Piskovatska et al, 2020

    How does it work?

    That’s still being studied, but the scientific consensus is that it works by inducing hormesis—the process by which minor stress signals cells to start repairing themselves. How does it induce that hormesis? Again, still being studied, but it appears to do it by activating a specific enzyme; namely, the AMP-activated protein kinase:

    Read: Metformin-enhances resilience via hormesis

    It also has been found to slow aging by means of an anti-inflammatory effect, as a bonus!

    Any bad news?

    Well, firstly, in most places it’s only prescribed for diabetes management, not for healthy life extension. A lot of anti-aging enthusiasts have turned to the grey market online to get it, and we can’t recommend that.

    Secondly, it does have some limitations:

    • Its bioavailability isn’t great in tablet form (the form in which it is most commonly given)
    • It has quite a short elimination half-life (around 6 hours), which makes it great to fix transient hyperglycemia in diabetics—job done and it’s out—but presents a logistical challenge when it comes to something so pernicious as aging.
    • Some people are non-responders (a non-responder, in medicine, is someone for whom a drug simply doesn’t work, for no obvious reason)

    Want to know more? Check out:

    Metformin in aging and aging-related diseases: clinical applications and relevant mechanism

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