How (And Why) To Train Your Pre-Frontal Cortex

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Dr. Chapman’s Keys For Mental Focus

This is Dr. Sandra Chapman; she’s a cognitive neuroscientist, on a mission to, in her words, further our understanding of:

  • what makes the brain stronger, faster and last longer
  • what enhances human cognitive capacity, and
  • what enhances the underlying brain systems across the lifespan.

To this end, she’s also the founder and Chief Director of the Center For Brain Health, where she has worked on her mission for the past 25 years (clocking up hundreds of peer-reviewed publications to her name), as well as being a professor of Behavioral and Brain Sciences at UT Dallas.

What does she want us to know?

Get your brain into gear

When it comes to your brainpower, it is “use it or lose it”, but it is also perfectly possible to use it and lose it.

Why?

Very often, what we are using our brains for is high-strain, low-yield stuff, such as multitasking, overthinking, or overthinking while multitasking. And to make it worse, we often do it without sufficient rest.

This is the equivalent of owning a Ferrari but trying to drive it in second and third gear at once by switching between the two as rapidly as possible. And doing that for 18 hours each day.

Suffice it to say, you’ll be going nowhere quickly.

An alternative “use” of brainpower is low-strain, low-yield stuff, such as having to pay close attention to a boring conversation. It’s enough to stop your mind from doing anything else, but not enough to actually stimulate you.

This is the equivalent of owning a Ferrari but keeping it idling. The wear and tear is minimal this time, but you’re not actually going anywhere either.

Better, of course, are the other two quadrants:

  • low-strain, high-yield: consistently using our brain in relatively non-taxing ways that encourage its development
  • high-strain, high-yield: here the Ferrari metaphor definitely fails, because unlike cars, our bodies (including our brains) are machines that benefit from judicious regular progressive overloading (but just by a bit, and with adequate recovery time between overloads).

See also: 12 Weeks To Measurably Boost Your Brain

How to do the “low-strain, low-yield” part

When it comes to “what’s the most important part of the brain to help in the face of cognitive decline?” the usual answer is either to focus on memory (hippocampi) or language (various parts, but for example Wernicke’s area and Broca’s area), since people most fear losing memory, and language is very important both socially and practically.

Those are indeed critical, and we at 10almonds stand by them, but Dr. Chapman (herself having originally trained as speech and language pathologist!) makes a strong case for adding a third brain part to the list.

Specifically, she advocates for strengthening the pre-frontal cortex, which is responsible for inhibition, task-switching, working memory, and cognitive flexibility. If that seems like a lot, do remember it’s a whole cortex and not one of the assorted important-but-small brain bits we mentioned above.

How? She has developed training programs for this, based on what she calls Strategic Memory Advanced Reasoning Tactics (SMART), to support support attention, planning, judgment and emotional management.

You can read more about those programs here:

Center For Brain Health | Our Programs

Participation in those is mostly not free, however, if you join their…

Center For Brain Health | BrainHealth Project

…then they will periodically invite you to join pilot programs, research programs, and the like, which will either be free or they-pay-you affairs—because this is how science is done, and you can read about yourself (anonymized, of course) later in peer-reviewed papers of the kind we often cite here.

If you’re not interested in any of that though, we will say that according to Dr. Chapman, the keys are:

Inhibition: be conscious of this function of your brain, and develop it. This is the function of your brain that stops you from making mistakes—or put differently: stops you from saying/doing something stupid.

Switching: do this consciously; per “I am now doing this task, now I am switching to this other task”, rather than doing the gear-grinding thing we discussed earlier

Working memory: this is effectively your brain’s RAM. Unlike the RAM of a computer (can be enhanced by adding another chip or replacing with a bigger chip), our brain’s RAM can be increased by frequent use, and especially by judicious use of progressive overloading (with rests between!) which we’ll discuss in the high-strain, high-yield section.

Flexibility: this is about creative problem-solving, openness to new ideas, and curiosity

See also: Curiosity Kills The Neurodegeneration

How to do the “high-strain, high-yield” part

Delighting this chess-playing writer, Dr. Chapman recommends chess. Although, similar games such as go (a Chinese game that looks simpler than chess but actually requires more calculation) work equally well too.

Why?

Games like chess and go cause structural changes that are particularly helpful, in terms of engaging in such foundational tasks as learning, abstract reasoning, problem-solving and self-control:

Chess Practice as a Protective Factor in Dementia

Basically, it checks (so to speak) a lot of boxes, especially for the pre-frontal cortex. Some notes:

  • Focusing on the game is required for brain improvement; simply pushing wood casually will not do it. Ideally, calculating several moves ahead will allow for strong working memory use (because to calculate several moves ahead, one will have to hold increasingly many possible positions in the mind while doing so).
  • The speed of play must be sufficiently slow as to allow not only for thinking, but also for what in chess is called “blunder-checking”, in other words, having decided on one’s move, pausing to consider whether it is a mistake, and actively trying to find evidence that it is. This is the crucial “inhibition habit”, and when one does it reflexively, one will make fewer mistakes. Tying this to dementia, see for example how one of the common symptoms of dementia is falling for scams that one wouldn’t have previously. How did cognitive decline make someone naïve? It didn’t, per se; it just took away their ability to, having decided what to do, pause to consider whether it was a mistake, and actively trying to find evidence that it is.
  • That “conscious switching” that we talked about, rather than multitasking? In chess, there is a difference between strategy and tactics. Don’t worry about what that difference is for now (learn it if you want to take up chess), but know that strong players will only strategize while it is their opponent’s turn, and only calculate (tactics) while it is their own turn. It’s very tempting to flit constantly between one and the other, but chess requires players to have the mental discipline be able to focus on one task or the other and stick with that task until it’s the appointed time to switch.

If you feel like taking up chess, this site (and related app, if you want it) is free (it’s been funded by voluntary donations for a long time now) and good and even comes with free tuition and training tools: LiChess.org

Here’s another site that this writer (hi, it’s me) personally uses—it has great features too, but many are paywalled (I’m mostly there just because I’ve been there nearly since its inception, so I’m baked into the community now): Chess.com

Want to know more?

You might like this book by Dr. Chapman, which we haven’t reviewed yet but it did inform large parts of today’s article:

Make Your Brain Smarter: Increase Your Brain’s Creativity, Energy, and Focus – by Dr. Sandra Chapman

Enjoy!

Don’t Forget…

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  • How To Leverage Placebo Effect For Yourself

    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.

    Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago

    The placebo effect is a well-known, well-evidenced factor that is very relevant when it comes to the testing and implementation of medical treatments:

    NIH | National Center for Biotechnology Information | Placebo Effect

    Some things that make placebo effect stronger include:

    • Larger pills instead of small ones: because there’s got to be more going on in there, right?
    • Thematically-colored pills: e.g. red for stimulant effects, blue for relaxing effects
    • Things that seem expensive: e.g. a well-made large heavy machine, over a cheap-looking flimsy plastic device. Similarly, medication from a small glass jar with a childproof lock, rather than popped out from a cheap blister-pack.
    • Things that seem rational: if there’s an explanation for how it works that you understand and find rational, or at least you believe you understand and find rational ← this works in advertising, too; if there’s a “because”, it lands better almost regardless of what follows the word “because”
    • Things delivered confidently by a professional: this is similar to the “argument from authority” fallacy (whereby a proposed authority will be more likely trusted, even if this is not their area of expertise at all, e.g. celebrity endorsements), but in the case of placebo trials, this often looks like a well-dressed middle-aged or older man with an expensive haircut calling for a young confident-looking aide in a lab coat to administer the medicine, and is received better than a slightly frazzled academic saying “and, uh, this one’s yours” while handing you a pill.
    • Things with ritual attached: this can be related to the above (the more pomp and circumstance is given to the administration of the treatment, the better), but it can also be as simple as an instruction on an at-home-trial medication saying “take 20 minutes before bed”. Because, if it weren’t important, they wouldn’t bother to specify that, right? So it must be important!

    And now for a quick personality test

    Did you see the above as a list of dastardly tricks to watch out for, or did you see the above as a list of things that can make your actual medication more effective?

    It’s arguably both, of course, but the latter more optimistic view is a lot more useful than the former more pessimistic one.

    Since placebo effect works at least somewhat even when you know about it, there is nothing to stop you from leveraging it for your own benefit when taking medication or doing health-related things.

    Next time you take your meds or supplements or similar, pause for a moment for each one to remember what it is and what it will be doing for you. This is a lot like the principles (which are physiological as well as psychological) of mindful eating, by the way:

    How To Get More Nutrition From The Same Food

    Placebo makes some surprising things evidence-based

    We’ve addressed placebo effect sometimes as part of an assessment of a given alternative therapy, often in our “Mythbusting Friday” edition of 10almonds.

    • In some cases, placebo is adjuvant to the therapy, i.e. it is one of multiple mechanisms of action (example: chiropractic or acupuncture)
    • In some cases, placebo is the only known mechanism of action (example: homeopathy)
    • In some cases, even placebo can’t help (example: ear candling)

    One other fascinating and far-reaching (in a potentially good way) thing that placebo makes evidence-based is: prayer

    …which is particularly interesting for something that is fundamentally faith-based, i.e. the opposite of evidence-based.

    Now, we’re a health science publication, not a theological publication, so we’ll consider actual divine intervention to be beyond the scope of mechanisms of action we can examine, but there’s been a lot of research done into the extent to which prayer is beneficial as a therapy, what things it may be beneficial for, and what factors affect whether it helps:

    Prayer and healing: A medical and scientific perspective on randomized controlled trials

    👆 full paper here, and it is very worthwhile reading if you have time, whether or not you are religious personally

    Placebo works best when there’s a clear possibility for psychosomatic effect

    We’ve mentioned before, and we’ll mention again:

    • psychosomatic effect does not mean: “imagining it”
    • psychosomatic effect means: “your brain regulates almost everything else in your body, directly or indirectly, including your autonomic functions, and especially notably when it comes to illness, your immune responses”

    So, a placebo might well heal your rash or even shrink a tumor, but it probably won’t regrow a missing limb, for instance.

    And, this is important: it’s not about how credible/miraculous the outcome will be!

    Rather, it is because we have existing pre-programmed internal bodily processes for healing rashes and shrinking tumors, that just need to be activated—whereas we don’t have existing pre-programmed internal bodily processes for regrowing a missing limb, so that’s not something our brain can just tell our body to do.

    So for this reason, in terms of what placebo can and can’t do:

    • Get rid of cancer? Yes, sometimes—because the body has a process for doing that; enjoy your remission
    • Fix a broken nail? No—because the body has no process for doing that; you’ll just have to cut it and wait for it to grow again

    With that in mind, what will you use the not-so-mystical powers of placebo for? What ever you go for… Enjoy, and take care!

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  • Sunflower Oil vs Canola Oil – Which is Healthier?

    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.

    Our Verdict

    When comparing sunflower oil to canola oil, we picked the sunflower oil.

    Why?

    They’re both terrible! But canola oil is worse. Sunflower oil is marketed as being higher in polyunsaturated fats, which it is, albeit not by much.

    Canola oil is very bad for the heart, and sunflower oil is only moderately bad for the heart, to the point that it can be heart-neutral if used sparingly.

    As seed oils, they are both sources of vitamin E, but you’d need to drink a cup of oil to get your daily dose, so please just eat some seeds (or nuts, or fruit, or something) instead. It can even be sunflower seeds if you like! Rapeseed* itself (the seed that canola oil is made from) isn’t really sold as a foodstuff, so that one’s less of an option.

    *Fun fact: if you’re N. American and wondering what this “rapeseed” is, know that most of the rest of the Anglosphere calls canola oil “rapeseed oil”, as it’s made from rapeseed, which comes from a plant called rape, whose name is unrelated to the crime of the same name, and comes from rāpa, the Latin word for turnip. Anyway, “canola” is a portmanteau of “Canadian” and “Ola” meaning oil, and is a trademark that has made its way into generic use throughout N. America, as a less alarming name.

    Back to health matters: while sunflower seeds are healthy in moderation, the ultraprocessed and refined sunflower and canola oils are not.

    Canola oil has also been found to be implicated in age-related cognitive decline, whereas sunflower oil has had mixed results in that regard.

    In summary

    Sunflower oil is relatively, and we stress relatively, healthier than canola oil. Please use a healthier oil than either if you can. Olive oil is good for most things, and if you need something with a higher smoke point (and/or less distinctive flavor), consider avocado oil, which is also very healthy and whose smoke point is even higher than the seed oils we’ve been discussing today.

    Want to know more?

    Check out:

    Avocado Oil vs Olive Oil – Which is Healthier?

    Enjoy!

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  • Never Too Old?

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    Age Limits On Exercise?

    In Tuesday’s newsletter, we asked you your opinion on whether we should exercise less as we get older, and got the above-depicted, below-described, set of responses:

    • About 42% said “No, we must keep pushing ourselves, to keep our youth“
    • About 29% said “Only to the extent necessary due to chronic conditions etc”
    • About 29% said “Yes, we should keep gently moving but otherwise take it easier”

    One subscriber who voted for “No, we must keep pushing ourselves, to keep our youth“ wrote to add:

    ❝I’m 71 and I push myself. I’m not as fast or strong as I used to be but, I feel great when I push myself instead of going through the motions. I listen to my body!❞

    ~ 10almonds subscriber

    One subscriber who voted for “Only to the extent necessary due to chronic conditions etc” wrote to add:

    ❝It’s never too late to get stronger. Important to keep your strength and balance. I am a Silver Sneakers instructor and I see first hand how helpful regular exercise is for seniors.❞

    ~ 10almonds subscriber

    One subscriber who voted to say “Yes, we should keep gently moving but otherwise take it easier” wrote to add:

    ❝Keep moving but be considerate and respectful of your aging body. It’s a time to find balance in life and not put yourself into a positon to damage youself by competing with decades younger folks (unless you want to) – it will take much longer to bounce back.❞

    ~ 10almonds subscriber

    These will be important, because we’ll come back to them at the end.

    So what does the science say?

    Endurance exercise is for young people only: True or False?

    False! With proper training, age is no barrier to serious endurance exercise.

    Here’s a study that looked at marathon-runners of various ages, and found that…

    • the majority of middle-aged and elderly athletes have training histories of less than seven years of running
    • there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
    • after 55 years, running times did increase on average, but not consistently (i.e. there were still older runners with comparable times to the younger age bracket)

    See: Performance, training and lifestyle parameters of marathon runners aged 20–80 years: results of the PACE-study

    The researchers took this as evidence of aging being indeed a biological process that can be sped up or slowed down by various lifestyle factors.

    See also:

    Age & Aging: What Can (And Can’t) We Do About It?

    this covers the many aspects of biological aging (it’s not one number, but many!) and how our various different biological ages are often not in sync with each other, and how we can optimize each of them that can be optimized

    Resistance training is for young people only: True or False?

    False! In fact, it’s not only possible for older people, but is also associated with a reduction in all-cause mortality.

    Specifically, those who reported strength-training at least once per week enjoyed longer lives than those who did not.

    You may be thinking “is this just the horse-riding thing again, where correlation is not causation and it’s just that healthier people (for other reasons) were able to do strength-training more, rather than the other way around?“

    …which is a good think to think of, so well-spotted if you were thinking that!

    But in this case no; the benefits remained when other things were controlled for:

    ❝Adjusted for demographic variables, health behaviors and health conditions, a statistically significant effect on mortality remained.

    Although the effects on cardiac and cancer mortality were no longer statistically significant, the data still pointed to a benefit.

    Importantly, after the physical activity level was controlled for, people who reported strength exercises appeared to see a greater mortality benefit than those who reported physical activity alone.❞

    ~ Dr. Jennifer Kraschnewski

    See the study: Is strength training associated with mortality benefits? A 15 year cohort study of US older adults

    And a pop-sci article about it: Strength training helps older adults live longer

    Closing thoughts

    As it happens… All three of the subscribers we quoted all had excellent points!

    Because in this case it’s less a matter of “should”, and more a selection of options:

    • We (most of us, at least) can gain/regain/maintain the kind of strength and fitness associated with much younger people, and we need not be afraid of exercising accordingly (assuming having worked up to such, not just going straight from couch to marathon, say).
    • We must nevertheless be mindful of chronic conditions or even passing illnesses/injuries, but that goes for people of any age
    • We also can’t argue against a “safety first” cautious approach to exercise. After all, sure, maybe we can run marathons at any age, but that doesn’t mean we have to. And sure, maybe we can train to lift heavy weights, but if we’re content to be able to carry the groceries or perhaps take our partner’s weight in the dance hall (or the bedroom!), then (if we’re also at least maintaining our bones and muscles at a healthy level) that’s good enough already.

    Which prompts the question, what do you want to be able to do, now and years from now? What’s important to you?

    For inspiration, check out: Train For The Event Of Your Life!

    Take care!

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  • How do I handle it if my parent is refusing aged care? 4 things to consider

    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 a shock when we realise our parents aren’t managing well at home.

    Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.

    You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?

    Here are four things to consider.

    1. Start with more help at home

    Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.

    Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.

    Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.

    Call My Aged Care to discuss your options.

    An older man with a serious expression on his face looks out a window.
    Is Mum or Dad OK at home?
    Nadino/Shutterstock

    2. Be prepared for multiple conversations

    Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.

    Ideally, the older person feels supported rather than attacked during these conversations.

    Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.

    Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.

    3. Understand the options when help at home isn’t enough

    If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be considering a nursing home (also known as residential aged care in Australia).

    Every person has a legal right to choose where we live (unless they have lost capacity to make that decision).

    This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.

    It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).

    Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?

    Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.

    Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.

    Research suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.

    Mum and Dad should be involved in the decision-making process about where they live, and when they might move.

    Some families start looking “just in case” as it often takes some time to find the right nursing home and there can be a wait.

    After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.

    We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.

    For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.

    Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.

    An older Asian woman sits with her daughter.
    You might need to have multiple conversations about aged care.
    CGN089/Shutterstock

    4. Understand the options if a parent has lost capacity to make decisions

    If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.

    If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.

    Mum or Dad may have appointed an enduring guardian to make decisions about their health and lifestyle decisions when they are not able to.

    An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.

    If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can appoint that person a private guardian (usually a family member, close friend or unpaid carer).

    If no such person is available to act as private guardian, a public official may be appointed as public guardian.

    Deal with your own feelings

    Families often feel guilt and grief during the decision-making and transition process.

    Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.The Conversation

    Lee-Fay Low, Professor in Ageing and Health, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    Don’t Forget…

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    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Health & Happiness From Outside & In

    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.

    A friend in need…

    In a recent large (n=3,486) poll across the US:

    • 90% of people aged 50 and older say they have at least one close friend
    • 75% say they have enough close friends
    • 70% of those with a close friend say they can definitely count on them to provide health-related support

    However, those numbers shrink by half when it comes to people whose physical and/or mental health is not so great, resulting in a negative feedback loop of fewer close friends whom one sees less often, and progressively worse physical and/or mental health. In other words, the healthier you are, the more likely you are to have a friend who’ll support you in your health:

    Read in full: Friendships promote healthier living in older adults, says new survey

    Related: How To Beat Loneliness & Isolation

    Kindness makes a difference to healthcare outcomes

    Defining kindness as action-oriented, positively focused, and purposeful in nature, this sets kindness apart from compassion and empathy, when it’s otherwise often been conflated with those, and thus overlooked. This also means that kindness can still be effected when clinicians are too burned-out to be compassionate, and/or when patients are not in a state of mind where empathy is useful.

    Furthermore, unkindness (again, as defined by this review) was found in large studies to be the root cause of ¾ of patient harm events in hospital settings. This means that far from being a wishy-washy abstraction, kindness/unkindness can be a very serious factor when it comes to healthcare outcomes:

    Read in full: Review suggests kindness could make for better health care

    Related: The Human Touch vs AI, The Doctor That Never Tires

    The gift of health?

    🎵 Last Christmas, I gave you my heart
    Which turned out to be a silly idea
    This year, to save me from tears
    I’ll just get you a Fitbit or something🎵

    Health & happiness go hand in hand, so does that make health stuff a good gift? It can do! But there are also plenty of opportunities for misfires.

    For example, getting someone a gym membership when they don’t have time for that may not help them at all, and sports equipment that they’ll use once and then leave to gather dust might not be great either. In contrast, the American Heart Association recommends to first consider what they enjoy doing, and work with that, and ideally make it something versatile and/or portable. Wearable gadgets are a fine option for many, but a gift doesn’t have to be fancy to be good—with a blood pressure monitoring cuff being a suggestion from Dr. Sperling (a professor of preventative cardiology):

    Read in full: Oh, there’s no gift like health for the holidays

    Related: Here’s Where Activity Trackers Help (And Also Where They Don’t)

    How you use social media matters more than how much

    A study commissioned by the European Commission’s Joint Research Centre found that while the quantity of time one spends on social media is not associated (positively or negatively) with loneliness, they did find a correlation between passive (as opposed to engaged) use of social media, and loneliness. In other words, people who were chatting with friends less, were more lonely! Shocking news.

    While the findings may seem obvious, it does present a call-to-action for anyone who is feeling lonely: to use social media not just to see what everyone else is up to, but also, to reach out to people.

    Read in full: Unpacking the link between social media and loneliness

    Related: Make Social Media Work For Your Mental Health Rather Than Against It

    Gut-only antidepressants

    Many antidepressants work by increasing serotonin levels in the brain; a new study suggests that targeting antidepressants to work only in the gut (which is where serotonin is made, not the brain) could not only be an effective treatment for mood disorders, but also cause fewer adverse side-effects:

    Read in full: Antidepressants may act in gut to reduce depression and anxiety

    Related: Antidepressants: Personalization Is Key!

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Childhood Vaccination Rates, a Rare Health Bright Spot in Struggling States, Are Slipping

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    Jen Fisher can do only so much to keep her son safe from the types of infections that children can encounter at school. The rest, she said, is up to other students and parents in their hometown of Franklin, Tennessee.

    Fisher’s son Raleigh, 12, lives with a congenital heart condition, which has left him with a weakened immune system. For his protection, Raleigh has received all the recommended vaccines for a child his age. But even with his vaccinations, a virus that might only sideline another child could sicken him and land him in the emergency room, Fisher said.

    “We want everyone to be vaccinated so that illnesses like measles and things that have basically been eradicated don’t come back,” Fisher said. “Those can certainly have a very adverse effect on Raleigh.”

    For much of Raleigh’s life, Fisher could take comfort in the high childhood vaccination rate in Tennessee — a public health bright spot in a conservative state with poor health outcomes and one of the shortest life expectancies in the nation.

    Mississippi and West Virginia, two similarly conservative states with poor health outcomes and short life expectancies, also have some of the highest vaccination rates for kindergartners in the nation — a seeming contradiction that stems from the fact that childhood vaccination requirements don’t always align with states’ other characteristics, said James Colgrove, a Columbia University professor who studies factors that influence public health.

    “The kinds of policies that states have don’t map neatly on to ‘red’ versus ‘blue’ or one region or another,” Colgrove said.

    Advocates, doctors, public health officials, and researchers worry such public health bright spots in some states are fading: Many states have recently reported an increase in people opting out of vaccines for their kids as Americans’ views shift.

    During the 2023-24 school year, the percentage of kindergartners exempted from one or more vaccinations rose to 3.3%, the highest ever reported, with increases in 40 states and Washington, D.C., according to Centers for Disease Control and Prevention data. Tennessee and Mississippi were among those with increases. Nearly all exemptions nationally were for nonmedical reasons.

    Vaccine proponents worry anti-vaccine messaging could accelerate a growing “health freedom” movement that has been pushed by leaders in states such as Florida. Momentum against vaccines is likely to continue to grow with the election of Donald Trump as president and his proposed nomination of anti-vaccine activist Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services.

    Pediatricians in states with high exemption rates, such as Florida and Georgia, say they’re concerned by what they see — declining immunization levels for kindergartners, which could lead to a resurgence in vaccine-preventable diseases such as measles. The Florida Department of Health reported nonmedical exemption rates as high as 50% for children in some areas.

    “The religious exemption is huge,” said Brandon Chatani, a pediatric infectious disease doctor in Orlando. “That has allowed for an easy way for these kids to enter schools without vaccines.”

    In many states, it’s easier to get a religious exemption than a medical one, which often requires signoff from a doctor.

    Over the past decade, California, Connecticut, Maine, and New York have removed religious and philosophical exemptions from school vaccination requirements. West Virginia has not had them.

    Idaho, Alaska, and Utah had the highest exemption rates for the 2023-24 school year, according to the CDC. Those states allow parents or legal guardians to exempt their children for religious reasons by submitting a notarized form or a signed statement.

    Florida and Georgia, with some of the lowest reported minimum vaccination rates for kindergartners, allow parents to exempt their children by submitting a form with the child’s school or day care.

    Both states have reported declines in uptake of the measles, mumps, and rubella vaccine, which is one of the most common childhood shots. In Georgia, MMR coverage for kindergartners dropped to 88.4% in the 2023-24 school year from 93.1% in 2019-20, according to the CDC. Florida dropped to 88.1% from 93.5% during the same period.

    Andi Shane, a pediatric infectious disease specialist in Atlanta, traces Georgia’s declining rates to families who lack access to a pediatrician. State policies on exemptions are also key, she said.

    “There’s lots of data to support the fact that when personal belief exemptions are not permitted, that vaccination rates are higher,” she said.

    In December, Georgia public health officials put out an advisory saying the state had recorded significantly more whooping cough cases than in the prior year. According to CDC data, Georgia reported 280 cases in 2024 compared with 96 the year before.

    Until 2023, Mississippi was one of the few states that allowed parents to opt out of vaccinating their kids only for medical reasons — and only with the approval of a doctor. That gave it among the highest vaccination rates in the nation as of the 2023-24 school year.

    “It’s one of the few things Mississippi has done well,” said Anita Henderson, a pediatrician who has practiced in the southern part of the state for nearly 30 years. In terms of health, she said, childhood vaccination rates were the state’s one “shining star.”

    But that changed in April 2023 when a federal judge ordered state officials to start allowing religious exemptions. The ruling has emboldened many families, Henderson said.

    “We are seeing more and more skepticism, more and more vaccine hesitancy, and a lack of confidence because of this ruling,” she said.

    State officials have granted more than 5,000 religious exemptions since the court order allowing them, according to the state health department. Daniel Edney, the state health officer, said most of the requests have come from “more affluent” residents in “pockets” of the state.

    “Most people listen to the expert opinions of their pediatricians and family medicine doctors to stay on the vaccine schedule, because it’s what is best to protect their children,” he said.

    West Virginia’s vaccine law — which hasn’t allowed nonmedical exemptions — also could soon change, Matthew Christiansen said in December before he resigned as the state’s health officer.

    A bill that would have broadened exemptions made it through the legislature last year but was vetoed by outgoing Republican Gov. Jim Justice. The new governor, Republican Pat Morrisey, has been a vocal critic of vaccine mandates. And just a day after being inaugurated, he issued an executive order to propose provisions by Feb. 1 that could allow religious and conscientious exemptions.

    “I want to send a message that if you have a religious belief, then we’re going to have an exception,” he said at a Jan. 14 press conference. “We’re not going to be the outlier.”

    People asserting their personal freedoms to decline vaccines for their kids can ultimately curtail the ability of others to live full lives, Christiansen said. “Kids getting measles and mumps and polio and being paralyzed for their whole life is an impediment on personal freedom and autonomy for those kids,” he said.

    Since the covid pandemic, anti-vaccine sentiment has been growing in Tennessee. One organization, Stand for Health Freedom, drafted a letter for constituents to send to their state lawmakers calling for the resignation of the medical director of Tennessee’s Vaccine-Preventable Diseases and Immunization Program. The group said she demonstrated a “lack of respect for the informed consent rights” of the people.

    “They feel emboldened by the idea that this presidential administration seems to feel very strongly that a lot of these issues should be taken back to the states,” said Emily Delikat, director of Tennessee Families for Vaccines, a pro-vaccine group.

    Ultimately, like many effective public health interventions, vaccines are a victim of their own success, said Henderson, the Mississippi pediatrician. Most people haven’t seen outbreaks of measles or polio, so they forget how dangerous the diseases are, she said.

    “It may unfortunately take a resurgence of those diseases to raise awareness to the fact that these are dangerous, these are deadly, these are preventable,” she said. “I hope it doesn’t come to that.”

    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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    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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    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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