Good Health From Head To Toe
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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: I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?
Very important stuff! We wrote about this not long back:
- See: How To Reduce Your Alzheimer’s Risk
- See also: Brain Food? The Eyes Have It!
(one good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!)
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!
Q: Veganism, staying mentally sharp, best exercises for weight gain?
All great stuff! Let’s do a run-down:
- Veganism? As a health and productivity newsletter, we’ll only be focusing veganism’s health considerations, but it does crop up from time to time! For example:
- Which Plant Milk? (entirely about such)
- Plant vs Animal Protein (mostly about such)
- Making Friends With Your Gut (You Can Thank Us Later) (discusses one benefit of such)
- Staying mentally sharp? You might like the things-against-dementia pieces we linked to in the previous response!
- It’s also worth noting that some kinds of dementia, such as Alzheimer’s, can begin the neurodegenerative process 20 years before symptoms show, and can be influenced by lifestyle choices 20 years before that, so it’s definitely never too early be on top of these things!
- Best exercises for weight gain? We’ll do a main feature one of these days (filled with good science and evidence), but in few words meanwhile: core exercises, large muscle groups, heavy weights, few reps, build up slowly. Squats are King.
Q: I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress
You’re going to love our Psychology Sunday editions of 10almonds! You might like some of these…
- Relationships: Seriously Useful Communication Skills!
- Purpose: Are You Flourishing? (There’s a Scale)
- Managing stress: Lower Your Cortisol! (Here’s Why & How)
- Also about managing stress: Sunday Stress-Buster
- Also applicable to stress: How To Set Your Anxiety Aside
Q: I’d like to know more about type 2 diabetic foot problems
You probably know that the “foot problems” thing has less to do with the feet and more to do with blood and nerves. So, why the feet?
The reason feet often get something like the worst of it, is because they are extremities, and in the case of blood sugars being too high for too long too often, they’re getting more damage as blood has to fight its way back up your body. Diabetic neuropathy happens when nerves are malnourished because the blood that should be keeping them healthy, is instead syrupy and sluggish.
We’ll definitely do a main feature sometime soon on keeping blood sugars healthy, for both types of diabetes plus pre-diabetes and just general advice for all.
In the meantime, here’s some very good advice on keeping your feet healthy in the context of diabetes. This one’s focussed on Type 1 Diabetes, but the advice goes for both:
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Complex PTSD – by Pete Walker
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We’ve written before about Complex PTSD, but there’s a lot more to be said than we can fit into an article or two.
Pete Walker, a licensed marriage and family therapist, does an excellent job and pulls no punches, starting from the book’s dedication and carrying the hard-hitting seriousness all the way through to the Appendices.
To this end, it absolutely may not be an easy book to read at times (emotionally speaking), especially if you have C-PTSD. On the other hand, you may also find it a very validating 300-odd pages of “Yes, he is telling my life story in words, now this makes sense!”
That said, it’s mostly not an anecdotes-based book and nor is it just a feelsy ride; it’s also a textbook and a how-to manual. It’s a textbook of how and why things come about the way they do, and a manual of how to effectively manage C-PTSD, and find peace. There’s no silver bullet here, but there is a very comprehensive guide, and chapters full of tools to use (and no, not the same CBT things you’ve probably read a hundred times, this is C-PTSD-specific stuff).
Bottom line: this is the C-PTSD book; if you buy only one book on the topic, make it this one.
Click here to check out Complex PTSD: From Surviving To Thriving, and indeed thrive!
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Science of Yoga – by Ann Swanson
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There are a lot of yoga books out there to say “bend this way, hold this that way” and so forth, but few that really explain what is going on, how, and why. And understanding those things is of course key to motivation and adherence. So that’s what this book provides!
The book is divided into sections, and in the first part we have a tour of human anatomy and physiology. This may seem almost unrelated to yoga, but is valuable necessary-knowledge to get the most out of the next section:
The next few parts are given over to yoga asanas (stretches, positions, poses, call them what you will in English) and now we are given a clear idea of what it is doing: we get to understand exactly what’s being stretched, what blood flow is being increased and how, what organs are being settled into their correct place, and many other such things.
Importantly, this means we also understand why certain things are the way they are, and why they can’t be done in some other slightly different but perhaps superficially easier way.
The style of the book is like a school textbook, really, but without patronizing the reader. The illustrations, of which there are many, are simple enough to be clear while being detailed enough to be informative.
Bottom line: if you’re ever doing yoga at home and wondering if you should cut a certain corner, this is the book that will tell you why you shouldn’t.
Click here to check out Science of Yoga, and optimize your practice!
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Coffee & Your Gut
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Coffee, in moderation, is generally considered a healthful drink—speaking for the drink itself, at least! Because the same cannot be said for added sugar, various sorts of creamers, or iced caramelatte mocha frappucino dessert-style drinks:
The Bitter Truth About Coffee (or is it?)
Caffeine, too, broadly has more pros than cons (again, in moderation):
Caffeine: Cognitive Enhancer Or Brain-Wrecker?
Some people will be concerned about coffee and the heart. Assuming you don’t have a caffeine sensitivity (or you do but you drink decaf), it is heart-neutral in moderation, though there are some ways of preparing it that are better than others:
Make Your Coffee Heart-Healthier!
So, what about coffee and the gut?
The bacteria who enjoy a good coffee
Amongst our trillions of tiny friends, allies, associates, and enemies-on-the-inside, which ones like coffee, and what kind of coffee do they prefer?
A big (n=35,214) international multicohort analysis examined the associations between coffee consumption and very many different gut microbial species, and found:
115 species were positively associated with coffee consumption, mostly of the kind considered “friendly”, including ones often included in probiotic supplements, such as various Bifidobacterium and Lactobacillus species.
The kind that was most strongly associated with coffee consumption, however, was Lawsonibacter asaccharolyticus, a helpful little beast who converts chlorogenic acid (one of the main polyphenols in coffee) into caffeic acid, quinic acid, and various other metabolites that we can use.
More specifically: moderate coffee-drinkers, defined as drinking 1–3 cups per day, enjoyed a 300–400% increase in L. asaccharolyticus, while high coffee-drinkers (no, not that kind of high), defined as drinking 4 or more cups of coffee per day, enjoyed a 400–800% increase, compared to “never/rarely” coffee-drinkers (defined as drinking 2 or fewer cups per month).
Click here to see more data from the study, in a helpful infographic
Things that did not affect the outcome:
- The coffee-making method—it seems the bacteria are not fussy in this regard, as espresso or brewed, and even instant, yielded the same gut microbiome benefits
- The caffeine content—as both caffeinated and decaffeinated yielded the same gut microbiome benefits
You can read the paper itself in full for here:
Want to enjoy coffee, but not keen on the effects of caffeine or the taste of decaffeinated?
Taking l-theanine alongside coffee flattens the curve of caffeine metabolism, and means one can get the benefits without unwanted jitteriness:
Enjoy!
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Rethinking Diabetes – by Gary Taubes
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We’ve previously reviewed this author’s “The Case Against Sugar” and “Why We Get Fat And What To Do About It“. There’s an obvious theme, and this book caps it off nicely:
By looking at the history of diabetes treatment (types 1 and 2) in the past hundred years, and analysing the patterns over time, we can see how:
- diabetics have been misled a lot over time by healthcare providers
- we can learn from those mistakes going forwards
Happily, he does this without crystal-balling the future or expecting diet to fix, for example, a pancreas that can’t produce insulin. But what he does do is focus on the “can” items rather than the “can’t” items.
In the category of criticism, one of the strategies he argues for is basically the keto diet, which is indeed just fine for diabetes but often not great for the heart in the long-term (it depends on various factors, including genes). However, even if you choose not to implement that, there is plenty more to try out in this book.
Bottom line: whether you have diabetes, love someone who does, or just plain like to be on top of your glycemic health, this book is full of important insights and opportunities to improve things progressively along the way.
Click here to check out Rethinking Diabetes, and rethink diabetes!
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Hormones & Health, Beyond The Obvious
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Wholesome Health
This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.
What does she want us to know?
Beyond “bikini zone health”
Dr. Gottfried urges us to pay attention to our whole health, in context.
“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.
And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.
That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:
- The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
- The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one
Nor are brains exempt from his…
The female brain (kinda)
While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…
The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.
See for example:
Alzheimer’s Sex Differences May Not Be What They Appear
Dr. Gottfried urges us to take the above seriously!
Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.
She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:
Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)
The other very relevant hormone
…that Dr. Gottfried wants us to pay attention to is insulin.
Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.
In other words: to fight neurodegeneration, keep your blood sugars healthy.
This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:
The Surprising Link Between Type 2 Diabetes & Alzheimer’s
Want more from Dr. Gottfried?
You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:
Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD
…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.
Enjoy!
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What’s the difference between miscarriage and stillbirth?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.
Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.
Here are some similarities and differences between miscarriage and stillbirth, and why they matter.
christinarosepix/Shutterstock Let’s start with some definitions
In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).
This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.
However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.
The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.
Internationally, definitions of stillbirth vary depending on the jurisdiction.
How common are they?
It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.
Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.
Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.
Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.
Who’s at risk?
Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.
Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.
Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.
For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.
An older dad can be a risk factor for stillbirth, but not miscarriage. Elizaveta Galitckaia/Shutterstock Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.
Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.
So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.
Why do they happen?
Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.
Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.
Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.
Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.
Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.
In many cases, however, the specific cause of pregnancy loss is not known.
How about the long-term health risks?
Miscarriage and stillbirth can be early indicators of health issues later in life.
For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).
Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.
Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.
We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.
Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.
Long-term health risks of recurrent miscarriages or stillbirths include developing lung disease later in life. PRPicturesProduction/Shutterstock Why is all this important?
Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.
Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.
More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.
Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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