Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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7 Healthy Gut Habits For Women Over 40 – by Lara West
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With regard to the titular 7 healthy gut habits for women over 40, a chapter is devoted to each one of those habits, and she goes into quite some detail in each category, more than you might expect.
As for the 7 things, we’ll not keep them a mystery; they are:
- Intermittent fasting
- Prebiotics & probiotics
- Mindful eating
- Understanding ingredients
- Movement
- Sleep
- Stress management
Of course, all of these things are good regardless of one’s age or gender, but West is writing with women over 40 in mind, and as such, she will focus on things that are especially relevant to those of us who are indeed women over 40.
You may be wondering: what if I’m a long way over 40, and menopause is a distant memory? In that case, 90% of this will still be relevant to you; the only parts that won’t be, are those that pertain specifically to the menopausal transitional phase itself, rather than the post-menopause state.
You may also be wondering: what if I’m a man, and menopause is just not in the cards for me? In that case, maybe about 70% of this will still be relevant to you, because of the broad applicability of most of the advice. That said, if it’s just for yourself, you’d probably do better with a book of which 100% is relevant to you, rather than this one.
The style is conversational pop-science, with personal anecdotes mixed in with references to science. It’s definitely on the light/easy-reading end of books that we’ve reviewed on the topic.
Bottom line: if you’re a woman over 40 who would like to improve your gut health, this book was written for you.
Click here to check out 7 Healthy Gut Habits For Women Over 40, and rediscover vitality!
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Is ADHD Being Over-Diagnosed For Cash?
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Is ADHD Being Systematically Overdiagnosed?
The BBC’s investigative “Panorama” program all so recently did a documentary in which one of their journalists—who does not have ADHD—went to three private clinics and got an ADHD diagnosis from each of them:
- The BBC documentary: Private ADHD Clinics Exposed (28 mins)
- Their “5 Minutes” version: ADHD Undercover: How I Was Misdiagnosed (6 mins)
So… Is it really a case of show up, pay up, and get a shiny new diagnosis?
The BBC Panorama producers cherry-picked 3 private providers, and during those clinical assessments, their journalist provided answers that would certainly lead to a diagnosis.
This was contrasted against a three-hour assessment with an NHS psychiatrist—something that rarely happens in the NHS. Which prompts the question…
How did he walk into a 3-hour psychiatrist assessment, when most people have to wait in long waiting lists for a much more cursory appointment first with assorted gatekeepers, before going on another long waiting list, for an also-much-shorter appointment with a psychiatrist?
That would be because the NHS psychiatrist was given advance notification that this was part of an investigation and would be filmed (the private clinics were not gifted the same transparency)
So, maybe just a tad unequal treatment!
In case you’re wondering, here’s what that very NHS psychiatrist had to say on the topic:
Is it really too easy to be diagnosed with ADHD?
(we’ll give you a hint—remember Betteridge’s Law!)
❝Since the documentary aired, I have heard from people concerned that GPs could now be more likely to question legitimate diagnoses.
But as an NHS psychiatrist it is clear to me that the root of this issue is not overdiagnosis.
Instead, we are facing the combined challenges of remedying decades of underdiagnosis and NHS services that were set up when there was little awareness of ADHD.❞
~ Dr. Mike Smith, Psychiatrist
The ADHD foundation, meanwhile, has issued its own response, saying:
❝We are disappointed that BBC Panorama has opted to broadcast a poorly researched, sensationalist piece of television journalism.❞
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What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring
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In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a cardiac arrest.
Many media outlets incorrectly referred to the event as a “heart attack” or used the terms interchangeably.
A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.
With some background in how the heart works, we can see how they differ and how they’re related.
Explode/Shutterstock Understanding the heart
The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.
For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.
This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.
Heart attack or cardiac arrest?
Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.
A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.
In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.
Why do they happen? Who’s at risk?
Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.
The underlying cause in about 75% of people is a process called atherosclerosis. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.
Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.
Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.
Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.
Here’s a simple way to remember the difference. Author provided But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to electrical malfunctions in the heart. There are four distinct types:
- ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than 100 beats per minute (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately
- ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute
- pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse
- asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.
Remember this flat-line rhythm from the movies? It’s asystole, when there’s no electrical activity in the heart. Kateryna Kon/Shutterstock Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a congenital heart defect, a heart condition he was born with.
But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting for 70% of all cases.
So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.
So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.
What do they look like?
Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.
But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.
What’s the take-home message?
While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.
A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.
Despite their different nature both conditions can have severe consequences and require immediate medical attention.
Michael Todorovic, Associate Professor of Medicine, Bond University and Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What Grief Does To Your Body (And How To Manage It)
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What Grief Does To The Body (And How To Manage It)
In life, we will almost all lose loved ones and suffer bereavement. For most people, this starts with grandparents, eventually moves to parents, and then people our own generation; partners, siblings, close friends. And of course, sometimes and perhaps most devastatingly, we can lose people younger than ourselves.
For something that almost everyone suffers, there is often very little in the way of preparation given beforehand, and afterwards, a condolences card is nice but can’t do a lot for our mental health.
And with mental health, our physical health can go too, if we very understandably neglect it at such a time.
So, how to survive devastating loss, and come out the other side, hopefully thriving? It seems like a tall order indeed.
First, the foundations:
You’re probably familiar with the stages of grief. In their most commonly-presented form, they are:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
You’ve probably also heard/read that we won’t always go through them in order, and also that grief is deeply personal and proceeds on its own timescale.
It is generally considered healthy to go through them.
What do they look like?
Naturally this can vary a lot from person to person, but examples in the case of bereavement could be:
- Denial: “This surely has not really happened; I’ll carry on as though it hasn’t”
- Anger: “Why didn’t I do xyz differently while I had the chance?!”
- Bargaining: “I will do such-and-such in their honor, and this will be a way of expressing the love I wish I could give them in a way they could receive”
- Depression: “What is the point of me without them? The sooner I join them, the better.”
- Acceptance: “I was so lucky that we had the time together that we did, and enriched each other’s lives while we could”
We can speedrun these or we can get stuck on one for years. We can bounce back and forth. We can think we’re at acceptance, and then a previous stage will hit us like a tonne of bricks.
What if we don’t?
Assuming that our lost loved one was indeed a loved one (as opposed to someone we are merely societally expected to mourn), then failing to process that grief will tend to have a big impact on our life—and health. These health problems can include:
As you can see, three out of five of those can result in death. The other two aren’t great either. So why isn’t this taken more seriously as a matter of health?
Death is, ironically, considered something we “just have to live with”.
But how?
Coping strategies
You’ll note that most of the stages of grief are not enjoyable per se. For this reason, it’s common to try to avoid them—hence denial usually being first.
But, that is like not getting a lump checked out because you don’t want a cancer diagnosis. The emotional reasoning is understandable, but it’s ultimately self-destructive.
First, have a plan. If a death is foreseen, you can even work out this plan together.
But even if that time has now passed, it’s “better late than never” to make a plan for looking after yourself, e.g:
- How you will try to get enough sleep (tricky, but sincerely try)
- How you will remember to eat (and ideally, healthily)
- How you will still get exercise (a walk in the park is fine; see some greenery and get some sunlight)
- How you will avoid self-destructive urges (from indirect, e.g. drinking, to direct, e.g. suicidality)
- How you will keep up with the other things important in your life (work, friends, family)
- How you will actively work to process your grief (e.g. journaling, or perhaps grief counselling)
Some previous articles of ours that may help:
- How To Keep On Keeping On ← this is about looking after general health when motivation is low
- The Mental Health First-Aid You’ll Hopefully Never Need ← this is about managing depression
- How To Stay Alive (When You Really Don’t Want To) ← this is about managing suicidality
- Life After Death? (Your Life; A Loved One’s Death) ← this is about bereavement and romance
If it works, it works
If we are all unique, then any relationship between any two people is uniqueness squared. Little wonder, then, that our grief may be unique too. And it can be complicated further:
- Sometimes we had a complicated relationship with someone
- Sometimes the circumstances of their death were complicated
There is, for that matter, such a thing as “complicated grief”:
Read more: Complicated grief and prolonged grief disorder (Medical News Today)
We also previously reviewed a book on “ambiguous loss”, exploring grieving when we cannot grieve in the normal way because someone is gone and/but/maybe not gone.
For example, if someone is in a long-term coma from which they may never recover, or if they are missing-presumed-dead. Those kinds of situations are complicated too.
Unusual circumstances may call for unusual coping strategies, so how can we discern what is healthy and what isn’t?
The litmus test is: is it enabling you to continue going about your life in a way that allows you to fulfil your internal personal aspirations and external social responsibilities? If so, it’s probably healthy.
Look after yourself. And if you can, tell your loved ones you love them today.
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Coenzyme Q10 From Foods & Supplements
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Coenzyme Q10 and the difference it makes
Coenzyme Q10, often abbreviated to CoQ10, is a popular supplement, and is often one of the more expensive supplements that’s commonly found on supermarket shelves as opposed to having to go to more specialist stores or looking online.
What is it?
It’s a compound naturally made in the human body and stored in mitochondria. Now, everyone remembers the main job of mitochondria (producing energy), but they also protect cells from oxidative stress, among other things. In other words, aging.
Like many things, CoQ10 production slows as we age. So after a certain age, often around 45 but lifestyle factors can push it either way, it can start to make sense to supplement.
Does it work?
The short answer is “yes”, though we’ll do a quick breakdown of some main benefits, and studies for such, before moving on.
First, do bear in mind that CoQ10 comes in two main forms, ubiquinol and ubiquinone.
Ubiquinol is much more easily-used by the body, so that’s the one you want. Here be science:
What is it good for?
Benefits include:
- Against aging
- Against skin cancer
- Against breast cancer
- Against prostate cancer
- Against heart failure
- Against obesity
- Against diabetes
- Against Alzheimer’s
- Against Parkinson’s
Can we get it from foods?
Yes, and it’s equally well-absorbed through foods or supplementation, so feel free to go with whichever is more convenient for you.
Read: Intestinal absorption of coenzyme Q10 administered in a meal or as capsules to healthy subjects
If you do want to get it from food, you can get it from many places:
- Organ meats: the top source, though many don’t want to eat them, either because they don’t like them or some of us just don’t eat meat. If you do, though, top choices include the heart, liver, and kidneys.
- Fatty fish: sardines are up top, along with mackerel, herring, and trout
- Vegetables: leafy greens, and cruciferous vegetables e.g. cauliflower, broccoli, sprouts
- Legumes: for example soy, lentils, peanuts
- Nuts and seeds: pistachios come up top; sesame seeds are great too
- Fruit: strawberries come up top; oranges are great too
If supplementing, how much is good?
Most studies have used doses in the 100mg–200mg (per day) range.
However, it’s also been found to be safe at 1200mg (per day), for example in this high-quality study that found that higher doses resulted in greater benefit, in patients with early Parkinson’s Disease:
Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline
Wondering where you can get it?
We don’t sell it (or anything else for that matter), and you can probably find it in your local supermarket or health food store. However, if you’d like to buy it online, here’s an example product on Amazon
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Foods for Stronger Bones
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It’s Q&A Day!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
Q: Foods that help build stronger bones and cut inflammation? Thank you!
We’ve got you…
For stronger bones / To cut inflammation
That “stronger bones” article is about the benefits of collagen supplementation for bones, but there’s definitely more to say on the topic of stronger bones, so we’ll do a main feature on it sometime soon!
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