Does Eating Shellfish Contribute To Gout?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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 😎
❝I have a question about seafood as healthy, doesn’t eating shellfish contribute to gout?❞
It can do! Gout (a kind of inflammatory arthritis characterized by the depositing of uric acid crystals in joints) has many risk factors, and diet is one component, albeit certainly the most talked-about one.
First, you may be wondering: isn’t all arthritis inflammatory? Since arthritis is by definition the inflammation of joints, this is a reasonable question, but when it comes to classifying the kinds, “inflammatory” arthritis is caused by inflammation, while “non-inflammatory” arthritis (a slightly confusing name) merely has inflammation as one of its symptoms (and is caused by physical wear-and-tear). For more information, see:
- Tips For Avoiding/Managing Rheumatoid Arthritis ←inflammatory
- Tips For Avoiding/Managing Osteoarthritis ← “non-inflammatory”
As for gout specifically, top risk factors include:
- Increasing age: risk increases with age
- Being male: women do get gout, but much less often
- Hypertension: all-cause hypertension is the biggest reasonably controllable factor
There’s not a lot we can do about age (but of course, looking after our general health will tend to slow biological aging, and after all, diseases only care about the state of our body, not what the date on the calendar is).
As for sex, this risk factor is hormones, and specifically has to do with estrogen and testosterone’s very different effects on the immune system (bearing in mind that chronic inflammation is a disorder of the immune system). However, few if any men would take up feminizing hormone therapy just to lower their gout risk!
That leaves hypertension, which happily is something that we can all (barring extreme personal circumstances) do quite a bit about. Here’s a good starting point:
Hypertension: Factors Far More Relevant Than Salt
…and for further pointers:
How To Lower Your Blood Pressure (Cardiologists Explain)
As for diet specifically (and yes, shellfish):
The largest study into this (and thus, one of the top ones cited in a lot of other literature) looked at 47,150 men with no history of gout at the baseline.
So, with the caveat that their findings could have been different for women, they found:
- Eating meat in general increased gout risk
- Narrowing down specific meats: beef, pork, and lamb were the worst offenders
- Eating seafood in general increased gout risk
- Narrowing down specific seafoods: all seafoods increased gout risk within a similar range
- As a specific quirk of seafoods: the risk was increased if the man had a BMI under 25
- Eating dairy in general was not associated with an increased risk of gout
- Narrowing down specific dairy foods: low-fat dairy products such as yogurt were associated with a decreased risk of gout
- Eating purine-rich vegetables in general was not associated with an increased risk of gout
- Narrowing down to specific purine-rich vegetables: no purine-rich vegetable was associated with an increase in the risk of gout
Dairy products were included in the study, as dairy products in general and non-fermented dairy products in particular are often associated with increased inflammation. However, the association was simply not found to exist when it came to gout risk.
Purine-rich vegetables were included in the study, as animal products highest in purines have typically been found to have the worst effect on gout. However, the association was simply not found to exist when it came to plants with purines.
You can read the full study here:
Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men
So, the short answer to your question of “doesn’t eating shellfish contribute to the risk of gout” is:
Yes, it can, but occasional consumption probably won’t result in gout unless you have other risk factors going against you.
If you’re a slim male 80-year-old alcoholic smoker with hypertension, then definitely do consider skipping the lobster, but honestly, there may be bigger issues to tackle there.
And similarly, obviously skip it if you have a shellfish allergy, and if you’re vegan or vegetarian or abstain from shellfish for religious reasons, then you can certainly live very healthily without ever having any.
See also: Do We Need Animal Products, To Be Healthy?
For most people most of the time, a moderate consumption of seafood, including shellfish if you so desire, is considered healthy.
As ever, do speak with your own doctor to know for sure, as your individual case may vary.
For reference, this question was surely prompted by the article:
Lobster vs Crab – Which is Healthier?
Take care!
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‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters
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Pratik Raul, University of Canberra; Jeroen van Boxtel, University of Canberra, and Jovana Acevska, University of Canberra
Autism is a neurodevelopmental difference associated with specific experiences and characteristics.
For decades, autism research has focused on behavioural, cognitive, social and communication difficulties. These studies highlighted how autistic people face issues with everyday tasks that allistic (meaning non-autistic) people do not. Some difficulties may include recognising emotions or social cues.
But some research, including our own study, has explored specific advantages in autism. Studies have shown that in some cognitive tasks, autistic people perform better than allistic people. Autistic people may have greater success in identifying a simple shape embedded within a more complex design, arranging blocks of different shapes and colours, or spotting an object within a cluttered visual environment (similar to Where’s Wally?). Such enhanced performance has been recorded in babies as young as nine months who show emerging signs of autism.
How and why do autistic individuals do so well on these tasks? The answer may be surprising: more “neural noise”.
What is neural noise?
Generally, when you think of noise, you probably think of auditory noise, the ups and downs in the amplitude of sound frequencies we hear.
A similar thing happens in the brain with random fluctuations in neural activity. This is called neural noise.
This noise is always present, and comes on top of any brain activity caused by things we see, hear, smell and touch. This means that in the brain, an identical stimulus that is presented multiple times won’t cause exactly the same activity. Sometimes the brain is more active, sometimes less. In fact, even the response to a single stimulus or event will fluctuate continuously.
Neural noise in autism
There are many sources of neural noise in the brain. These include how the neurons become excited and calm again, changes in attention and arousal levels, and biochemical processes at the cellular level, among others. An allistic brain has mechanisms to manage and use this noise. For instance, cells in the hippocampus (the brain’s memory system) can make use of neural noise to enhance memory encoding and recall.
Evidence for high neural noise in autism can be seen in electroencephalography (EEG) recordings, where increased levels of neural fluctuations were observed in autistic children. This means their neural activity is less predictable, showing a wider range of activity (higher ups and downs) in response to the same stimulus.
In simple terms, if we imagine the EEG responses like a sound wave, we would expect to see small ups and downs (amplitude) in allistic brains each time they encounter a stimulus. But autistic brains seem to show bigger ups and downs, demonstrating greater amplitude of neural noise.
Many studies have linked this noisy autistic brain with cognitive, social and behavioural difficulties.
But could noise be a bonus?
The diagnosis of autism has a long clinical history. A shift from the medical to a more social model has also seen advocacy for it to be reframed as a difference, rather than a disorder or deficit. This change has also entered autism research. Neuroaffirming research can examine the uniqueness and strengths of neurodivergence.
Psychology and perception researcher David Simmons and colleagues at the University of Glasgow were the first to suggest that while high neural noise is generally a disadvantage in autism, it can sometimes provide benefits due to a phenomenon called stochastic resonance. This is where optimal amounts of noise can enhance performance. In line with this theory, high neural noise in the autistic brain might enhance performance for some cognitive tasks.
Our 2023 research explores this idea. We recruited participants from the general population and investigated their performance on letter-detection tasks. At the same time, we measured their level of autistic traits.
We performed two letter-detection experiments (one in a lab and one online) where participants had to identify a letter when displayed among background visual static of various intensities.
By using the static, we added additional visual noise to the neural noise already present in our participants’ brains. We hypothesised the visual noise would push participants with low internal brain noise (or low autistic traits) to perform better (as suggested by previous research on stochastic resonance). The more interesting prediction was that noise would not help individuals who already had a lot of brain noise (that is, those with high autistic traits), because their own neural noise already ensured optimal performance.
Indeed, one of our experiments showed people with high neural noise (high autistic traits) did not benefit from additional noise. Moreover, they showed superior performance (greater accuracy) relative to people with low neural noise when the added visual static was low. This suggests their own neural noise already caused a natural stochastic resonance effect, resulting in better performance.
It is important to note we did not include clinically diagnosed autistic participants, but overall, we showed the theory of enhanced performance due to stochastic resonance in autism has merits.
Why this is important?
Autistic people face ignorance, prejudice and discrimination that can harm wellbeing. Poor mental and physical health, reduced social connections and increased “camouflaging” of autistic traits are some of the negative impacts that autistic people face.
So, research underlining and investigating the strengths inherent in autism can help reduce stigma, allow autistic people to be themselves and acknowledge autistic people do not require “fixing”.
The autistic brain is different. It comes with limitations, but it also has its strengths.
Pratik Raul, PhD candidiate, University of Canberra; Jeroen van Boxtel, Associate professor, University of Canberra, and Jovana Acevska, Honours Graduate Student, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Buckwheat vs Oats – Which is Healthier?
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Our Verdict
When comparing buckwheat to oats, we picked the oats.
Why?
First of all, for any thinking about the health concerns sometimes associated with wheat: buckwheat is not a kind of wheat, nor is it even in the same family; it’s not a grain, but a flowering plant. Buckwheat is to wheat as a lionfish is to lions.
That said, while these are both excellent foods, one of them is so good it makes the other one look bad in comparison:
In terms of macros, oats have more carbs, but also more protein and more fiber.
When it comes to vitamins, a clear winner emerges: oats have more of vitamins B1, B2, B5, B6, and B9, while buckwheat is higher in vitamin K and choline.
In the category of minerals, things are even more pronounced: oats are higher in calcium, iron, magnesium, manganese, phosphorus, potassium, and zinc. On the other hand, buckwheat is higher in selenium.
All in all: as ever, enjoy both, but if you’re picking one, oats cannot be beaten.
Want to learn more?
You might like to read:
The Best Kind Of Fiber For Overall Health?
Take care!
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Fast Diet, Fast Exercise, Fast Improvements
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Diet & Exercise, Optimized
This is Dr. Michael Mosley. He originally trained in medicine with the intention of becoming a psychiatrist, but he grew disillusioned with psychiatry as it was practised, and ended up pivoting completely into being a health educator, in which field he won the British Medical Association’s Medical Journalist of the Year Award.
He also died under tragic circumstances very recently (he and his wife were vacationing in Greece, he went missing while out for a short walk on the 5th of June, appears to have got lost, and his body was found 100 yards from a restaurant on the 9th). All strength and comfort to his family; we offer our small tribute here today in his honor.
The “weekend warrior” of fasting
Dr. Mosley was an enjoyer (and proponent) of intermittent fasting, which we’ve written about before:
Fasting Without Crashing? We Sort The Science From The Hype
However, while most attention is generally given to the 16:8 method of intermittent fasting (fast for 16 hours, eat during an 8 hour window, repeat), Dr. Mosley preferred the 5:2 method (which generally means: eat at will for 5 days, then eat a reduced calorie diet for the other 2 days).
Specifically, he advocated putting that cap at 800 kcal for each of the weekend days (doesn’t have to be specifically the weekend).
He also tweaked the “eat at will for 5 days” part, to “eat as much as you like of a low-carb Mediterranean diet for 5 days”:
❝The “New 5:2” approach involves restricting calories to 800 on fasting days, then eating a healthy lower carb, Mediterranean-style diet for the rest of the week.
The beauty of intermittent fasting means that as your insulin sensitivity returns, you will feel fuller for longer on smaller portions. This is why, on non-fasting days, you do not have to count calories, just eat sensible portions. By maintaining a Mediterranean-style diet, you will consume all of the healthy fats, protein, fibre and fresh plant-based food that your body needs.❞
Read more: The Fast 800 | The New 5:2
And about that tweaked Mediterranean Diet? You might also want to check out:
Four Ways To Upgrade The Mediterranean Diet
Knowledge is power
Dr. Mosley encouraged the use of genotyping tests for personal health, not just to know about risk factors, but also to know about things such as, for example, whether you have the gene that makes you unable to gain significant improvements in aerobic fitness by following endurance training programs:
The Real Benefit Of Genetic Testing
On which note, he himself was not a fan of exercise, but recognised its importance, and instead sought to minimize the amount of exercise he needed to do, by practising High Intensity Interval Training. We reviewed a book of his (teamed up with a sports scientist) not long back; here it is:
Fast Exercise: The Simple Secret of High Intensity Training – by Dr. Michael Mosley & Peta Bee
You can also read our own article on the topic, here:
How To Do HIIT (Without Wrecking Your Body)
Just One Thing…
As well as his many educational TV shows, Dr. Mosley was also known for his radio show, “Just One Thing”, and a little while ago we reviewed his book, effectively a compilation of these:
Just One Thing: How Simple Changes Can Transform Your Life – by Dr. Michael Mosley
Enjoy!
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Do Try This At Home: The 12-Week Brain Fitness Program
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12 Weeks To Measurably Boost Your Brain
This is Dr. Majid Fotuhi. From humble beginnings (being smuggled out of Iran in 1980 to avoid death in the war), he went on (after teaching himself English, French, and German, hedging his bets as he didn’t know for sure where life would lead him) to get his MD from Harvard Medical School and his PhD in neuroscience from Johns Hopkins University. Since then, he’s had a decades-long illustrious career in neurology and neurophysiology.
What does he want us to know?
The Brain Fitness Program
This is not, by the way, something he’s selling. Rather, it was a landmark 12-week study in which 127 people aged 60–80, of which 63% female, all with a diagnosis of mild cognitive impairment, underwent an interventional trial—in other words, a 12-week brain fitness course.
After it, 84% of the participants showed statistically significant improvements in cognitive function.
Not only that, but of those who underwent MRI testing before and after (not possible for everyone due to practical limitations), 71% showed either no further deterioration of the hippocampus, or actual growth above the baseline volume of the hippocampus (that’s good, and it means functionally the memory center of the brain has been rejuvenated).
You can read a little more about the study here:
As for what the program consisted of, and what Dr. Fotuhi thus recommends for everyone…
Cognitive stimulation
This is critical, so we’re going to spend most time on this one—the others we can give just a quick note and a pointer.
In the study this came in several forms and had the benefit of neurofeedback technology, but he says we can replicate most of the effects by simply doing something cognitively stimulating. Whatever challenges your brain is good, but for maximum effect, it should involve the language faculties of the brain, since these are what tend to get hit most by age-related cognitive decline, and are also what tends to have the biggest impact on life when lost.
If you lose your keys, that’s an inconvenience, but if you can’t communicate what is distressing you, or understand what someone is explaining to you, that’s many times worse—and that kind of thing is a common reality for many people with dementia.
To keep the lights brightly lit in that part of the brain: language-learning is good, at whatever level suits you personally. In other words: there’s a difference between entry-level Duolingo Spanish, and critically analysing Rumi’s poetry in the original Persian, so go with whatever is challenging and/but accessible for you—just like you wouldn’t go to the gym for the first time and try to deadlift 500lbs, but you also probably wouldn’t do curls with the same 1lb weights every day for 10 years.
In other words: progressive overloading is key, for the brain as well as for muscles. Start easy, but if you’re breezing through everything, it’s time to step it up.
If for some reason you’re really set against the idea of learning another language, though, check out:
Reading As A Cognitive Exercise ← there are specific tips here for ensuring your reading is (and remains) cognitively beneficial
Mediterranean diet
Shocking nobody, this is once again recommended. You might like to check out the brain-healthy “MIND” tweak to it, here:
Four Ways To Upgrade The Mediterranean Diet ← it’s the fourth one
Omega-3 supplementation
Nothing complicated here. The brain needs a healthy balance of these fatty acids to function properly, and most people have an incorrect balance (too little omega-3 for the omega-6 present):
What Omega-3 Fatty Acids Really Do For Us ← scroll to “against cognitive decline”
Increasing fitness
There’s a good rule of thumb: what’s healthy for your heart, is healthy for your brain. This is because, like every other organ in your body, the brain does not function well without good circulation bringing plenty of oxygen and nutrients, which means good cardiovascular health is necessary. The brain is extra sensitive to this because it’s a demanding organ in terms of how much stuff it needs delivering via blood, and also because of the (necessary; we’d die quickly and horribly without it) impediment of the blood-brain barrier, and the possibility of beta-amyloid plaques and similar woes (they will build up if circulation isn’t good).
How To Reduce Your Alzheimer’s Risk ← number two on the list here
Practising mindfulness medication
This is also straightforward, but not to be underestimated or skipped over:
No-Frills, Evidence-Based Mindfulness
Want to step it up? Check out:
Meditation Games That You’ll Actually Enjoy
Lastly…
Dr. Fotuhi wants us to consider looking after our brain the same way we look after our teeth. No, he doesn’t want us to brush our brain, but he does want us to take small measurable actions multiple times per day, every day.
You can’t just spend the day doing nothing but brushing your teeth for the entirety of January the 1st and then expect them to be healthy for the rest of the year; it doesn’t work like that—and it doesn’t work like that for the brain, either.
So, make the habits, and keep them going
Take care!
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We’re only using a fraction of health workers’ skills. This needs to change
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Roles of health professionals are still unfortunately often stuck in the past. That is, before the shift of education of nurses and other health professionals into universities in the 1980s. So many are still not working to their full scope of practice.
There has been some expansion of roles in recent years – including pharmacists prescribing (under limited circumstances) and administering a wider range of vaccinations.
But the recently released paper from an independent Commonwealth review on health workers’ “scope of practice” identifies the myriad of barriers preventing Australians from fully benefiting from health professionals’ skills.
These include workforce design (who does what, where and how roles interact), legislation and regulation (which often differs according to jurisdiction), and how health workers are funded and paid.
There is no simple quick fix for this type of reform. But we now have a sensible pathway to improve access to care, using all health professionals appropriately.
A new vision for general practice
I recently had a COVID booster. To do this, I logged onto my general practice’s website, answered the question about what I wanted, booked an appointment with the practice nurse that afternoon, got jabbed, was bulk-billed, sat down for a while, and then went home. Nothing remarkable at all about that.
But that interaction required a host of facilitating factors. The Victorian government regulates whether nurses can provide vaccinations, and what additional training the nurse requires. The Commonwealth government has allowed the practice to be paid by Medicare for the nurse’s work. The venture capitalist practice owner has done the sums and decided allocating a room to a practice nurse is economically rational.
The future of primary care is one involving more use of the range of health professionals, in addition to GPs.
It would be good if my general practice also had a physiotherapist, who I could see if I had back pain without seeing the GP, but there is no Medicare rebate for this. This arrangement would need both health professionals to have access to my health record. There also needs to be trust and good communication between the two when the physio might think the GP needs to be alerted to any issues.
This vision is one of integrated primary care, with health professionals working in a team. The nurse should be able to do more than vaccination and checking vital signs. Do I really need to see the GP every time I need a prescription renewed for my regular medication? This is the nub of the “scope of practice” issue.
How about pharmacists?
An integrated future is not the only future on the table. Pharmacy owners especially have argued that pharmacists should be able to practise independently of GPs, prescribing a limited range of medications and dispensing them.
This will inevitably reduce continuity of care and potentially create risks if the GP is not aware of what other medications a patient is using.
But a greater role for pharmacists has benefits for patients. It is often easier and cheaper for the patient to see a pharmacist, especially as bulk billing rates fall, and this is one of the reasons why independent pharmacist prescribing is gaining traction.
It’s often easier for a patient to see a pharmacist than a GP. PeopleImages.com – Yuri A/Shutterstock Every five years or so the government negotiates an agreement with the Pharmacy Guild, the organisation of pharmacy owners, about how much pharmacies will be paid for dispensing medications and other services. These agreements are called “Community Pharmacy Agreements”. Paying pharmacists independent prescribing may be part of the next agreement, the details of which are currently being negotiated.
GPs don’t like competition from this new source, even though there will be plenty of work around for GPs into the foreseeable future. So their organisations highlight the risks of these changes, reopening centuries old turf wars dressed up as concerns about safety and risk.
Who pays for all this?
Funding is at the heart of disputes about scope of practice. As with many policy debates, there is merit on both sides.
Clearly the government must increase its support for comprehensive general practice. Existing funding of fee-for-service medical benefits payments must be redesigned and supplemented by payments that allow practices to engage a range of other health professionals to create health-care teams.
This should be the principal direction of primary care reform, and the final report of the scope of practice review should make that clear. It must focus on the overall goal of better primary care, rather than simply the aspirations of individual health professionals, and working to a professional’s full scope of practice in a team, not a professional silo.
In parallel, governments – state and federal – must ensure all health professionals are used to their best of their abilities. It is a waste to have highly educated professionals not using their skills fully. New funding arrangements should facilitate better access to care from all appropriately qualified health professionals.
In the case of prescribing, it is possible to reconcile the aspirations of pharmacists and the concerns of GPs. New arrangements could be that pharmacists can only renew medications if they have agreements with the GP and there is good communication between them. This may be easier in rural and suburban areas, where the pharmacists are better known to the GPs.
The second issues paper points to the complexity of achieving scope of practice reforms. However, it also sets out a sensible path to improve access to care using all health professionals appropriately.
Stephen Duckett, Honorary Enterprise Professor, School of Population and Global Health, and Department of General Practice and Primary Care, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Heart Smarter for Women – by Dr. Jennifer Mieres
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Dr. Mieres takes us through understanding our own heart disease risks as individuals rather than as averages. As the title suggests, she does assume a female readership, so if you are a man and have no female loved ones, this might not be the book for you. But aside from that, she walks us through examining risk in the context of age, other health conditions, lifestyle factors, and so forth—including not turning a blind eye to factors that might intersect, such as for example if a physical condition reduces how much we can exercise, or if there’s some reason we can’t follow the usual gold standard of heart-healthy diet.
On which note, she does offer dietary advice, including information around recipes, meal-planning, and what things to always have in stock, as well as what things matter the most when it comes to what and how we eat.
It’s not all lifestyle medicine though; Dr. Mieres gives due attention to many of the medications available for heart health issues—and the pros and cons of these.
The style of the book is very simple and readable pop-science, without undue jargon, and with a generous glossary. As with many books of this genre, it does rely on (presumably apocryphal) anecdotes, though an interesting choice for this book is that it keeps a standing cast of four recurring characters, each to represent a set of circumstances and illustrate how certain things can go differently for different people, with different things then being needed and/or possible. Hopefully, any given reader will find themself represented at least moderately well somewhere in or between these four characters.
Bottom line: this is a very informative and accessible book, that demystifies a lot of common confusions around heart health.
Click here to check out Heart Smarter For Women, and take control of your health!
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