Growing Young – by Marta Zaraska
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This one will be a slightly mixed review, but we think the book has more than enough of value to make it a very worthwhile read.
The premise of the book is that, as the subtitle suggests, positive social qualities increase personal longevity.
Author (and science journalist) Marta Zaraska looks at a lot of research to back this up, and also did a lot of travelling and digging into stories. This is of great value, because she notes where a lot of misconceptions have arisen.
To give one example, it’s commonly noted that marriage (or as-though-marriage life partnerships) is generally* associated with longer life.
*Statistics suggest that marriage-related longevity is enjoyed by men married to women, and people in same-sex marriages regardless of gender, but is not so much the case for women married to men.
However! Zaraska notes a factor she learned from Gottman’s research (yes, that Gottman), that what matters is not the official status of a relationship, so much as the sense of secure lifelong commitment to it.
These kinds of observations (throughout the book) add an extra layer beyond “common wisdom”, and allow us to better understand what’s really going on. The book’s main weaknesses, meanwhile, are twofold:
- The author is (in this reviewer’s opinion) unduly dismissive of physical health lifestyle factors such as diet and exercise, because they “only” account for a similar bonus to healthy longevity.
- Like many, she does not always consider where correlation might not mean causation. For example, she cites that volunteering free time increases healthspan by 22%, but neglects to note that perhaps it is having the kind of socioeconomic situation that allows one free time to volunteer, that gives the benefit.
Bottom line: the book has its flaws, but we think that only serves to make it more engaging. After all, reading should not be a purely passive activity! Zaraska’s well-studied insights give plenty of pointers for tweaking the social side of anyone’s quest for healthy longevity.
Click here to check out Growing Young, increase your healthspan, and take joy in doing it!
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Watermelon vs Grapes – Which is Healthier?
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Our Verdict
When comparing watermelon to grapes, we picked the watermelon.
Why?
It was close! And certainly both are very healthy.
Both fruits are (like most fruits) good sources of water, fiber, vitamins, and minerals. Any sugar content (of which grapes are slightly higher) is offset by their fiber content and polyphenols.
See: Which Sugars Are Healthier, And Which Are Just The Same?
While both are good sources of vitamins A and C, watermelon has about 10x as much vitamin A, and about 6x as much vitamin C (give or take individual plants, how they were grown, etc, but the overall balance is clearly in watermelon’s favor).
When it comes to antioxidants, both fruits are good, but again watermelon is the more potent source. Grapes famously contain resveratrol, and they also contain quercetin, albeit you’d have to eat quite a lot of grapes to get a large portion.
Now, having to eat a lot of grapes might not sound like a terrible fate (who else finds that the grapes are gone by the time the groceries are put away?), but we are comparing the fruits here, and on a list of “100 best foods for quercetin”, for example, grapes took 99th place.
Watermelon’s main antioxidant meanwhile is lycopene, and watermelon is one of the best sources of lycopene in existence (better even than tomatoes).
We’ll have to do a main feature about lycopene sometime soon, so watch this space
Take care!
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When Doctors Make House Calls, Modern-Style!
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In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:
- About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
- About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
- And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”
*We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.
So, what does the science say?
A quick note first
Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.
Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.
Nevertheless, we’ll do what we can with the science we have!
Telehealth is more accessible than in-person consultations: True or False?
True, for most people. For example…
❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.
Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.
Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞
whereas…
❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞
~ Ibid.
Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review
Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.
The quality of care provided via telehealth is as good as in-person: True or False?
True, ostensibly, with caveats. The caveats are:
- We’re going offreported patient satisfaction, not objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
- We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.
*we did find some, but it wasn’t very helpful yet. For example:
An electronic trigger to detect telemedicine-related diagnostic errors
this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.
While most oft-considered demographic groups reported comparable patient satisfaction (per race, gender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).
However!
Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:
❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞
Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology
There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?
True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:
❝The doctor uses his five senses to assess. This cannot be attained over the phone❞
~ 10almonds subscriber
A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!
Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).
However, nowadays indeed a doctor will use sight, sound, touch, and sometimes even smell.
In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.
With this in mind, it really comes down to what you need from your doctor in that consultation.
- If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
- If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
- If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.
If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.
Take care!
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What you need to know about H5N1 bird flu
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On May 30, the Centers for Disease Control and Prevention reported that a Michigan dairy worker tested positive for H5N1 bird flu. It was the fourth person to test positive for H5N1 in the United States, following another recent case in Michigan, an April case in Texas, and an initial case in Colorado in 2022.
H5N1 bird flu has been spreading among bird species in the U.S. since 2021, killing millions of wild birds and poultry. In late March 2024, H5N1 bird flu was found in cows for the first time, causing an outbreak in dairy cows across several states.
U.S. public health officials and researchers are particularly concerned about this outbreak because the virus has infected cows and other mammals and has spread from a cow to a human for the first time.
This bird flu strain has shown to not only make wild mammals, including marine mammals and bears, very sick but to also cause high rates of death among species, says Jane Sykes, professor of small animal medicine at the University of California, Davis, School of Veterinary Medicine.
“And now that it has been found in cattle, [it] raises particular concern for spread to all the animal species, including people,” adds Sykes.
Even though the risk for human infection is low and there has never been human-to-human transmission of H5N1, there are several actions you can take to stay protected. Read on to learn more about H5N1 bird flu and the current outbreak.
What is H5N1?
H5N1 is a type of influenza virus that most commonly affects birds, causing them severe respiratory illness and death.
The H5N1 strain first emerged in China in the 1990s, and it has continued to spread around the world since then. In 1997, the virus spread from animals to humans in Hong Kong for the first time, infecting 18 people, six of whom died.
Since 2020, the H5N1 strain has caused “an unprecedented number of deaths in wild birds and poultry in many countries,” according to the World Health Organization.
Even though bird flu is rare in humans, an H5N1 infection can cause mild to severe illness and can be fatal in some cases. It can cause eye infection, upper respiratory symptoms, and pneumonia.
What do we know about the 2024 human cases of H5N1 in the U.S.?
The Michigan worker who tested positive for H5N1 in late May is a dairy worker who was exposed to infected livestock. They were the first to experience respiratory symptoms—including a cough without a fever—during the current outbreak. They were given an antiviral and the CDC says their symptoms are resolving.
The Michigan farm worker who tested positive earlier in May only experienced eye-related symptoms and has already recovered. And the dairy worker who tested positive for the virus in Texas in April only experienced eye redness as well, was treated with an antiviral medication for the flu, and is recovering.
Is H5N1 bird flu in the milk we consume?
The Food and Drug Administration has found traces of H5N1 bird flu virus in raw or unpasteurized milk. However, pasteurized milk is safe to drink.
Pasteurization, the process of heating milk to high temperatures to kill harmful bacteria (which the majority of commercially sold milk goes through), deactivates the virus. In 20 percent of pasteurized milk samples, the FDA found small, inactive (not live nor infectious) traces of the virus, but these fragments do not make pasteurized milk dangerous.
In a recent Infectious Diseases Society of America briefing, Dr. Maximo Brito, a professor at the University of Illinois College of Medicine, said that it’s important for people to avoid “drinking unpasteurized or raw milk [because] there are other diseases, not only influenza, that could be transmitted by drinking unpasteurized milk.”
What can I do to prevent bird flu?
While the risk of H5N1 infection in humans is low, people with exposure to infected animals (like farmworkers) are most at risk. But there are several actions you can take to stay protected.
One of the most important things, according to Sykes, is taking the usual precautions we’ve taken with COVID-19 and other respiratory viruses, including frequent handwashing, especially before eating.
“Handwashing and mask-wearing [are important], just as we learned from the pandemic,” Sykes adds. “And it’s not wearing a mask at all times, but thinking about high-risk situations, like when you’re indoors in a crowded environment, where transmission of respiratory viruses is much more likely to occur.”
There are other steps you can take to prevent H5N1, according to the CDC:
- Avoid direct contact with sick or dead animals, including wild birds and poultry.
- Don’t touch surfaces that may have been contaminated with animal poop, saliva, or mucus.
- Cook poultry and eggs to an internal temperature of 165 degrees Fahrenheit to kill any bacteria or virus, including H5N1. Generally, avoid eating undercooked food.
- Avoid consuming unpasteurized or raw milk or products like cheeses made with raw milk.
- Avoid eating uncooked or undercooked food.
- Poultry and livestock farmers and workers and bird flock owners should wear masks and other personal protective equipment “when in direct or close physical contact with sick birds, livestock, or other animals; carcasses; feces; litter; raw milk; or surfaces and water that might be contaminated with animal excretions from potentially or confirmed infected birds, livestock, or other animals.” (The CDC has more recommendations for this population here.)
Is there a vaccine for H5N1?
The CDC said there are two candidate H5N1 vaccines ready to be made and distributed in case the virus starts to spread from person to person, and the country is now moving forward with plans to produce millions of vaccine doses.
The FDA has approved several bird flu vaccines since 2007. The U.S. has flu vaccines in stockpile through the National Pre-Pandemic Influenza Vaccine Stockpile program, which allows for quick response as strains of the flu virus evolve.
Could this outbreak become a pandemic?
Scientists and researchers are concerned about the possibility of H5N1 spreading among people and causing a pandemic. “Right now, the risk is low, but as time goes on, the potential for mutation to cause widespread human infection increases,” says Sykes.
“I think this virus jumping into cows has shown the urgency to keep tracking [H5N1] a lot more closely now,” Peter Halfmann, research associate professor at the University of Wisconsin-Madison’s Influenza Research Institute tells PGN. “We have our eyes on surveillance now. … We’re keeping a much closer eye, so it’s not going to take us by surprise.”
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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A Guide to the Good Life – by Dr. William Irvine
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“Living well” is a surprisingly underrated part of wellness. We spend much of our lives in turmoil. Some of us, windswept and battered by the storms of life; others, up in quietly crumbling towers, seemingly “great” but definitely not feeling it. Diet and exercise etc will only get us so far. What else, then, can we do?
For Dr. Irvine, the key lies in two main things:
- Deciding how we intend to live our life (and doing so)
- Remaining tranquil in the face of external stressors
In Japanese terms, these things can be seen in ikigai and zen, respectively. This book puts them in Western terms, specifically, that of Stoic philosophy. But the goals and methods are very similar.
Far from being an abstract tome of wishy-washy philosophy, this book offers down-to-earth practical exercises and easily applicable advice. There was even an exercise that was new to this reviewer who has been reading such things for decades.
The writing style is also, true to Stoic principles, unpretentious and simple. This is an easy book to read, while being nonethless very engaging from start to finish—and thereafter!
Bottom line: so far as we know, we only get one shot at life, so we might as well make it a good one. Applying the ideas found in this book can help any reader to live better, and take more joy in it along the way.
Click here to check out a Guide to the Good Life, and live your best!
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What Does “Balance Your Hormones” Even Mean?
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Hormonal Health: Is It Really A Balancing Act?
Have you ever wondered what “balancing your hormones” actually means?
The popular view is that men’s hormones look like this:
Testosterone (less) ⟷ Testosterone (more)
…And that women’s hormones look more like this:
♀︎ Estrogen ↭ Progesterone ⤵︎
⇣⤷ FSH ⤦ ↴ ☾ ⤹⤷ Luteinizing Hormone ⤦
DHEA ↪︎ Gonadotrophin ⤾
↪︎ Testosterone? ⥅⛢
Clear as mud, right?
But, don’t worry, Supplements McHerbal Inc will sell you something guaranteed to balance your hormones!
How can a supplement (or dietary adjustment) “balance” all that hotly dynamic chaos, and make everything “balanced”?
The truth is, “balanced” in such a nebulous term, and this is why you will not hear endocrinologists using it. It’s used in advertising to mean “in good order”, and “not causing problems”, and “healthy”.
In reality, our hormone levels depend on everything from our diet to our age to our anatomy to our mood to the time of the day to the phase of the moon.
Not that the moon has an influence on our physiology at all—that’s a myth—but you know, 28 day cycle and all. And, yes, half the hormones affect the levels of the others, either directly or indirectly.
Trying to “balance” them would be quite a game of whack-a-mole, and not something that a “cure-all” single “hormone-balancing” supplement could do.
So why aren’t we running this piece on Friday, for our “mythbusting” section? Well, we could have, but the more useful information is yet to come and will take up more of today’s newsletter than the myth-busting!
What, then, can we do to untangle the confusion of these hormones?
Well first, let’s understand what they do, in the most simple terms possible:
- Estrogen—the most general feminizing hormone from puberty onwards, busiest in the beginning of the menstrual cycle, and starts getting things ready for ovulation.
- Progesterone—secondary feminizing hormone, fluffs the pillows for the oncoming fertilized egg to be implanted, increases sex drive, and adjusts metabolism accordingly. Busiest in the second half of the menstrual cycle.
- Testosterone—is also present, contributes to sex drive, is often higher in individuals with PCOS. If menopause is untreated, testosterone will also rise, because there will be less estrogen
- (testosterone and estrogen “antagonize” each other, which is the colorfully scientific way of saying they work against each other)
- DHEA—Dehydroepiandrosterone, supports production of testosterone (and estrogen!). Sounds self-balancing, but in practice, too much DHEA can thus cause elevated testosterone levels, and thus hirsutism.
- Gonadotrophin—or more specifically human chorionic gonadotrophin, HcG, is “the pregnancy hormone“, present only during pregnancy, and has specific duties relating to such. This is what’s detected in (most) pregnancy test kits.
- FSH—follicle stimulating hormone, is critical to ovulation, and is thus essential to female fertility. On the other hand, when the ovaries stop working, FSH levels will rise in a vain attempt to encourage the ovulation that isn’t going to happen anymore.
- Luteinizing hormone—says “go” to the new egg and sends it on its merry way to go get fertilized. This is what’s detected by ovulation prediction kits.
Sooooooo…
What, for most women, most often is meant by a “hormonal imbalance” is:
- Low levels of E and/or P
- High levels of DHEA and/or T
- Low or High levels of FSH
In the case of low levels of E and/or P, the most reliable way to increase these is, drumroll please… To take E and/or P. That’s it, that’s the magic bullet.
Bonus Tip: take your E in the morning (this is when your body will normally make more and use more) take your P in the evening (it won’t make you sleepy, but it will improve your sleep quality when you do sleep)
In the case of high levels of DHEA and/or T, then that’s a bit more complex:
- Taking E will antagonize (counteract) the unwanted T.
- Taking T-blockers (such as spironolactone or bicalutamide) will do what it says on the tin, and block T from doing the jobs it’s trying to do, but the side-effects are considered sufficient to not prescribe them to most people.
- Taking spearmint or saw palmetto will lower testosterone’s effects
- Scientists aren’t sure how or why spearmint works for this
- Saw palmetto blocks testosterone’s conversion into a more potent form, DHT, and so “detoothes” it a bit. It works similarly to drugs such as finasteride, often prescribed for androgenic alopecia, called “male pattern baldness”, but it affects plenty of women too.
In the case of low levels of FSH, eating leafy greens will help.
In the case of high levels of FSH, see a doctor. HRT (Hormone Replacement Therapy) may help. If you’re not of menopausal age, it could be a sign something else is amiss, so it could be worth getting that checked out too.
What can I eat to boost my estrogen levels naturally?
A common question. The simple answer is:
- Flaxseeds and soy contain plant estrogens that the body can’t actually use as such (too incompatible). They’ve lots of high-quality nutrients though, and the polyphenols and isoflavones can help with some of the same jobs when it comes to sexual health.
- Fruit, especially peaches, apricots, blueberries, and strawberries, contain a lot of lignans and also won’t increase your E levels as such, but will support the same functions and reduce your breast cancer risk.
- Nuts, especially almonds (yay!), cashews, and pistachios, contain plant estrogens that again can’t be used as bioidentical estrogen (like you’d get from your ovaries or the pharmacy) but do support heart health.
- Leafy greens and cruciferous vegetables support a lot of bodily functions including good hormonal health generally, in ways that are beyond the scope of this article, but in short: do eat your greens!
Note: because none of these plant-estrogens or otherwise estrogenic nutrients can actually do the job of estradiol (the main form of estrogen in your body), this is why they’re still perfectly healthy for men to eat too, and—contrary to popular “soy boy” social myths—won’t have any feminizing effects whatsoever.
On the contrary, most of the same foods support good testosterone-related health in men.
The bottom line:
- Our hormones are very special, and cannot be replaced with any amount of herbs or foods.
- We can support our body’s natural hormonal functions with good diet, though.
- Our hormones naturally fluctuate, and are broadly self-correcting.
- If something gets seriously out of whack, you need an endocrinologist, not a homeopath or even a dietician.
In case you missed it…
We gave a more general overview of supporting hormonal health (including some hormones that aren’t sex hormones but are really important too), back in February.
Check it out here: Healthy Hormones And How To Hack Them
Want to read more?
Anthea Levi, RD, takes much the same view:
❝For some ‘hormone-balancing’ products, the greatest risk might simply be lost dollars. Others could come at a higher cost.❞
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Popcorn vs Peanuts – Which is Healthier
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Our Verdict
When comparing air-popped popcorn to peanuts (without an allergy), we picked the peanuts.
Why?
Peanuts, if we were to list popular nuts in order of healthfulness, would not be near the top of the list. Many other nuts have more nutrients and fewer/lesser drawbacks.
But the comparison to popcorn shines a different light on it:
Popcorn has very few nutrients. It’s mostly carbs and fiber; it’s just not a lot of carbs because the manner of its consumption makes it a very light snack (literally). You can eat a bowlful and it was perhaps 30g. It has some small amounts of some minerals, but nothing that you could rely on it for. It’s mostly fresh air wrapped in fiber.
Peanuts, in contrast, are a much denser snack. High in calories yes, but also high in protein, their fats are mostly healthy, and they have not only a fair stock of vitamins and minerals, but also a respectable complement of beneficial phytochemicals: mostly assorted antioxidant polyphenols, but also oleic acid (as in olives, good for healthy triglyceride levels).
Another thing worth a mention is their cholesterol-reducing phytosterols (these reduce the absorption of dietary cholesterol, “good” and “bad”, so this is good for most people, bad for some, depending on the state of your cholesterol and what you ate near in time to eating the nuts)
Peanuts do have their clear downsides too: its phytic acid content can reduce the bioavailability of iron and zinc taken at the same time.
In summary: while popcorn’s greatest claim to dietary beneficence is its fiber content and that it’s close to being a “zero snack”, peanuts (eaten in moderation, say, the same 30g as the popcorn) have a lot to contribute to our daily nutritional requirements.
We do suggest enjoying other nuts though!
Read more: Why You Should Diversify Your Nuts!
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