At The Heart Of Women’s Health
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A woman’s heart is a particular thing
For the longest time (and still to a large degree now), “women’s health” is assumed to refer to the health of organs found under a bikini. But there’s a lot more to it than that. We are whole people, with such things as brains and hearts and more.
Today (Valentine’s Day!) we’re focusing on the heart.
A quick recap:
We’ve talked previously about some of these sex differences when it comes to the heart, for example:
Heart Attack: His & Hers (Be Prepared!)
…but that’s fairly common knowledge at least amongst those who are attentive to such things, whereas…
…is much less common knowledge, especially with the ways statins are more likely to make things worse for a lot of women (not all though; see the article for some nuance about that).
We also talked about:
What Menopause Does To The Heart
…which is well worth reading too!
A question:
Why are women twice as likely to die from a heart attack as their age-equivalent male peers? Women develop heart disease later, but die from it sooner. Why is that?
That’s been a question scientists have been asking (and tentatively answering, as scientists do—hypotheses, theories, conclusions even sometimes) for 20 years now. Likely contributing factors include:
- A lack of public knowledge of the different symptoms
- A lack of confidence of bystanders to perform CPR on a woman
- A lack of public knowledge (including amongst prescribers) about the sex-related differences for statins
- A lack of women in cardiology, comparatively.
- A lack of attention to it, simply. Men get heart disease earlier, so it’s thought of as a “man thing”, by health providers as much as by individuals. Men get more regular cardiovascular check-ups, women get a mammogram and go.
Statistically, women are much more likely to die from heart disease than breast cancer:
- Breast cancer kills around 0.02% of us.
- Heart disease kills one in three.
And yet…
❝In a nationwide survey, only 22% of primary care doctors and 42% of cardiologists said they feel extremely well prepared to assess cardiovascular risks in women.
We are lagging in implementing risk prevention guidelines for women.
A lot of women are being told to just watch their cholesterol levels and see their doctor in a year. That’s a year of delayed care.❞
Source: The slowly evolving truth about heart disease and women
(there’s a lot more in that article than we have room for in ours, so do check it out!)
Some good news:
The “bystanders less likely to feel confident performing CPR on a woman” aspect may be helped by the deployment of new automatic external defibrillator, that works from four sides instead of one.
It’s called “double sequential external defibrillation”, and you can learn about it here:
A new emergency procedure for cardiac arrests aims to save more lives—here’s how it works
(it’s in use already in Canada and Aotearoa)
Gentlemen-readers, thank you for your attention to this one even if it was mostly not about you! Maybe someone you love will benefit from being aware of this
On a lighter note…
Since it’s Valentine’s Day, a little more on affairs of the heart…
Is chocolate good for the heart? And is it really an aphrodisiac?
We answered these questions and more in our previous main feature:
Chocolate & Health: Fact or Fiction?
Enjoy!
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The Liver Cure – by Dr. Russell Blaylock
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We’ve written before about How To Unfatty A Fatty Liver, but there’s a lot more that can be said in a book that we couldn’t fit into our article.
In this book, Dr. Blaylock looks at the causes and symptoms of liver disease, the mechanisms behind such, and how we can adjust our dietary habits (and other things) to do better for ourselves.
While the book’s primary focus is on diet, he does also look at medications (especially: those that hinder liver health, which are many, including simple/common stuff like Tylenol and similar), and the effects of different lifestyle choices, including ones that aren’t diet-related.
Because most people’s knowledge of liver disease starts and ends at “don’t drink yourself to death”, this book is an important tome of knowledge for actually keeping this critical organ in good order—especially since symptoms of liver disease can initially be subtle, and slow to show, often escaping notice until it’s already far, far worse than it could have been.
Many people find out by experiencing liver failure.
The writing style is… A little repetitive for this reviewer’s preference, but it does make sure that you won’t miss things. Also, when it comes to supplements, he repeatedly recommends a particular company, and it’s not clear whether he has a financial interest there. But the actual medical information is good and important and comprehensive.
Bottom line: if you’d like to keep your liver in good health, this is a book that will help you to do just that.
Click here to check out The Liver Cure, and keep yours working well!
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Kiwi vs Grapefruit – Which is Healthier?
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Our Verdict
When comparing kiwi to grapefruit, we picked the kiwi.
Why?
In terms of macros, kiwi has nearly 2x the protein, slightly more carbs, and 2x the fiber; both fruits are low glycemic index foods, however.
When it comes to vitamins, kiwi has more of vitamins B3, B6, B7, B9, C, E, K, and choline, while grapefruit has more of vitamins A, B1, B2, and B5. An easy win for kiwi.
In the category of minerals, kiwi is higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while grapefruit is not higher in any minerals. So, no surprises for guessing which wins this category.
One thing that grapefruit is a rich source of: furanocoumarin, which can inhibit cytochrome P-450 3A4 isoenzyme and P-glycoptrotein transporters in the intestine and liver—slowing down their drug metabolism capabilities, thus effectively increasing the bioavailability of many drugs manifold.
This may sound superficially like a good thing (improving bioavailability of things we want), but in practice it means that in the case of many drugs, if you take them with (or near in time to) grapefruit or grapefruit juice, then congratulations, you just took an overdose. This happens with a lot of meds for blood pressure, cholesterol (including statins), calcium channel-blockers, anti-depressants, benzo-family drugs, beta-blockers, and more. Oh, and Viagra, too. Which latter might sound funny, but remember, Viagra’s mechanism of action is blood pressure modulation, and that is not something you want to mess around with unduly. So, do check with your pharmacist to know if you’re on any meds that would be affected by grapefruit or grapefruit juice!
All in all, adding up the categories makes for an overwhelming total win for kiwis.
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is top of the list!
Take care!
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How To Reduce Or Quit Alcohol
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Rethinking Drinking
When we’re looking at certain health risks, there are often five key lifestyle factors that have a big impact; they are:
- Have a good diet
- Get good exercise
- Get good sleep
- Reduce (or eliminate) alcohol
- Don’t smoke
Today, we’re focussing the alcohol bit. Maybe you’d like to quit, maybe just cut down, maybe the topic just interests you… So, here’s a quick rundown of some things that will help make that a lot easier:
With a big enough “why”, you can overcome any “how”
Research and understand the harm done by drinking, including:
And especially as we get older, memory problems:
Alcohol-related dementia: an update of the evidence
And as for fear of missing out, or perhaps even of no longer being relaxed/fun… Did you ever, while sober, have a very drunk person try to converse with you, and you thought “I wish that were me”?
Probably not
Know your triggers
Why do you drink? If your knee-jerk response is “because I like it”, dig deeper. What events prompt you to have a drink?
- Some will be pure habit born of convention—perhaps with a meal, for example
- Others may be stress-management—after work, perhaps
- Others may be pseudo-medicinal—a nightcap for better* sleep, for instance
*this will not work. Alcohol may make us sleepy but it will then proceed to disrupt that very sleep and make it less restorative
Become mindful
Now that you know why you’d like to drink less (or quit entirely), and you know what triggers you to drink, you can circumvent that a little, by making deals with yourself, for example
- “I can drink alcohol, if and only if I have consumed a large glass of water first” (cuts out being thirsty as a trigger to drink)
- “I can drink alcohol, if and only if I meditate for at least 5 minutes first” (reduces likelihood of stress-drinking)
- “I can drink alcohol, if and only if it is with the largest meal of the day” (minimizes total alcohol consumption)
Note that these things also work around any FOMO, “Fear Of Missing Out”. It’s easier to say “no” when you know you can have it later if you still want it.
Get a good replacement drink
There are a lot of alcohol-free alcohol-like drinks around these days, and many of them are very good. Experiment and see. But!
It doesn’t even have to be that. Sometimes what we need is not even an alcohol-like drink, but rather, drinkable culinary entertainment.
If you like “punch-in-the-face” flavors (as this writer does), maybe strong black coffee is the answer. If you like “crisp and clear refreshment” (again, same), maybe your favorite herbal tea will do it for you. Or maybe for you it’ll be lemon-water. Or homemade ginger ale.
Whatever it is… make it fun, and make it yours!
Bonus item: find replacement coping strategies
This one goes if you’ve been using alcohol to cope with something. Stress, depression, anxiety, whatever it may be for you.
The thing is, it feels like it helps briefly in the moment, but it makes each of those things progressively worse in the long-run, so it’s not sustainable.
Consider instead things like therapy, exercise, and/or a new hobby to get immersed in; whatever works for you!
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Ham Substitute in Bean Soup
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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 am interested in what I can substitute for ham in bean soup?
Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.
Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).
Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.
Wondering about the health aspects of MSG? Check out our main feature on this, from last month:
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Play Bold – by Magnus Penker
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This book is very different to what you might expect, from the title.
We often see: “play bold, believe in yourself, the universe rewards action” etc… Instead, this one is more: “play bold, pay attention to the data, use these metrics, learn from what these businesses did and what their results were”, etc.
We often see: “here’s an anecdote about a historical figure and/or celebrity who made a tremendous bluff and it worked out well so you should too” etc… Instead, this one is more: “see how what we think of as safety is actually anything but! And how by embracing change quickly (or ideally: proactively), we can stay ahead of disaster that may otherwise hit us”.
Penker’s background is also relevant here. He has decades of experience, having “launched 10 start-ups and acquired, turned around, and sold over 30 SMEs all over Europe”. Importantly, he’s also “still in the game”… So, unlike many authors whose last experience in the industry was in the 1970s and who wonder why people aren’t reaping the same rewards today!
Penker is the therefore opposite of many who advocate to “play bold” but simply mean “fail fast, fail often”… While quietly relying on their family’s capital and privilege to leave a trail of financial destruction behind them, and simultaneously gloating about their imagined business expertise.
In short: boldness does not equate to foolhardiness, and foolhardiness does not equate to boldness.
As for telling the difference? Well, for that we recommend reading the book—It’s a highly instructive one.
Take The First Bold Step Of Checking Out This Book On Amazon!
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Semaglutide’s Surprisingly Unexamined Effects
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Semaglutide’s Surprisingly Big Research Gap
GLP-1 receptor agonists like Ozempic, Wegovy, and other semaglutide drugs. are fast becoming a health industry standard go-to tool in the weight loss toolbox. When it comes to recommending that patients lose weight, “Have you considered Ozempic?” is the common refrain.
Sometimes, this may be a mere case of kicking the can down the road with regard to some other treatment that it can be argued (sometimes even truthfully) would go better after some weight loss:
How weight bias in health care can harm patients with obesity: Research
…which we also covered in fewer words in the second-to-last item here:
But GLP-1 agonists work, right?
Yes, albeit there’s a litany of caveats, top of which are usually:
- there are often adverse gastrointestinal side effects
- if you stop taking them, weight regain generally ensues promptly
For more details on these and more, see:
…but now there’s another thing that’s come to light:
The dark side of semaglutide’s weight loss
In academia, “dark” is often used to describe “stuff we don’t have much (or in some cases, any) direct empirical evidence of, but for reasons of surrounding things, we know it’s there”.
Well-known examples include “dark matter” in physics and the Dark Ages in (European) history.
In the case of semaglutide and weight loss, a review by a team of researchers (Drs. Sandra Christenen, Katie Robinson, Sara Thomas, and Dominique Williams) has discovered how little research has been done into a certain aspect of GLP-1 agonist’s weight loss effects, namely…
Dietary changes!
There’s been a lot of popular talk about “people taking semaglutide eat less”, but it’s mostly anecdotal and/or presumed based on parts of the mechanism of action (increasing insulin production, reducing glucagon secretions, modulating dietary cravings).
Where studies have looked at dietary changes, it’s almost exclusively been a matter of looking at caloric intake (which has been found to be a 16–39% reduction), and observations-in-passing that patients reported reduction in cravings for fatty and sweet foods.
This reduction in caloric intake, by the way, is not significantly different to the reduction brought about by counselling alone (head-to-head studies have been done; these are also discussed in the research review).
However! It gets worse. Very few studies of good quality have been done, even fewer (two studies) actually had a registered dietitian nutritionist on the team, and only one of them used the “gold standard” of nutritional research, the 24-hour dietary recall test. Which, in case you’re curious, you can read about what that is here:
Dietary Assessment Methods: What Is A 24-Hour Recall?
Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.
And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it is to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!
Any other bad news?
While we’re talking research gaps, guess how many studies looked into micronutrient intake changes in people taking GLP-1 agonists?
If you guessed zero, you guessed correctly.
You can find the paper itself here:
What’s the main take-away here?
On a broad, scoping level: we need more research!
On a “what this means for individuals who want to lose weight” level: maybe we should be more wary of this still relatively new (less than 10 years old) “wonder drug”. And for most of those 10 years it’s only been for diabetics, with weight loss use really being in just the past few years (2021 onwards).
In other words: not necessarily any need to panic, but caution is probably not a bad idea, and natural weight loss methods remain very reasonable options for most people.
See also: How To Lose Weight (Healthily!)
Take care!
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