Fast Burn – by Dr. Ian K. Smith
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Intermittent fasting seems simple enough: how complicated can “stop eating for a bit” be? Well, there are nuances and tweaks and hacks and “if you do this bit wrong it will sabotage your benefits” things to know about, too.
Dr. Smith takes us through the basic essentials first, and covers each of the main kinds of intermittent fasting, for example:
- Time-restricted eating; 12:12, 16:8, etc, with those being hours fasting vs hours eating
- Caloric restriction models; for example 5:2, where one eats “normally” for 5 days a week, and on two non-consecutive days, eats only 500 calories
- Day off models and more; for example, “no eating on Sundays” that can, depending on your schedule, be anything from a 24-hour fast to 36 hours or more.
…and, most notably, what they each do metabolically.
Then, the real meat of the book is his program. Taking into account the benefits of each form of fasting, he weaves together a 9-week program to first ease us gently into intermittent fasting, and then enjoy the maximum benefits with minimum self-sabotage.
Which is the biggest stumbling-block for many trying intermittent fasting for the first time, so it’s a huge help that he takes care of this here.
He also includes meal plans and recipes; readers can use those or not; the fasting plan stands on its own two feet without them too.
Bottom line: if you’ve been thinking of trying intermittent fasting but have been put off by all the kinds or have had trouble sticking to it, this book may be just what you need.
Click here to check out Fast Burn on Amazon and see what you can achieve!
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For Seniors With Hoarding Disorder, a Support Group Helps Confront Stigma and Isolation
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A dozen people seated around folding tables clap heartily for a beaming woman: She’s donated two 13-gallon garbage bags full of clothes, including several Christmas sweaters and a couple of pantsuits, to a Presbyterian church.
A closet cleanout might not seem a significant accomplishment. But as the people in this Sunday-night class can attest, getting rid of stuff is agonizing for those with hoarding disorder.
People with the diagnosis accumulate an excessive volume of things such as household goods, craft supplies, even pets. In extreme cases, their homes become so crammed that moving between rooms is possible only via narrow pathways.
These unsafe conditions can also lead to strained relationships.
“I’ve had a few relatives and friends that have condemned me, and it doesn’t help,” said Bernadette, a Pennsylvania woman in her early 70s who has struggled with hoarding since retiring and no longer allows guests in her home.
People who hoard are often stigmatized as lazy or dirty. NPR, Spotlight PA, and KFF Health News agreed to use only the first names of people with hoarding disorder interviewed for this article because they fear personal and professional repercussions if their condition is made public.
As baby boomers age into the group most affected by hoarding disorder, the psychiatric condition is a growing public health concern. Effective treatments are scarce. And because hoarding can require expensive interventions that drain municipal resources, more funding and expertise is needed to support those with the diagnosis before the issue grows into a crisis.
For Bernadette, the 16-week course is helping her turn over a new leaf.
The program doubles as a support group and is provided through Fight the Blight. The Westmoreland County, Pennsylvania, organization started offering the course at a local Masonic temple after founder Matt Williams realized the area lacked hoarding-specific mental health services.
Fight the Blight uses a curriculum based on cognitive behavioral therapy to help participants build awareness of what fuels their hoarding. People learn to be more thoughtful about what they purchase and save, and they create strategies so that decluttering doesn’t become overwhelming.
Perhaps more importantly, attendees say they’ve formed a community knitted together through the shared experience of a psychiatric illness that comes with high rates of social isolation and depression.
“You get friendship,” said Sanford, a classmate of Bernadette’s.
After a lifetime of judgment, these friendships have become an integral part of the changes that might help participants eventually clear out the clutter.
Clutter Catches Up to Baby Boomers
Studies have estimated that hoarding disorder affects around 2.5% of the general population — a higher rate than schizophrenia.
The mental illness was previously considered a subtype of obsessive-compulsive disorder, but in 2013 it was given its own diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5.
The biological and environmental factors that may drive hoarding are not well understood. Symptoms usually appear during the teenage years and tend to be more severe among older adults with the disorder. That’s partly because they have had more time to acquire things, said Kiara Timpano, a University of Miami psychology professor.
“All of a sudden you have to downsize this huge home with all the stuff and so it puts pressures on individuals,” she said. In Bernadette’s case, her clutter includes a collection of VHS tapes, and spices in her kitchen that she said date back to the Clinton administration.
But it’s more than just having decades to stockpile possessions; the urge to accumulate strengthens with age, according to Catherine Ayers, a psychiatry professor at the University of California-San Diego.
Researchers are working to discern why. Ayers and Timpano theorize that age-related cognitive changes — particularly in the frontal lobe, which regulates impulsivity and problem-solving — might exacerbate the disorder.
“It is the only mental health disorder, besides dementia, that increases in prevalence and severity with age,” Ayers said.
As the U.S. population ages, hoarding presents a growing public health concern: Some 1 in 5 U.S. residents are baby boomers, all of whom will be 65 or older by 2030.
This population shift will require the federal government to address hoarding disorder, among other age-related issues that it has not previously prioritized, according to a July report by the Democratic staff of the U.S. Senate Special Committee on Aging, chaired then by former Sen. Bob Casey (D-Pa.).
Health Hazards of Hoarding
Clutter creates physical risks. A cramped and disorderly home is especially dangerous for older adults because the risk of falling and breaking a bone increases with age. And having too many things in one space can be a fire hazard.
Last year, the National Fallen Firefighters Foundation wrote to the Senate committee’s leadership that “hoarding conditions are among the most dangerous conditions the fire service can encounter.” The group also said that cluttered homes delay emergency care and increase the likelihood of a first responder being injured on a call.
The Bucks County Board of Commissioners in Pennsylvania told Casey that hoarding-related mold and insects can spread to adjacent households, endangering the health of neighbors.
Due to these safety concerns, it might be tempting for a family member or public health agency to quickly empty someone’s home in one fell swoop.
That can backfire, Timpano said, as it fails to address people’s underlying issues and can be traumatic.
“It can really disrupt the trust and make it even less likely that the individual is willing to seek help in the future,” she said.
It’s more effective, Timpano said, to help people build internal motivation to change and help them identify goals to manage their hoarding.
For example, at the Fight the Blight class, a woman named Diane told the group she wanted a cleaner home so she could invite people over and not feel embarrassed.
Sanford said he is learning to keep his documents and record collection more organized.
Bernadette wants to declutter her bedroom so she can start sleeping in it again. Also, she’s glad she cleared enough space on the first floor for her cat to play.
“Because now he’s got all this room,” she said, “he goes after his tail like a crazy person.”
Ultimately, the home of someone with hoarding disorder might always be a bit cluttered, and that’s OK. The goal of treatment is to make the space healthy and safe, Timpano said, not to earn Marie Kondo’s approval.
Lack of Treatment Leaves Few Options
A 2020 study found that hoarding correlates with homelessness, and those with the disorder are more likely to be evicted.
Housing advocates argue that under the Fair Housing Act, tenants with the diagnosis are entitled to reasonable accommodation. This might include allowing someone time to declutter a home and seek therapy before forcing them to leave their home.
But as outlined in the Senate aging committee’s report, a lack of resources limits efforts to carry out these accommodations.
Hoarding is difficult to treat. In a 2018 study led by Ayers, the UCSD psychiatrist, researchers found that people coping with hoarding need to be highly motivated and often require substantial support to remain engaged with their therapy.
The challenge of sticking with a treatment plan is exacerbated by a shortage of clinicians with necessary expertise, said Janet Spinelli, the co-chair of Rhode Island’s hoarding task force.
Could Changes to Federal Policy Help?
Casey, the former Pennsylvania senator, advocated for more education and technical assistance for hoarding disorder.
In September, he called for the Substance Abuse and Mental Health Services Administration to develop training, assistance, and guidance for communities and clinicians. He also said the Centers for Medicare & Medicaid Services should explore ways to cover evidence-based treatments and services for hoarding.
This might include increased Medicare funding for mobile crisis services to go to people’s homes, which is one way to connect someone to therapy, Spinelli said.
Another strategy would involve allowing Medicaid and Medicare to reimburse community health workers who assist patients with light cleaning and organizing; research has found that many who hoard struggle with categorization tasks.
Williams, of Fight the Blight, agrees that in addition to more mental health support, taxpayer-funded services are needed to help people address their clutter.
When someone in the group reaches a point of wanting to declutter their home, Fight the Blight helps them start the process of cleaning, removing, and organizing.
The service is free to those earning less than 150% of the federal poverty level. People making above that threshold can pay for assistance on a sliding scale; the cost varies also depending on the size of a property and severity of the hoarding.
Also, Spinelli thinks Medicaid and Medicare should fund more peer-support specialists for hoarding disorder. These mental health workers draw on their own life experiences to help people with similar diagnoses. For example, peer counselors could lead classes like Fight the Blight’s.
Bernadette and Sanford say courses like the one they enrolled in should be available all over the U.S.
To those just starting to address their own hoarding, Sanford advises patience and persistence.
“Even if it’s a little job here, a little job there,” he said, “that all adds up.”
This article is from a partnership that includes Spotlight PA, NPR, and KFF Health News.
Spotlight PA is an independent, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds power to account and drives positive change in Pennsylvania. Sign up for its free newsletters.
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.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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This Is When Your Muscles Are Strongest
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Dr. Karyn Esser is a professor in the Department of Physiology and Aging at the University of Florida, where she’s also the co-director of the University of Florida Older Americans Independence Center, and she has insights to share on when it’s best to exercise:
It’s 4–5pm
Surprise, no clickbait or burying the lede!
This goes regardless of age or sex, but as we get older, it’s common for our circadian rhythm to weaken, which may result in a tendency to fluctuate a bit more.
However, since it’s healthy to keep one’s circadian rhythm as stable as reasonably possible, this is a good reason to try to keep our main exercise focused around that time of day, as it provides a sort of “anchor point” for the rest of our day to attach to, so that our body can know what time it is relative to that.
It’s also the most useful time of day to exercise, because most exercises give benefits proportional to progressive overloading, so training at our peak efficiency time will give the most efficient results. So much for those 5am runs!
On which note: while the title says “strongest” and the thumbnail has dumbbells, this does go for all different types of exercises that have been tested.
For more details on all of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Circadian Rhythm: Far More Than Most People Know
Take care!
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The Blue Zones, Second Edition – by Dan Buettner
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Eat beans & greens, take walks, have a purpose; you can probably list off the top of your head some of the “advices from Blue Zones”, so what makes this book stand out?
This is perhaps one of the most thoughtful investigations; the author (a National Geographic researcher) toured and researched all the Blue Zones, took many many notes (we get details), and asked a lot of questions that others skipped.
For example, a lot of books about the Blue Zones mention the importance of community—but they don’t go into much detail of what that looks like… And they certainly don’t tend to explain what we should do about it.
And that’s because community is often viewed as environmental in a way that we can’t control. If we want to take supplements, eat a certain way, exercise, etc, we can do all those things alone if we want. But if we want community? We’re reliant on other people—and that’s a taboo in the US, and US-influenced places.
So, one way this book excels is in describing how exactly people foster community in the Blue Zones (hint: the big picture—the form of the community—is different in each place, but the individual actions taken are similar), with particular attention to the roles actively taken on by the community elders.
In a similar vein, “reduce stress” is good, but what mindsets and mechanisms do they use that are still reproducible if we are not, for example, Okinawan farmers? Again, Buettner delivers in spades.
Bottom line: this is the Blue Zones book that digs deeper than others, and makes the advices much more applicable no matter where we live.
Click here to check out The Blue Zones, and build these 9 things into your life!
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Resistance Is Useful! (Especially As We Get Older)
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Resistance Is Useful!
At 10almonds we talk a lot about the importance of regular moderate exercise (e.g. walking, gardening, housework, etc), and with good reason: getting in those minutes (at least 150 minutes per week, so, a little over 20 minutes per day, or 25 minutes per day with one day off) is the exericise most consistently linked to better general health outcomes and reduced mortality risk.
We also often come back to mobility, because at the end of the day, being able to reach for something from a kitchen cabinet without doing oneself an injury is generally more important in life than being able to leg-press a car.
Today though, we’re going to talk about resistance training.
What is resistance training?
It can be weight-lifting, or it can be bodyweight exercises. In those cases, what you’re resisting is gravity. It can also be exercises with resistance bands or machines. In all cases, it’s about building and/or maintaining strength.
Why does it matter?
Let’s say you’re not an athlete, soldier, or laborer, and the heaviest thing you have to pick up is a bag of groceries. Strength still matters, for two main reasons:
- Muscle strength correlates to bone strength. You can’t build (or maintain) strong muscles on weak bones, so if you take care of your muscles, then your body will keep your bones strong too.
- That’s assuming you have a good diet as well—but today’s not about that. If you’d like to know more about eating for bone health though, do check out this previous article about that!
- Muscle strength correlates to balance and stability. You can’t keep yourself from falling over if you are physically frail.
Both of those things matter, because falls and fractures often have terrible health outcomes (e.g., slower recovery and more complications) the older we get. So, we want to:
- Ideally, not fall in the first place
- If we do fall, have robust bones
See also: Effects of Resistance Exercise on Bone Health
How much should we do?
Let’s go to the Journal of Strength and Conditioning Research on this one:
❝There is strong evidence to support the benefits of resistance exercise for countering many age-related processes of sarcopenia, muscle weakness, mobility loss, chronic disease, disability, and even premature mortality.
In addition, this Position Statement provides specific evidence-based practice recommendations to aid in the implementation of resistance exercise programs for healthy older adults and those with special considerations.
While there are instances where low-intensity, low-volume programs are appropriate (i.e., beginning programs for individuals with frailty or CVDs), the greatest benefits are possible with progression to moderate to higher intensity programs.❞
~ Fragala et al
Read the statement in full:
There’s a lot of science there and it’s well worth reading if you have the time. It’s particularly good at delineating how much is not enough vs how much is too much, and the extent to which we should (or shouldn’t) train to exhaustion.
If you don’t fancy that, though, and/or just want to start with something accessible and work your way up, the below is a very good (and also evidence-based) start-up plan:
Healthline’s Exercise Plan For Seniors—For Strength, Balance, & Flexibility
(it has a weekly planner, step-by-step guides to the exercises, and very clear illustrative animations of each)
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- Muscle strength correlates to bone strength. You can’t build (or maintain) strong muscles on weak bones, so if you take care of your muscles, then your body will keep your bones strong too.
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The Diet Myth – by Dr. Tim Spector
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Why are we supposed to go low-carb, but get plenty of whole grains? Avoid saturated fat, but olive oil is one of the healthiest fats around? Will cheese kill us or save us? Even amongst the well-informed, there’s a lot of confusion. This book addresses these and many such topics.
A main theme of the book is howa lot of it relates to the state of our gut microbiome, and what is good or bad for that. He also discusses, for example, how microbes predict obesity better than genes, and the good news is: we can change our microbes a lot more easily than we can change our genes!
In the category of criticism, he repeats some decades-old bad science in some areas outside of his field (i.e. unrelated to nutrition), so that’s unfortunate, and/but doesn’t detract from the value of the book if we keep to the main topic.
Bottom line: if you’d like to understand better the physiology and microbiology behind why dieting does work for most people (and how to do it better), then this is a great book for that.
Click here to check out The Diet Myth, and learn the science behind the confusion!
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World Menopause Day Health News Round-Up
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In order to provide variety in this week’s round-up, not all of this is menopause-related, but it is all important:
Menopause & CVD
Untreated menopause is associated with higher incidence of heart disease, and higher mortality. People often forget about how much estrogen does for us (well, for those of us with a physiology running on estrogen, anyway; gentlemen, your testosterone is fine for you), and think it is “just” a sex hormone, but it’s a lot more.
Read in full: Menopause transition linked to increased heart disease risk
Related: What Menopause Does To The Heart
Extraterrestrial medical technology
The much lower gravity in Earth orbit has allowed for tissue engineering techniques that Earth’s normal gravity imposes limitations on. This is big news, because it means that rather than replacing a whole liver, tissue implants could be grafted, allowing the extant liver to repair itself (something livers are famously good at, but they need enough undamaged base material to work with).
Read in full: How liver tissue from the International Space Station may transform tissue engineering
Related: How To Unfatty A Fatty Liver
One thing and then another
As if endometriosis weren’t unpleasant enough in and of itself, the endothelial dysfunction inherent to it also raises cardiovascular disease risk. This is important, because while endometriosis has (like many maladies predominantly affecting women) generally been shrugged off by the medical world as an unhappy inconvenience but not life-threatening, now we know it comes with extra existential risks too:
Read in full: Understanding cardiovascular risks in endometriosis patients
Related: What You Need To Know About Endometriosis
Push-button meditation
Unlike mindfulness meditation, listening to music is a very passive experience, and thus requires less effort from the user. And yet, it has been associated with lower perceived pain levels, lower self-reported anxiety levels, less opioid use, and measurably lower heart-rate.
Read in full: Listening to music may speed up recovery from surgery, research suggests
Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Cholesterol in menopause: quality over quantity
Much like previous research has shown that the quantity of LDL is not nearly so predictive of health outcomes in women as it is in men, this study into HDL and menopausal women shows that quantity of HDL does not matter nearly so much as the quality of it.
Read in full: HDL quality, not quantity, contribute to the first sign of Alzheimer’s disease in women
Related: Statins: His & Hers? ← consistent with the above, statins (to lower LDL cholesterol) generally help more for men and produce more adverse side effects for women. So again, a case of “the actual amount of cholesterol isn’t so important for women as for men”.
Take care!
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