Alzheimer’s Causative Factors To Avoid
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The Best Brains Bar Nun?
This is Dr. David Snowdon. He’s an epidemiologist, and one of the world’s foremost experts on Alzheimer’s disease. He was also, most famously, the lead researcher of what has become known as “The Nun Study”.
We recently reviewed his book about this study:
…which we definitely encourage you to check out, but we’ll do our best to summarize its key points today!
Reassurance up-front: no, you don’t have to become a nun
The Nun Study
In 1991, a large number (678) of nuns were recruited for what was to be (and until now, remains) the largest study of its kind into the impact of a wide variety of factors on aging, and in particular, Alzheimer’s disease.
Why it was so important: because the nuns were all from the same Order, had the same occupation (it’s a teaching Order), with very similar lifestyles, schedules, socioeconomic status, general background, access to healthcare, similar diets, same relationship status (celibate), same sex (female), and many other factors also similar, this meant that most of the confounding variables that confound other studies were already controlled-for here.
Enrollment in the study also required consenting to donating one’s brain for study post-mortem—and of those who have since died, indeed 98% of them have been donated (the other 2%, we presume, may have run into technical administrative issues with the donation process, due to the circumstances of death and/or delays in processing the donation).
How the study was undertaken
We don’t have enough space to describe the entire methodology here, but the gist of it is:
- Genetic testing for relevant genetic factors
- Data gathered about lives so far, including not just medical records but also autobiographies that the nuns wrote when they took their vows (at ages 19–21)
- Extensive ongoing personal interviews about habits, life choices, and attitudes
- Yearly evaluations including memory tests and physical function tests
- Brain donation upon death
What they found
Technically, The Nun Study is still ongoing. Of the original 678 nuns (aged 75–106), three are still alive (based on the latest report, at least).
However, lots of results have already been gained, including…
Genes
A year into the study, in 1992, the “apolipoprotein E” (APOE) gene was established as a likely causative factor in Alzheimer’s disease. This is probably not new to our readers in 2024, but there are interesting things being learned even now, for example:
The Alzheimer’s Gene That Varies By Race & Sex
…but watch out! Because also:
Alzheimer’s Sex Differences May Not Be What They Appear
Words
Based on the autobiographies written by the nuns in their youth upon taking their vows, there were two factors that were later correlated with not getting dementia:
- Longer sentences
- Positive outlook
- “Idea density”
That latter item means the relative linguistic density of ideas and complexity thereof, and the fluency and vivacity with which they were expressed (this was not a wishy-washy assessment; there was a hard-science analysis to determine numbers).
Want to spruce up yours? You might like to check out:
Reading, Better: Reading As A Cognitive Exercise
…for specific, evidence-based ways to tweak your reading to fight cognitive decline.
Food
While the dietary habits of the nuns were fairly homogenous, those who favored eating more and cooked greens, beans, and tomatoes, lived longer and with healthier brains.
See also: Brain Food? The Eyes Have It!
Other aspects of brain health & mental health
The study also found that nuns who avoided stroke and depression, were also less likely to get dementia.
For tending to these, check out:
- Two Things You Can Do To Improve Stroke Survival Chances
- Depression, And The Mental Health First-Aid That You’ll Hopefully Never Need
- Behavioral Activation Against Depression & Anxiety
Community & Faith
Obviously, in this matter the nuns were quite a homogenous group, scoring heavily in community and faith. What’s relevant here is the difference between the nuns, and other epidemiological studies in other groups (invariably not scoring so highly).
Community & faith are considered, separately and together, to be protective factors against dementia.
Faith may be something that “you have it or you don’t” (we’re a health science newsletter, not a theological publication, but for the interested, philosopher John Stuart Mill’s 1859 essay “On Liberty“ makes a good argument for it not being something one can choose, prompting him to argue for religious tolerance, on the grounds that religious coercion is a futile effort precisely because a person cannot choose to dis/believe something)
…but community can definitely be chosen, nurtured, and grown. We’ve written about this a bit before:
You might also like to check out this great book on the topic:
Purpose: Design A Community And Change Your Life – by Gina Bianchini
Want more?
We gave a ground-up primer on avoiding Alzheimer’s and other dementias; check it out:
How To Reduce Your Alzheimer’s Risk
Take care!
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Upgrade Your Life – by Pat Divilly
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Pat Divilly takes us through the steps to establish what it is we want out of life, adopt daily habits of success, build our self-esteem and confidence, and pursue what’s actually fulfilling, whatever that is for us as individuals.
The general layout of the book is: first, figuring out where you genuinely want to go (not just where people expect you to want to go!), and then seeing about what things you can change, first small and then larger, to get there.
The scope of the book covers work life and personal life, and treats them both as something where you can optimize how things work for you, and those around you. All in all, unless your life is literally perfect in every way imaginable, there’s probably something in this book that will help you to, indeed, “upgrade your life”. And who wouldn’t want that?
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Foods That Cause You to Lose Weight – by Dr. Neal Barnard
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We previously reviewed Dr. Barnard’s “The Power Foods Diet”, and this time his work is about weight loss.
This time there are more recipes (which take up most of the book, so this one could be reasonably described as a cookbook), but not until after nearly a hundred pages of concepts, principles, and tips.
The recipes themselves are again very respectable, even if some may be a little redundant (e.g. the double-page recipe for blueberry muffins is followed by a double-page recipe for banana and date muffins, instead of just saying “or substitute this”—things like that) and run the gamut from salad dressings to hearty main meals.
A strength of the book is that it’s about what you eat, not how much of it you eat, so if you love eating (which is a very healthy trait to have in general), then you’ll enjoy that aspect.
Bottom line: if you’d like to eat more and weigh less, then this is a top-tier book for you.
Click here to check out “Foods That Cause You To Lose Weight”, and enjoy eating!
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8 Signs On Your Breast You Shouldn’t Ignore
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Can you name the 8 signs that may indicate breast cancer? This video discusses them, and also shows what they look like on various different skintones:
Stay abreast:
Dr Simi Adedeji bids us watch out for:
- Inverted nipple: a newly inverted nipple (pointing inward or folded) should be checked by a doctor, especially if it’s a recent change.
- Flaky rash: a flaky, itchy, or red rash around the nipple or areola could indicate an underlying issue and should not be dismissed as just a skin condition.
- Tethering: skin pulling or denting, noticeable when raising your arms, may signal a deeper problem.
- Dimpling: skin resembling an orange peel (po orang sign) with dips and accentuated pores could indicate swelling or thickening and requires medical evaluation.
- Redness or heat: unusual warmth, redness, or tenderness in the breast, particularly if not breastfeeding, should be investigated.
- Nipple discharge: any unusual fluid from the nipple (be it yellow, green, milky, clear, or blood-stained) warrants attention, especially if spontaneous or only from one side.
- Change in size: sudden changes in the size or shape of one breast should not be ignored.
- Breast lump: a firm, irregular, or persistent lump in the breast, armpit, or collarbone area should be checked promptly, even if it’s not always harmful.
The above signs may indicate cancer or something else, but none of them are things that should be ignored (even if you get just one sign).
For more on each of these, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Take care!
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When BMI Doesn’t Measure Up
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When BMI Doesn’t Quite Measure Up
Last month, we did a “Friday Mythbusters” edition of 10almonds, tackling many of the misconceptions surrounding obesity. Amongst them, we took a brief look at the usefulness (or lack thereof) of the Body Mass Index (BMI) scale of weight-related health for individuals. By popular subscriber request, we’re now going to dive a little deeper into that today!
The wrong tool for the job
BMI was developed as a tool to look at large-scale demographic trends, stemming from a population study of white European men, who were for the purpose of the study (the widescale health of the working class in that geographic area in that era), considered a reasonable default demographic.
In other words: as a system, it’s now being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
If you want to know yours…
Here’s the magic formula for calculating your BMI:
- Metric: divide your weight in kilograms by your height in square meters
- Imperial: divide your weight in pounds by your height in square inches and then multiply by 703
“What if my height doesn’t come in square meters or square inches, because it’s a height, not an area?”
We know. Take your height and square it anyway. If this seems convoluted and arbitrary, yes, it is.
But!
While on the one hand it’s convoluted and arbitrary… On the other hand, it’s also a gross oversimplification. So, yay for the worst of both worlds?
If you don’t want to grab a calculator, here’s a quick online tool to calculate it for you.
So, how did you score?
According to the CDC, a BMI score…
- Under 18.5 is underweight
- 18.5 to 24.9 is normal
- 25 to 29.9 is overweight
- 30 and over is obese
And, if we’re looking at a representative sample of the population, where the representation is average white European men of working age, that’s not a bad general rule of thumb.
For the rest of us, not so representative
BMI is a great and accurate tool as a rule of thumb, except for…
Women
An easily forgotten demographic, due to being a mere 51% of the world’s population, women generally have a higher percentage of body fat than men, and this throws out BMI’s usefulness.
If pregnant or nursing
A much higher body weight and body fat percentage—note that these are two things, not one. Some of the extra weight will be fat to nourish the baby; some will be water weight, and if pregnant, some will be the baby (or babies!). BMI neither knows nor cares about any of these things. And, this is a big deal, because BMI gets used by healthcare providers to judge health risks and guide medical advice.
People under the age of 16 or over the age of 65
Not only do people below and above those ages (respectively) tend to be shorter—which throws out the calculations and mean health risks may increase before the BMI qualifies as overweight—but also:
- BMI under 23 in people over the age of 65 is associated with a higher health risk
- A meta-analysis showed that a BMI of 27 was the best in terms of decreased mortality risk for the over-65 age group
This obviously flies in the face of conventional standards regards BMI—as you’ll recall from the BMI brackets we listed above.
Read the science: BMI and all-cause mortality in older adults: a meta-analysis
Athletic people
A demographic often described in scientific literature as “athletes”, but that can be misleading. When we say “athletes”, what comes to mind? Probably Olympians, or other professional sportspeople.
But also athletic, when it comes to body composition, are such people as fitness enthusiasts and manual laborers. Which makes for a lot more people affected by this!
Athletic people tend to have more lean muscle mass (muscle weighs more than fat), and heavier bones (can’t build strong muscles on weak bones, so the bones get stronger too, which means denser)… But that lean muscle mass can actually increase metabolism and help ward off many of the very same things that BMI is used as a risk indicator for (e.g. heart disease, and diabetes). So people in this category will actually be at lower risk, while (by BMI) getting told they are at higher risk.
If not white
Physical characteristics of race can vary by more than skin color, relevant considerations in this case include, for example:
- Black people, on average, not only have more lean muscle mass and less fat than white people, but also, have completely different risk factors for diseases such as diabetes.
- Asian people, on average, are shorter than white people, and as such may see increased health risks before BMI qualifies as overweight.
- Hispanic people, on average, again have different physical characteristics that throw out the results, in a manner that would need lower cutoffs to be even as “useful” as it is for white people.
Further reading on this: BMI and the BIPOC Community
In summary:
If you’re an average white European working-age man, BMI can sometimes be a useful general guide. If however you fall into one or more of the above categories, it is likely to be inaccurate at best, if not outright telling the opposite of the truth.
What’s more useful, then?
For heart disease risk and diabetes risk both, waist circumference is a much more universally reliable indicator. And since those two things tend to affect a lot of other health risks, it becomes an excellent starting point for being aware of many aspects of health.
Pregnancy will still throw off waist circumference a little (measure below the bump, not around it!), but it will nevertheless be more helpful than BMI even then, as it becomes necessary to just increase the numbers a little, according to gestational month and any confounding factors e.g. twins, triplets, etc. Ask your obstetrician about this, as it’s beyond the scope of today’s newsletter!
As to what’s considered a risk:
- Waist circumference of more than 35 inches for women
- Waist circumference of more than 40 inches for men
These numbers are considered applicable across demographics of age, sex, ethnicity, and lifestyle.
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The Sugar Alcohol That Reduces BMI!
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Inositol Does-It-Ol’!
First things first, a quick clarification up-front:
Myo-inositol or D-chiro-inositol?
We’re going to be talking about inositol today, which comes in numerous forms, but most importantly:
- Myo-inositol (myo-Ins)
- D-chiro-inositol (D-chiro-Ins)
These are both inositol, (a sugar alcohol!) and for our purposes today, the most relevant form is myo-inositol.
The studies we’ll look at today are either:
- just about myo-inositol, or
- about myo-inositol in the presence of d-chiro-inositol at a 40:1 ratio.
You have both in your body naturally; wherever supplementation is mentioned, it means supplementing with either:
- extra myo-inositol (because that’s the one the body more often needs more of), or
- both, at the 40:1 ratio that we mentioned above (because that’s one way to help balance an imbalanced ratio)
With that in mind…
Inositol against diabetes?
Inositol is known to:
- decrease insulin resistance
- increase insulin sensitivity
- have an important role in cell signaling
- have an important role in metabolism
The first two things there both mean that inositol is good against diabetes. It’s not “take this and you’re cured”, but:
- if you’re pre-diabetic it may help you avoid type 2 diabetes
- if you are diabetic (either type) it can help in the management of your diabetes.
It does this by allowing your body to make better use of insulin (regardless of whether that insulin is from your pancreas or from the pharmacy).
How does it do that? Research is still underway and there’s a lot we don’t know yet, but here’s one way, for example:
❝Evidence showed that inositol phosphates might enhance the browning of white adipocytes and directly improve insulin sensitivity through adipocytes❞
Read: Role of Inositols and Inositol Phosphates in Energy Metabolism
We mentioned its role in metabolism in a bullet-point above, and we didn’t just mean insulin sensitivity! There’s also…
Inositol for thyroid function?
The thyroid is one of the largest endocrine glands in the body, and it controls how quickly the body burns energy, makes proteins, and how sensitive the body should be to other hormones. So, it working correctly or not can have a big impact on everything from your mood to your weight to your energy levels.
How does inositol affect thyroid function?
- Inositol has an important role in thyroid function and dealing with autoimmune diseases.
- Inositol is essential to produce H2O2 (yes, really) required for the synthesis of thyroid hormones.
- Depletion of inositol may lead to the development of some thyroid diseases, such as hypothyroidism.
- Inositol supplementation seems to help in the management of thyroid diseases.
Read: The Role of Inositol in Thyroid Physiology and in Subclinical Hypothyroidism Management
Inositol for PCOS?
A systematic review published in the Journal of Gynecological Endocrinology noted:
- Inositol can restore spontaneous ovarian activity (and consequently fertility) in most patients with PCOS.
- Myo-inositol is a safe and effective treatment to improve:
- ovarian function
- healthy metabolism
- healthy hormonal balance
While very comprehensive (which is why we included it here), that review’s a little old, so…
Check out this cutting edge (Jan 2023) study whose title says it all:
Inositol for fertility?
Just last year, Mendoza et al published that inositol supplementation, together with antioxidants, vitamins, and minerals, could be an optimal strategy to improve female fertility.
This built from Gambiole and Forte’s work, which laid out how inositol is a safe compound for many issues related to fertility and pregnancy. In particular, several clinical trials demonstrated that:
- inositol can have therapeutic effects in infertile women
- inositol can also be useful as a preventive treatment during pregnancy
- inositol could prevent the onset of neural tube defects
- inositol also reduces the occurrence of gestational diabetes
Due to the safety and efficiency of inositol, it can take the place of many drugs that are contraindicated in pregnancy. Basically: take this, and you’ll need fewer other drugs. Always a win!
Read: Myo-Inositol as a Key Supporter of Fertility and Physiological Gestation
Inositol For Weight Loss
We promised you “this alcohol sugar can reduce your BMI”, and we weren’t making it up!
Zarezadeh et al conducited a very extensive systematic review, and found:
- Oral inositol supplementation has positive effect on BMI reduction.
- Inositol in the form of myo-inositol had the strongest effect on BMI reduction.
- Participants with PCOS and/or who were overweight, experienced the most significant improvement of all.
Want some inositol?
As ever, we don’t sell it (or anything else), but for your convenience, here’s myo-inositol and d-chiro-inositol at a 40:1 ratio, available on Amazon!
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What Weston Price Got Right (And Wrong)
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Weston Price: What Stood The Test of Time?
This is Dr. Weston Price, a dentist. You may guess from the photo, or perhaps already knew, his work is not new in 2023. We usually feature current health experts here, but we’re taking a day to do a blast from the past, because his ideas endure today, and inform a lot of people’s health views. So, he’s a good one to at least know about.
What was his deal?
Dr. Price (1870–1948) wanted to study focal infection theory—the idea that repairing root canals allowed bacterial infections that caused everything from heart disease to arthritis. His solution was that the teeth should be extracted instead.
This theory was popular in the 1920s, was challenged in the 1930s, ignored in the 1940s (the world was a bit busy), and by broad medical consensus anyway, rejected in the 1950s. But, while it was being challenged in the 1930s, Dr. Price decided to find more evidence for its support.
The result was his famous world tour of peoples living traditional lifestyles without the influence of “modern” diet. His findings, and the conclusions he drew from them, extended to far more than just dental health.
What did he find?
Dr. Price found that people living traditional lifestyles, with their traditional diets based on locally-sourced foods, had much better overall health. Of course, he was a dentist and not a general practitioner, so aside from examining their teeth, he largely relied on self-reported diagnoses of illness, or lack thereof.
In short: he found that people in places without modern medical institutions had fewer diagnoses of disease. From this, he concluded that incidence of disease was much lower.
There was also an unexamined element of survivorship bias—an undiagnosed disease is more likely to be fatal, and he questioned only living people, which skewed the stats rather. Nor did he examine infant mortality rate nor adult life expectancy, both of which were not great.
Was it all useless, then?
Actually no! He did hit upon some observations that have stood the test of time:
- He correctly concluded that modern diets with sugar and white flour were ruinous to the health.
- He correctly concluded that locally-sourced food, and grass-fed in the case of pastoral farming, tended to have much more nutritional value than the mass-produced results of intensive farming.
- He correctly concluded that many modern preservation methods robbed foods of their nutrients.
- He correctly concluded that many grains and seeds are more nutritions when fermented/soaked/sprouted.
About that “locally-sourced food”: the reason locally-sourced food tends to be more nutritious is that it has required less in the way of preservation for a long trip around the world, and will also tend to be fresher.
On the other hand, this does mean a lot of the foods that Dr. Price recommends are very much subject to availability. It may well be true that the Inuit people do not eat a lot of fruit and veg (which mostly do not grow there), but if you live in Nevada, maybe locally-sourced whale fat is just as difficult to find.
One person’s “this fatty organ meat contains the vitamin C we need” may be another person’s “that’s great; I have an apple tree in my garden though”.
Want to learn more?
Dr. Price’s most influential work is his magnum opus, “Nutrition and Physical Degeneration”. It’s a fascinating book in its historical context, but do be warned, it was written by a rich white man in 1939 and the writing is as racist as you might expect. Even when making favourable comparisons, the tone is very much “and here is what these savages are doing well”.
If you don’t fancy reading all that, here are two other sources about Weston Price’s work and conclusions, presented for balance:
- The Weston A. Price Foundation (Official Website)
- Weston Price’s Appalling Legacy (Science-Based Medicine.org)
Enjoy!
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