Health Simplified – by Daniel Cottmeyer
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Health Simplified – by Daniel Cottmeyer
A lot of books focus on the most marketable aspects of health, such as fat loss or muscle gain. Instead, Cottmeyer takes a “birds-eye-view” of health in all its aspects, and then boils it down to the most critical key parts.
Rather than giving a science-dense tome that nobody reads, or a light motivational piece that everyone reads but it amounts to “you can do it!”, here we get substance… but in a digestible form.
Which we at 10almonds love.
The book presents a simple action plan to:
- Improve your relationship with food/exercise
- Actually get better sleep
- Understand how nutrition really works
- Set up helpful habits that are workable and sustainable
- Bring these components together synergistically
Bottom line: if you’re going to buy only one health/fitness book, this is a fine contender.
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What immunocompromised people want you to know
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While many people in the U.S. have abandoned COVID-19 mitigations like vaccines and masking, the virus remains dangerous for everyone, and some groups face higher risks than others. Immunocompromised people—whose immune systems don’t work as well as they should due to health conditions or medications—are more vulnerable to infection and severe symptoms from the virus.
Public Good News spoke with three immunocompromised people about the steps they take to protect themselves and what they want others to know about caring for each other.
[Editor’s note: The contents of these interviews have been condensed for length.]
PGN: What measures have you been taking to protect yourself since the COVID-19 pandemic began?
Tatum Spears, Virginia
From less than a year old, I had serious, chronic infections and have missed huge chunks of my life. In 2020, I quit my public job, and I have not worked publicly since.
I have a degree in vocal performance and have been singing my whole life, but I haven’t performed publicly since 2019. I feel like a bird without wings. I had to stop traveling. Since no one wears a mask anymore, I can’t go to the movies or social outings or any party.
All my friends live in my phone now. It’s a community of people—a lot of them are immunocompromised or disabled in some way.
There are a good portion of them who just take COVID-19 seriously and want to protect their health, who feel the existential abandonment and the burden of all of this. It’s really isolating having to step back from any sort of social life. I have to assess my risk every single time I leave the house.
Gwendolyn Alyse Bishop, Washington
I was hit by a car when I was very young. I woke up from surgery, and doctors told me I had lost almost all of my spleen. So, I was always the sickest kid in my school.
When COVID-19 hit, I started working from home. At first, I wore cloth masks. I didn’t really learn about KN95 masks until right around the time that COVID-19 disabled me. [Editor’s note: N95 and KN95 masks have been shown to be significantly more effective at preventing the transmission of viral particles than cloth masks.]
I actually don’t get out much anymore because I am disabled by long COVID now, but when I do leave, I wear a respirator in all shared air spaces. My roommate and I have HEPA filters going in every room.And then we test. I have a Pluslife testing dock, and so we keep a weekly testing schedule with that and then test if there are any symptoms. I got reinfected [with COVID-19] last winter, and a Pluslife test helped me catch it early and get Paxlovid. [Editor’s note: Pluslife is a brand of an at-home COVID-19 nucleic acid amplification test, which has been shown to be significantly more effective at detecting COVID-19 than at-home antigen rapid tests.]
Abby Mahler, California
I have lupus, and in 2016, I started taking the drug hydroxychloroquine, which is an immunomodulator. I’m not as immunocompromised as some people, but I certainly don’t have a normal immune system, which has resulted in long-term infections like C. diff.I started masking early. My roommates and I prioritize going outside. We don’t remove our masks inside in public places.
We are in a pod with one other household, and the pod has agreements on the way that we interact with public space. So, we will only unmask with people who have tested ahead of time. We use Metrix, an at-home nucleic acid amplification test.
While it’s not easy and it’s not the life that we had prior to COVID-19’s existence, it is a life that has provided us quite a lot of freedom, in the sense that we are not sick all the time. We are conscientiously making decisions that allow us to have a nice time without a monkey on our backs, which is freeing.
PGN: What do you want people who are not immunocompromised to know?
T.S.: Don’t be afraid to be the only person in a room wearing a mask. Your own health is worth it. And you have to realize how callous [people who don’t wear a mask are] by existing in spaces and breathing [their] air [on immunocompromised people].
People think that vaccines are magic, but vaccines alone are not enough. I would encourage people to look at the Swiss cheese model of risk assessment.
Each slice of Swiss cheese has holes in it in different places, and each layer represents a layer of virus mitigation. One layer is vaccines. Another layer is masks. Then there’s staying home when you’re sick and testing.
G.A.B.: I wish people were masking. I wish people understood how likely it is that they are also now immunocompromised and vulnerable because of the widespread immune dysregulation that COVID-19 is causing. [Editor’s note: Research shows that COVID-19 infections may cause long-term harm to the immune system in some people.]
I want people to be invested in being good community members, and part of that is understanding that COVID-19 hits the poorest the hardest—gig workers, underpaid employees, frontline service workers, people who were already disabled or immunocompromised.
If people want to be good community members, they not only need to protect immunocompromised and disabled people by wearing a mask when they leave their homes, but they also need to actually start taking care of their community members and participating in mutual aid. [Editor’s note: Mutual aid is the exchange of resources and services within a community, such as people sharing extra N95 masks.]
I spend pretty much all of my time working on LongCOVIDAidBot, which promotes mutual aid for people who have been harmed by COVID-19.
A.M.: An important thing to think about when you’re not disabled is that it becomes a state of being for all people, if they’re lucky. You will become disabled, or you will die.
It is a privilege, in my opinion, to become disabled because I can learn different ways of living my life. And being able to see yourself as a body that changes over time, I hope, opens up a way of looking at your body as the porous reality that it is.
Some people think of themselves as being willing to make concessions or change their behavior when immunocompromised people are around, but you don’t always know when someone is immunocompromised.
So, if you’re not willing to change the way that you think about yourself as a person who is susceptible [to illness], then you should change the way that you consider other people around you. Wearing a mask—at the very least in public indoor spaces—means considering the unknown realities of all the people who are interacting with that space.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Antihistamines’ Generation Gap
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Are You Ready For Allergy Season?
For those of us in the Northern Hemisphere, fall will be upon us soon, and we have a few weeks to be ready for it. A common seasonal ailment is of course seasonal allergies—it’s not serious for most of us, but it can be very annoying, and can disrupt a lot of our normal activities.
Suddenly, a thing that notionally does us no real harm, is making driving dangerous, cooking take three times as long, sex laughable if not off-the-table (so to speak), and the lightest tasks exhausting.
So, what to do about it?
Antihistamines: first generation
Ye olde antihistamines such as diphenhydramine and chlorpheniramine are probably not what to do about it.
They are small molecules that cross the blood-brain barrier and affect histamine receptors in the central nervous system. This will generally get the job done, but there’s a fair bit of neurological friendly-fire going on, and while they will produce drowsiness, the sleep will usually be of poor quality. They also tax the liver rather.
If you are using them and not experiencing unwanted side effects, then don’t let us stop you, but do be aware of the risks.
See also: Long-term use of diphenhydramine ← this is the active ingredient in Benadryl in the US and Canada, but safety regulations in many other countries mean that Benadryl has different, safer active ingredients elsewhere.
Antihistamines: later generations
We’re going to aggregate 2nd gen, 3rd gen, and 4th gen antihistamines here, because otherwise we’ll be writing a history article and we don’t have room for that. But suffice it to say, later generations of antihistamines do not come with the same problems.
Instead of going in all-guns-blazing to the CNS like first-gens, they are more specific in their receptor-targetting, resulting in negligible collateral damage:
Special shout-out to cetirizine and loratadine, which are the drugs behind half the brand names you’ll see on pharmacy shelves around most of the world these days (including many in the US and Canada).
Note that these two are very often discussed in the same sentence, sit next to each other on the shelf, and often have identical price and near-identical packaging. Their effectiveness (usually: moderate) and side effects (usually: low) are similar and comparable, but they are genuinely different drugs that just happen to do more or less the same thing.
This is relevant because if one of them isn’t working for you (and/or is creating an unwanted side effect), you might want to try the other one.
Another honorable mention goes to fexofenadine, for which pretty much all the same as the above goes, though it gets talked about less (and when it does get mentioned, it’s usually by its most popular brand name, Allegra).
Finally, one that’s a little different and also deserving of a special mention is azelastine. It was recently (ish, 2021) moved from being prescription-only to being non-prescription (OTC), and it’s a nasal spray.
It can cause drowsiness, but it’s considered safe and effective for most people. Its main benefit is not really the difference in drug, so much as the difference in the route of administration (nasal rather than oral). Because the drug is in liquid spray form, it can be absorbed through the mucus lining of the nose and get straight to work on blocking the symptoms—in contrast, oral antihistamines usually have to go into your stomach and take their chances there (we say “usually”, because there are some sublingual antihistamines that dissolve under the tongue, but they are less common.)
Better than antihistamines?
Writer’s note: at this point, I was given to wonder: “wait, what was I squirting up my nose last time anyway?”—because, dear readers, at the time I got it I just bought one of every different drug on the shelf, desperate to find something that worked. What worked for me, like magic, when nothing else had, was beclometasone dipropionate, which a) smelled delightfully of flowers, which might just be the brand I got, b) needs replacing now because I got it in March 2023 and it expired July 2024, and c) is not an antihistamine at all.
But, that brings us to the final chapter for today: systemic corticosteroids
They’re not ok for everyone (check with your doctor if unsure), and definitely should not be taken if immunocompromised and/or currently suffering from an infection (including colds, flu, COVID, etc) unless your doctor tells you otherwise (and even then, honestly, double-check).
But! They can work like magic when other things don’t. Unlike antihistamines, which only block the symptoms, systemic corticosteroids tackle the underlying inflammation, which can stop the whole thing in its tracks.
Here’s how they measure up against antihistamines:
❝The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.❞
~ Dr. Robert Puy et al.
Take care!
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Apples vs Figs – Which is Healthier?
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Our Verdict
When comparing apples to figs, we picked the figs.
Why?
These two fruits are both known for being quite rich in sugar (but also rich in fiber, which offsets it metabolically), and indeed their macros are quite similar. That said, figs have slightly more protein, fiber, and carbs. Both are considered low glycemic index foods. We can consider this category a tie, or perhaps a nominal win for apples, whose glycemic index is the lower of the two. But since figs’ GI is also low, it’s really not a deciding factor.
In terms of vitamins, apples have more of vitamins C and E, while figs have more of vitamins A, B1, B2, B3, B5, B6, B9, and choline, with noteworthy margins of difference. A clear for figs here.
When it comes to minerals, apples are not higher in any minerals, while figs are several times higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. An overwhelming win for figs.
Of course, enjoy either or both, but if you want nutritional density, apples simply cannot compete with figs.
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Here’s To Getting Assuredly Good Health
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An unusual amount of excitement in the health news world this week, with health insurance in the spotlight:
Deny, Delay, Depose?
Insurance company UnitedHealthcare, which used AI with a 90% error rate to deny insurance claims (of which, disproportionately denying insurance claims of the elderly), has come under extra public scrutiny this week for its recent-years business practices:
❝Nearly 1 in 5 insured adults experienced claim denials during a 12-month period.
Those with job-based insurance or Affordable Care Act policies ran into this problem about twice as often as those covered by Medicare or Medicaid❞
…although, the company has dramatically increased its care denials for Medicare Advantage enrollees, doubling the rate of denials as it implemented its new, automated denials process.
Anesthesiologist Dr. Brain Schmutzler noted:
❝We have a bigger issue with the insurance companies in general, who, essentially, it’s their job to make money, not to actually pay for health care❞
And in those cases where healthcare is not denied, it is often dangerously delayed, as insurance companies can stall for time to decide whether they’re going to pay or not.
One useful take-away from all of this is that if your insurance claim is denied, consider fighting it, as often they can be overturned.
Specifically, it can be good to insist on knowing who (named persons) was involved in the denial process, and their qualifications. Once upon a time, this was mostly unqualified interns, which prompted insurance companies to reverse the denial rather than admit that; nowadays it’s mostly AI, which many companies can hope will shield them from culpability—either way, fighting for one’s rights can often be successful.
Read in full: Killing of UnitedHealthcare CEO prompts flurry of stories on social media over denied insurance claims
Related: With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help
Rest Easy
Health insurer Elevance Health (formerly Anthem Blue Cross Blue Shield), had last month announced plans to limit its coverage for anesthesia used in operations, whereby they would pay for only a certain amount of anesthetic, and if the procedure was still ongoing when that amount had been used, then well, you were on your own.
However, on Thursday afternoon and allegedly completely coincidentally in the wake of the Wednesday assassination of the CEO who oversaw the denial of so many health insurance claims, this decision to limit paying for anesthesia was reversed, retracted, and they are now doing their best to downplay what the proposal would have meant for anesthesiologists and patients:
Read in full: Insurance company halts plan to put time limits on coverage for anesthesia during surgery
Related: The Insider’s Guide To Making Hospital As Comfortable As Possible ← an anesthesiologist’s tips
Getting a good grip of your health
What’s the best indicator of good health when it comes to age-related health issues? It’s not BMI! Could it be blood pressure? It could, but the news presently is about grip strength.
While training to have an amazing grip (and neglecting all else) will not necessarily increase your general healthspan, having a weak or strong grip is strongly associated with, respectively, having weak or strong general health in later years.
This is because unless someone has been training very unnaturally, grip strength is a good general measure of overall muscle strength, which in turn is a good indicator of metabolic health, as well as bodily robustness.
Read in full: Handgrip strength is a reliable predictor for age-related disease and disability, finds study
Related: Resistance Is Useful! (Especially As We Get Older)
Take care!
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Gut Health 2.0
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Gene Expression & Gut Health
This is Dr. Tim Spector. After training in medicine and becoming a consultant rheumatologist, he’s turned his attention to medical research, and is these days a specialist in twin studies, genetics, epigenetics, microbiome, and diet.
What does he want us to know?
For one thing: epigenetics are for more than just getting your grandparents’ trauma.
More usefully: there are things we can do to improve epigenetic factors in our body
DNA is often seen as the script by which our body does whatever it’s going to do, but it’s only part of the story. Thinking of DNA as some kind of “magical immutable law of reality” overlooks (to labor the metaphor) script revisions, notes made in the margins, directorial choices, and ad-lib improvizations, as well as the quality of the audience’s hearing and comprehension.
Hence the premise of one of Dr. Spector’s older books, “Identically Different: Why We Can Change Our Genes”
(*in fact, it was his first, from all the way back in 2013, when he’d only been a doctor for 34 years)
Gene expression will trump genes every time, and gene expression is something that can often be changed without getting in there with CRISPR / a big pair of scissors and some craft glue.
How this happens on the micro level is beyond the scope of today’s article; part of it has to do with enzymes that get involved in the DNA transcription process, and those enzymes in turn are despatched or not depending on hormonal messaging—in the broadest sense of “hormonal”; all the body’s hormonal chemical messengers, not just the ones people think of as hormones.
However, hormonal messaging (of many kinds) is strongly influenced by something we can control relatively easily with a little good (science-based) knowledge: the gut.
The gut, the SAD, and the easy
In broad strokes: we know what is good for the gut. We’ve written about it before at 10almonds:
Making Friends With Your Gut (You Can Thank Us Later)
This is very much in contrast with what in scientific literature is often abbreviated “SAD”, the Standard American Diet, which is very bad for the gut.
However, Dr. Spector (while fully encouraging everyone to enjoy an evidence-based gut-healthy diet) wanted to do one better than just a sweeping one-size-fits-all advice, so he set up a big study with 15,000 identical twins; you can read about it here: TwinsUK
The information that came out of that was about a lot more than just gene expression and gut health, but it did provide the foundation for Dr. Spector’s next project, ZOE.
ZOE crowdsources huge amounts of data including individual metabolic responses to standardized meals in order to predict personalized food responses based on individual biology and unique microbiome profile.
In other words, it takes the guesswork out of a) knowing what your genes mean for your food responses b) tailoring your food choices with your genetic expression in mind, and c) ultimately creating a positive feedback loop to much better health on all levels.
Now, this is not an ad for ZOE, but if you so wish, you can…
- Get the free ZOE gut health guide (this is good, but generic, gut health information)
- Take the ZOE home gut health test (quiz followed by offers of lab tests)
- Browse the ZOE Health Academy, its education wing
Want to know more?
Dr. Spector has a bunch of books out, including some that we’ve reviewed previously:
- Spoon-Fed: Why Almost Everything We’ve Been Told About Food Is Wrong
- The Diet Myth: The Real Science Behind What We Eat
- Food for Life: The New Science of Eating Well
You can also check out our own previous main feature, which wasn’t about Dr. Spector’s work but was very adjacent:
The Brain-Gut Highway: A Two-Way Street
Enjoy!
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Frozen/Thawed/Refrozen Meat: How Much Is Safety, And How Much Is Taste?
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What You Can (And Can’t) Safely Do With Frozen Meat
Yesterday, we asked you:
❝You have meat in the freezer. How long is it really safe to keep it?❞
…and got a range of answers, mostly indicating to a) follow the instructions (a very safe general policy) and b) do not refreeze if thawed because that would be unsafe. Fewer respondents indicated that meat could be kept for much longer than guidelines say, or conversely, that it should only be kept for weeks or less.
So, what does the science say?
Meat can be kept indefinitely (for all intents and purposes) in a freezer; it just might get tougher: True or False?
False, assuming we are talking about a normal household electrical freezer that bottoms out at about -18℃ / 0℉.
Fun fact: cryobiologists cryopreserve tissue samples (so basically, meat) at -196℃ / -320℉, and down at those temperatures, the tissues will last a lot longer than you will (and, for all practical purposes: indefinitely). There are other complications with doing so (such as getting the sample through the glass transition point without cracking it during the vitrification process) but those are beyond the scope of this article.
If you remember back to your physics or perhaps chemistry classes at school, you’ll know that molecules move more quickly at higher temperatures, and more slowly at lower ones, only approaching true stillness as they near absolute zero (-273℃ / -459℉ / 0K ← we’re not saying it’s ok, although it is; rather, that is zero kelvin; no degree sign is used with kelvins)
That means that when food is frozen, the internal processes aren’t truly paused; it’s just slowed to a point of near imperceptibility.
So, all the way up at the relatively warm temperatures of a household freezer, a lot of processes are still going on.
What this means in practical terms: those guidelines saying “keep in the freezer for up to 4 months”, “keep in the freezer for up to 9 months”, “keep in the freezer for up to 12 months” etc are being honest with you.
More or less, anyway! They’ll usually underestimate a little to be on the safe side—but so should you.
Bad things start happening within weeks at most: True or False?
False, for all practical purposes. Again, assuming a normal and properly-working household freezer as described above.
(True, technically but misleadingly: the bad things never stopped; they just slowed down to a near imperceptible pace—again, as described above)
By “bad” here we should clarify we mean “dangerous”. One subscriber wrote:
❝Meat starts losing color and flavor after being in the freezer for too long. I keep meat in the freezer for about 2 months at the most❞
…and as a matter of taste, that’s fair enough!
It is unsafe to refreeze meat that has been thawed: True or False?
False! Assuming it has otherwise been kept chilled, just the same as for fresh meat.
Food poisoning comes from bacteria, and there is nothing about the meat previously having been frozen that will make it now have more bacteria.
That means, for example…
- if it was thawed (but chilled) for a period of time, treat it like you would any other meat that has been chilled for that period of time (so probably: use it or freeze it, unless it’s been more than a few days)
- if it was thawed (and at room temperature) for a period of time, treat it like you would any other meat that has been at room temperature for that period of time (so probably: throw it out, unless the period of time is very small indeed)
The USDA gives for 2 hours max at room temperature before considering it unsalvageable, by the way.
However! Whenever you freeze meat (or almost anything with cells, really), ice crystals will form in and between cells. How much ice crystallization occurs depends on several variables, with how much water there is present in the food is usually the biggest factor (remember that animal cells are—just like us—mostly water).
Those ice crystals will damage the cell walls, causing the food to lose structural integrity. When you thaw it out, the ice crystals will disappear but the damage will be left behind (this is what “freezer burn” is).
So if your food seems a little “squishy” after having been frozen and thawed, that’s why. It’s not rotten; it’s just been stabbed countless times on a microscopic level.
The more times you freeze and thaw and refreeze food, the more this will happen. Your food will degrade in structural integrity each time, but the safety of it won’t have changed meaningfully.
Want to know more?
Further reading:
You can thaw and refreeze meat: five food safety myths busted
Take care!
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