From Painkillers To Hunger-Killers
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Here’s this week’s selection of health news discoveries, the science behind them, what they mean for you, and where you can go from there:
Killing more than pain
It’s well-known that overuse of opioids can lead to many problems, and here’s another one: messing with the endocrine system. This time, mostly well-evidenced in men—however, the researchers are keen to point out that absence of evidence is very much not evidence of absence, hence “the hidden effects” in the headline below. It’s not that the effects are hard to see—it’s that a lot of the research has yet to be done. For now, though, we know at the very least that there’s an association between opioid use and hyperprolactinemia in men. The same research also begins to shine a light on the effects of opioid use on the hypothalamic-pituitary system and bone health, too:
Read in full: The hidden effects of opioid use on the endocrine system
Related: The 7 Approaches To Pain Management
Gut microbiome dysbiosis may lead to slipping disks
These things sound quite unconnected, but the association is strong. The likely mechanism of action is that the gut dysbiosis influences systemic inflammation, and thus spinal health—because the gut-spine axis cannot really be disconnected (while you’re alive, at least). It’s especially likely if you’re over 50 and female:
Read in full: Are back problems influenced by your gut?
Related: Is Your Gut Leading You Into Osteoporosis?
The Internet is really really great (for brains)
It’s common to see many articles on the Internet telling us, paradoxically, that we should spend less time on the Internet. However… Remember when in the 90s, it was all about “the information superhighway”? It turns out, the fact that it’s more like “the information spaghetti junction” these days doesn’t change the fact that stimulation is good for our brains, and daily Internet use improves memory, because of the different way that we index and store information that came from a virtual source. While there are parts of your brain for “things at home” and “things at the local supermarket”, there are also parts for “things at 10almonds” and “things at Facebook” and so forth. You are, in effect, building a vast mental library as you surf:
Read in full: Daily internet use supercharges your memory!
Related: Make Social Media Work For Your Mental Health
Fall back
Around this time of year in many places in the Northern Hemisphere, the clocks go back an hour (it’s next weekend in the US and Canada, by the way, and this weekend in most of Europe). Many enjoy this as the potential for an extra hour’s sleep, but for night owls, it can be more of a nuisance than a benefit—throwing out what’s often an already difficult relationship with the clock, and presenting challenges both practical and physiological (different processing of melatonin, for instance). Here be science:
Read in full: Why night owls struggle more when the clocks go back
Related: Early Bird Or Night Owl? Genes vs Environment
Can you outrun your hunger?
It seems so, though benefits are strongest in women. We say “outrun”, though this study did use stationary cycling. To put it in few words, intense exercise (but not moderate exercise) significantly reduced acylated ghrelin (hunger hormone) levels, and subjective reports of hunger, especially in women:
Read in full: Study finds intense exercise may suppress appetite in healthy humans
Related: 3 Appetite Suppressants Better Than Ozempic
Take care!
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Statins vs Breast Cancer
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We’ve written about both of these topics (statins and breast cancer) before, but this is the first time we’re talking about the effect of one on the other.
So, first of all, let’s recap a little: statins, often prescribed to lower cholesterol levels, are:
- often (but not always) much less effective for women than for men, and also
- often (but not always) come with side effects that are typically a lot more serious for women than for men.
The side effects can then lead to a “side effect train” whereby the patient then has to take something else to treat the side effect, then something else to treat the side effect(s) of that medication, and so on, until they are taking an increasingly large stack of medications. See also: Are You Taking PIMs? Getting Off The Overmedication Train
Based on that, statins will not be “the right choice” for women as often as they are for men.
You can read on that in detail, here: Statins: His & Hers?
Or if you want to get really into detail, then check out this excellent book that we reviewed (and whose information largely informed the above-linked article): The Truth About Statins – by Dr. Barbara H. Roberts
And to borrow from that article:
❝Statins do have their place, especially for men. They can, however, mask underlying problems that need treatment—which becomes counterproductive.
When it comes to women, statins are—in broad terms—statistically not as good. They are a little more likely to be helpful specifically in cases of atherosclerosis, whereby they have a 50/50 chance of helping.
For women in particular, it may be worthwhile looking into alternative non-statin drugs, and, for everyone: diet and exercise.❞
As for those non-statin alternatives, actually drugs (in the sense usually meant) are not the only option either, as there are natural compounds that have been shown to help, for example:
Policosanol: A Rival To Statins, Without The Side Effects?
…and:
Take These To Lower Cholesterol! (Statin Alternatives)
In statins’ favor…
Researchers (Dr. Alana Cavadino et al.) investigated the relationship between statins and breast cancer mortality.
This is highly relevant, because breast cancer is the most common and deadliest cancer in women; older women are at higher risk and often take statins for cardiovascular health. It’s not just a matter of “statins improve heart health and therefore indirectly improve breast cancer survivorship rates as part of decreasing all-cause mortality”, but rather, statins inhibit an enzyme overexpressed in breast cancer and influence cell proliferation, apoptosis, and immune responses.
Metabolic function in general is also important for breast cancer survivorship, though: What Your Metabolism Says About How Aggressive Breast Cancer Is Likely To Be For You
…which is why we also covered The Exercises That Help Keep Breast Cancer At Bay!
Now, previous studies linked statins to lower breast cancer recurrence and death, but may have been biased by factors like immortal time bias (ITB)*, cancer stage, estrogen receptor (ER) status, timing of statin use, and statin type.
*ITB = when survival time is misattributed to a treatment period before a patient actually starts treatment, potentially inflating the perceived benefit.
So, clearly more research was needed! Which is something, by the way, the authors of the aforementioned previous studies also acknowledged—towards the end of almost any decent scientific paper you will usually see two things:
- a list of limitations of the study that was just done (i.e., mentioning the possibility of the above data biases, for example)
- a suggestion (often a tacit plea) for more research in the area, often with examples of what things in particular they’d like to see done
Science is very collaborative like that; there is so much to be done that the only way forward is to share the work done, and not merely pass on the baton, but usually pass on several batons (new lines of research) while still continuing one’s own.
In this case, rather than taking to the lab and getting out the test tubes, the researchers opted for a meta-analysis, which basically means going through everyone else’s research with a fine-toothed comb, pooling data from a large number of studies, and doing some advanced mathematics to determine what conclusions can be made from the data available as a whole.
Think of it like a shell game: if a person hides a pea under one of a set of 3 inverted cups and shuffles them, and then you check under the cup, and the pea’s not there, then you know it’s under one of the other two. If someone else (who hasn’t seen what you saw) is able to look under another cup, and finds the pea is not there either, then they also know it’s under one of the other two that they didn’t check. Alone, you each have a 50% chance of being right about which cup the pea is under, but if you combine your knowledge, you now know more than either of you could have calculated alone.
So, that’s what a meta-analysis does, only it was 34 other separate teams of people most of whom didn’t talk to each other while looking under a combined total of 689,990 cups for the same pea.
With that in mind, some notes:
- What was included: this meta-analysis included 34 studies and 689,990 women with breast cancer; outcomes studied were breast cancer death (21 studies) and recurrence (20 studies) ← notice there is a small overlap because some studied both
- What the data was like: most studies adjusted for age, cancer stage, and other conditions, but only half adjusted for medication use. Follow-ups ranged from under 5 years to 10 years. Five studies were prospective.
- What statins were used and when: 14 studies differentiated between lipophilic and hydrophilic statins (this will be important later); 27 studies looked at post-diagnosis statin use, while others looked at pre-diagnosis or both.
What they found:
- About mortality: statin use was linked to a 20% reduction in breast cancer death risk; lipophilic statins had a stronger protective effect.
- About recurrence: statins were associated with a 24% reduction in recurrence risk; stronger effects seen in ER-positive patients (that is: patients in whom the cancer was made worse by estrogen, because the cancerous cells had estrogen receptors)
With regard to that concern about the potential data biases in the studies: small studies reported larger benefits, but analyses showed results remained valid even after correcting for publication bias.
You can read the paper in full, here: Statin use and breast cancer-specific mortality and recurrence: a systematic review and meta-analysis including the role of immortal time bias and tumour characteristics
Want to learn more?
Check out:
How To Triple Your Breast Cancer Survival Chances, and especially 8 Signs On Your Breast You Shouldn’t Ignore
For those curious about the hormonal side of things, you might consider: The Hormone Therapy That Reduces Breast Cancer Risk & More
And if you want to go deeply into it, then:
The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons
…is an excellent book on the topic.
Take care!
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Not So Fast: What Intermittent Fasting Will & Won’t Do
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First, for any unaware: intermittent fasting (IF) is the practice of fasting during certain periods and not during others. A common method is to eat during a set window of time per day, with an 8-hour window being perhaps the most common choice. Scientists often refer to this by the slightly more helpful term “time-restricted eating“, since well, all fasting is intermittent if you do it more than once. Nevertheless, we’ll stick to the popular term here.
Intermittent fasting has been found to, amongst other things, promote healthy apoptosis and autophagy (in other words: early programmed cell death and recycling—these are good things).
This means that intermittent fasting has anti-aging and anticancer potential. We wrote more about it the mechanism in this article:
Fisetin: The Anti-Aging Assassin ← as the name suggests, this is about a senolytic supplement that does the same thing, not about intermittent fasting per se, but the mechanism is the same and it explains why healthy apoptosis and autophagy is important for these things
If-specific research
It also has anti-inflammatory benefits and decreases the risk of insulin resistance. In other words, intermittent fasting boosts the metabolism while simultaneously guarding against some of the dangers of a faster metabolism (harms you’d get if you instead increased your metabolism by doing intense exercise and then eating a mountain of convenience food to compensate).
Read the science: Intermittent Fasting: Is the Wait Worth the Weight?
Read our prior article: Fasting Without Crashing? We Sort The Science From The Hype
And as for that about insulin sensitivity, see: Improve Your Insulin Sensitivity! ← for many ways to do that, including (but not limited to) IF!
However, not everyone will get to enjoy these same effects. And, ironically, those who are most likely to be trying to lose weight, are least likely to get that benefit:
Why Intermittent Fasting (& GLP-1 Drugs!) Might Not Work For You
The circadian benefit
This is an underrated one, and can be a benefit that stands when some of the others don’t.
For example, remember how we said that people who are most likely to be trying to lose weight are the least likely to get that benefit from IF? Well, researchers (Dr. Olga Pivovarova-Ramich et al.) looked into this, and found that for women in the “overweight” or “obese” category…
❝During the restricted 8-hour eating period, participants were asked to consume their habitual food quality and quantity. Insulin sensitivity did not differ between (−0.07; 95% CI, −0.77 to 0.62; P = 0.60) or within (eTRE: 0.31; 95% CI, −0.14 to 0.76; P = 0.11; lTRE: 0.19; 95% CI, −0.22 to 0.60; P = 0.25) interventions. Twenty-four–hour glucose, lipid, inflammatory, and oxidative stress markers showed no clinically meaningful between- or within-intervention differences. Participants demonstrated high timely adherence (eTRE, 96.5%; lTRE, 97.7%), unchanged dietary composition and physical activity, minor daily calorie deficit (eTRE, −167 kilocalories/day), and weight loss (eTRE, −1.08 kilograms; lTRE, −0.44 kilograms).❞
- TRE = time-restricted eating
- eTRE = early time-restricted eating
- lTRE = late time-restricted eating
In other words, for these women in those weight categories, an eight-hour eating window did not improve insulin sensitivity, blood sugar, blood fats, or inflammatory markers when calories and nutrients were held constant.
However!
What meal timing did do is it shifted participants’ internal clocks, with later eating leading to later bedtimes and later wake times.
And this is important, because that does have a big impact on many other aspects of our health, for example:
The Other Circadian Rhythms ← this is about what happens when your body parts clock on and off at the wrong times
Breaking the fast correctly
When it’s time to break the fast, there are considerations, such as:
- Breakfasting For Health: When To Do It
- What Size Breakfast Is Best, By Science?
- What Breakfast Means For Metabolic Syndrome
Want to get intentional with your circadian rhythm?
One of the leading figures in the field of circadian rhythm research is Dr. Satchin Panda, whose work we wrote about here:
The Circadian Rhythm: Far More Than Most People Know
His team’s (free!) app, “My Circadian Clock”, can help you track and organize all of the body’s measurable-by-you circadian events, and, if you give permission, will contribute to what will be the largest-yet human study into the topics covered today, to refine the conclusions and learn more about what works best.
Check out the iOS app here | Check out the Android app here
Enjoy!
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Safe seat syndrome? Why some hospitals get upgrades and others miss out
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On his campaign trail, Prime Minister Anthony Albanese pledged A$200 million to upgrade St John of God Midland Public Hospital in Perth. He promised more beds and operating theatres, and a redesigned obstetrics and neonatal unit.
It followed other recent election promises from the Labor government, including $120 million for new birthing facilities at Sydney’s planned Rouse Hill Hospital and $150 million to build a health centre in southern Adelaide.
New and expanded health facilities are welcome in fast-growing communities. But are hospital funding pledges in election campaigns based on health-care or political needs?
Does pork-barrelling drive health funding decisions?
Labor and the Coalition have faced allegations of pork-barrelling this election campaign.
Pork-barrelling means using public funds to target specific electorates to win votes, rather than allocating resources based on need. Four in five Australians consider pork-barrelling to be corrupt.
Former New South Wales Premier Gladys Berejiklian suggested pork-barrelling was “business as usual” in her government.
It also seems to occur at the federal level. The Australian National Audit Office found a $1.25 billion Community Health and Hospitals Program implemented by the former Morrison government “fell short of ethical requirements” and deliberately breached Commonwealth grant guidelines.
Of the 63 major projects funded, only two were rated “highly suitable” – the usual benchmark for shortlisting. In fact, most approved projects were picked by the government outside of the established expression of interest processes.
Who funds and manages public hospitals?
The National Health Reform Agreement makes states and territories responsible for managing public hospitals. States and territories contribute around 58% of hospital funding. They also oversee planning and infrastructure.
Local hospital networks help plan and implement capital projects such as new hospitals and facility upgrades.
Under the National Health Reform Agreement, the Commonwealth government also contributes public hospital funding through:
- activity-based funding. This is tied to the number and type of patients treated
- block funding for smaller regional and rural hospitals
- public health funding for initiatives such as vaccination programs.
The reform agreement outlines the Commonwealth’s responsibility for supporting public hospital services. But it doesn’t restrict the Commonwealth from making hospital infrastructure promises.
The Commonwealth often pledges direct hospital funding through supplementary agreements or ad hoc initiatives. Earlier this year, it announced an additional one-off $1.7 billion payment to ease pressure on public hospitals.
State planning vs federal politics: who decides?
States use formal planning frameworks to plan and prioritise health infrastructure projects. NSW Health, for example, applies a structured Facility Planning Process for projects over $10 million. This considers local population needs, health and community benefits, costs and workforce capacity.
These types of frameworks help ensure health capital investment decisions are transparent and evidence-based.
What is less transparent is how the Commonwealth decides which specific hospitals to pledge money to, particularly during election campaigns.
While some federal funding announcements may align with state priorities, picking one hospital over another comes with an “opportunity cost”. For every community that benefits from a new or upgraded hospital, another potentially higher-need community may miss out.
To prevent Commonwealth funding decisions being swayed by political priorities, more transparent processes for setting priorities and making decisions are needed.
What would a better system look like?
The way funds are allocated to medicines listed on the Pharmaceutical Benefits Scheme (PBS) provides the federal government with an exemplary approach to good health-care investment decisions.
The Pharmaceutical Benefits Advisory Committee (PBAC) provides independent advice to the Minister for Health on whether the government should allocate millions to new medicines. The PBAC uses rigorous, transparent processes to make listing recommendations based on patient need and cost-effectiveness.
Federal government hospital infrastructure funding decisions should also follow open, competitive, merit-based processes.
Prioritising evidence and having transparent decision-making guidelines would mean funding is more likely to be allocated based on the greatest population need rather than electoral considerations.
Other ways to improve federal government hospital funding decisions may include:
- incorporating nationally agreed principles for hospital capital funding in future National Health Reform Agreements
- increasing transparency. This could be achieved through a national public register of hospital development proposals, ranked by urgency and need
- strengthening safeguards on election-period pledges. This could improve disclosures and ensure hospital funding decisions align with independent needs assessments.
More hospitals or better prevention?
Former St Vincent’s Health CEO Toby Hall put it bluntly:
If Australia is to make the most of its healthcare future, it will likely need fewer hospitals, not more.
He pointed to Denmark, which cut its number of hospitals by 67% over 1999–2019. This was achieved by shifting as many services as possible from hospitals to other types of health care including primary care, health centres and outpatient clinics.
While more hospitals in Australia may be inevitable as the population ages, health policy should also focus on keeping people out of hospital in the first place. That means investing in prevention, early intervention and technology to support care at home.
Australia lags behind other wealthy nations in this space, ranking 20th out of 33 OECD countries in per capita spending on prevention. It ranks 27th when measured as a share of total health expenditure.
Some local health districts are showing what’s possible. This includes using home monitoring to help people manage chronic conditions. These kinds of innovations can improve health and reduce pressure on hospital infrastructure.
While new hospitals and wards make for compelling election promises, a better health system will come not just from “bricks and mortar”. It will come from smarter investments in prevention, early intervention and innovative care that keeps people healthier and out of hospital.
Anam Bilgrami, Senior Research Fellow, Macquarie University Centre for the Health Economy, Macquarie University and Henry Cutler, Professor and Director, Macquarie University Centre for the Health Economy, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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A Guide to Rational Living – by Drs. Albert Ellis and Robert Harper
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We’ve talked before about the evidence-based benefits of Cognitive Behavioral Therapy (CBT), and this book is indeed about CBT. In fact, it’s in many ways the book that popularized Third Wave CBT—in other words, CBT in its modern form.
Dr. Ellis’s specific branch of CBT is Rational Emotive Behavior Therapy, (REBT). What this means is using rationality to rewire emotions so that we’re not constantly sabotaging ourselves and our lives.
This is very much a “for the masses” book and doesn’t assume any prior knowledge of psychology, therapy, or psychotherapy. Or, for that matter, philosophy, since Stoic philosopher Epictetus had a lot to say that influenced Dr. Ellis’s work, too!
This book has also been described as “a self-help book for people who don’t like self-help books”… and certainly that Stoicism we mentioned does give the work a very different feel than a lot of books on the market.
The authors kick off with an initial chapter “How far can you go with self-therapy?”, and the answer is: quite far, even if it’s not a panacea. Everything has its limitations, and this book is no exception. On the other hand…
What the book does offer is a whole stack of tools, resources, and “How to…” chapters. In fact, there are so many “How to…” items in this book that, while it can be read cover-to-cover, it can also be used simply as a dip-in reference guide to refer to in times of need.
Bottom line: this book is highly recommendable to anyone and everyone, and if you don’t have it on your bookshelf, you should.
Click here to check out “A Guide To Rational Living” on Amazon today!
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Mindfulness – by Olivia Telford
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Olivia Telford takes us on a tour of mindfulness, meditation, mindfulness meditation, and how each of these things impacts stress, anxiety, and depression—as well as less obvious things too, like productivity and relationships.
In the category of how much this is a “how-to-” guide… It’s quite a “how-to” guide. We’re taught how to meditate, we’re taught assorted mindfulness exercises, and we’re taught specific mindfulness interventions such as beating various life traps (e.g. procrastination, executive dysfunction, etc) with mindfulness.
The writing style is simple and to the point, explanatory and very readable. References are made to pop-science and hard science alike, and all in all, is not too far from the kind of writing you might expect to find here at 10almonds.
Bottom line: if you’d like to practice mindfulness meditation and want an easy “in”, or perhaps you’re curious and wonder what mindfulness could tangibly do for you and how, then this book is a great choice for that.
Click here to check out Mindfulness, and enjoy being more present in life!
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Test For Whether You Will Be Able To Achieve The Splits
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Some people stretch for years without being able to do the splits; others do it easily after a short while. Are there people for whom it is impossible, and is there a way to know in advance whether our efforts will be fruitful? Liv (of “LivInLeggings” fame) has the answer:
One side of the story
There are several factors that affect whether we can do the splits, including:
- arrangement of the joint itself
- length of tendons and muscles
- “stretchiness” of tendons and muscles
The latter two things, we can readily train to improve. Yes, even the basic length can be changed over time, because the body adapts.
The former thing, however (arrangement of the joint itself) is near-impossible, because skeletal changes happen more slowly than any other changes in the body. In a battle of muscle vs bone, muscle will always win eventually, and even the bone itself can be rebuilt (as the body fixes itself, or in the case of some diseases, messes itself up). However, changing the arrangement of your joint itself is far beyond the auspices of “do some stretches each day”. So, for practical purposes, without making it the single most important thing in your life, it’s impossible.
How do we know if the arrangement of our hip joint will accommodate the splits? We can test it, one side at a time. Liv uses the middle splits, also called the side splits or box splits, as an example, but the same science and the same method goes for the front splits.
Stand next to a stable elevated-to-hip-height surface. You want to be able to raise your near-side leg laterally, and rest it on the surface, such that your raised leg is now perfectly perpendicular to your body.
There’s a catch: not only do you need to still be stood straight while your leg is elevated 90° to the side, but also, your hips still need to remain parallel to the floor—not tilted up to one side.
If you can do this (on both sides, even if not both simultaneously right now), then your hip joint itself definitely has the range of motion to allow you to do the side splits; you just need to work up to it. Technically, you could do it right now: if you can do this on both sides, then since there’s no tendon or similar running between your two legs to make it impossible to do both at once, you could do that. But, without training, your nerves will stop you; it’s an in-built self-defense mechanism that’s just firing unnecessarily in this case, and needs training to get past.
If you can’t do this, then there are two main possibilities:
- Your joint is not arranged in a way that facilitates this range of motion, and you will not achieve this without devoting your life to it and still taking a very long time.
- Your tendons and muscles are simply too tight at the moment to allow you even the half-split, so you are getting a false negative.
This means that, despite the slightly clickbaity title on YouTube, this test cannot actually confirm that you can never do the middle splits; it can only confirm that you can. In other words, this test gives two possible results:
- “Yes, you can do it!”
- “We don’t know whether you can do it”
For more on the anatomy of this plus a visual demonstration of the test, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Stretching Scientifically – by Thomas Kurz ← this is our review of the book she’s working from in this video; this book has this test!
Take care!
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