Heart Health Calculator Entry Issue
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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 tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞
(this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)
How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.
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Your Heart In Their Hands: Surgeon Preferences & Survival Rates
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Unless you are paying entirely out-of-pocket for a heart surgery, you will not usually get final say over which surgeon you get.
The surgeon, however, will have final say over what they actually do when they open you up.
And their preferences, it seems, can make all the difference:
MAG vs SAG
When doing coronary artery bypass grafting, (CABG), surgeons may prefer to do multi-arterial grafting (MAG) or single-arterial grafting (SAG).
Recently, there was a study analysing more than a million Americans who underwent CABG on Medicare over an 18-year period, looking at outcomes for MAG vs SAG.
The superficial news: those who received MAG had much better long-term survival chances than those who received SAG.
However: this may be less to do with the relative merits of the procedures themselves, and more to do with the preferences of the surgeon.
The “eyeball test”
If surgeons look at a patient and think they will not have many years to live after surgery, they may opt for the SAG, as the long-term benefits of the MAG will only manifest in the long-term.
This may seem a little self-defeating (indeed, maybe you won’t live to see the long-term if you don’t get the surgery type with the longer-term survival chances), there can be other factors involved, that may make surgeons more interested in your short-term survival chances.
Or you might just not have enough donor artery tissue available to pick and choose; after all, a person having a coronary artery bypass quite possibly won’t have great arteries in their arm or leg, either.
Or a person could be missing limbs (a common complication, given the comorbidities of both peripheral artery disease, and diabetes).
See also: How To Stay A Step Ahead Of Peripheral Artery Disease
Why it might be ok that things are like this
When factoring in surgeon preference for MAG or SAG as an instrumental variable, no significant difference in long-term survival was observed. This may explain inconsistencies with randomized controlled trials like the Arterial Revascularization Trial (ART), which also found no survival benefit of MAG over SAG.
Also, MAG recipients were generally younger, healthier, and from more resourceful areas, which likely had a further impact on MAG-giving decisions, and/but at the same time, may also have increased survival chances for reasons other than that they got MAG rather than SAG.
Here’s a pop-science article that goes into more detail about this:
Surgeon preferences may explain differences in CABG survival rates
How to look out for yourself, and advocate for yourself
…or your loved one, of course. Now, having a coronary artery bypass surgery of any kind is not a fun activity; it will be dangerous, it’ll be stressful before and after, and the recovery will often not be an easy time either. However, it is possible to learn more about what is going on / what will happen, ask the right questions, and get the best options for you (which may not always be the same as the best options for someone else).
We wrote about that in more detail here:
Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Take care!
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Maximize Your Misery! (7 Great Methods)
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Let’s imagine that instead of being healthily fulfilled in life, you wanted to spend your days as miserable as possible. What should you do?
Here are a few pointers:
Stay still
Avoid physical activity and/or outdoor exposure, to avoid any mood-lifting neurochemicals. In fact, remain indoors as much as possible, preferably in the same room.
If you want to absolutely maximize your misery, make your bedroom the sole space for all activities that it’s possible to do there.
Disrupt your sleep
Keep an irregular sleep schedule by varying your bedtime and wake-up times frequently. Sleep in as much as possible, and make up for it by staying up late to ensure ongoing exhaustion.
Maximize screentime
Use digital entertainment as much as possible to distract you from meaningful activities and rest—as a bonus, this will also help you to avoid self-reflection.
Begin and end your day with a device in hand.
Fuel negative emotions
If you’re going to focus on something, focus on problems you cannot control, to stoke the fires of anger and angst.
A good way of doing this is by staying informed about distressing events, while avoiding meaningful actions to address them. Contribute only in token gestures, and then lament the lack of change.
Follow your impulses
Act on short-term desires without considering long-term consequences, while avoiding behaviors that you know might improve your mood or wellbeing.
Trust that doing the same things that have not previously resulted in happiness, will continue to reliably deliver unhappiness.
Set goals to miss
It’s important that your goals should be vague, and overly ambitious in their scope and/or deliverability. Ideally you should also disregard any preparatory work that a person would normally do before embarking on such a project.
Bonus tip: you can further sabotage any chances of progress, by waiting for motivation to strike before you take any action.
Pursue happiness
Focus on chasing happiness itself, instead of improving your situation or skills. Treat happiness as an end goal, instead of a by-product of worthwhile activities.
Want to learn more?
If you’d like to know many more ways to be miserable, we featured these 7 from this book of 40, which we haven’t reviewed yet, but probably will one of these days:
How to Be Miserable: 40 Strategies You Already Use – by Dr. Randy Paterson
Alternatively…
If for some strange reason you’d rather not do those things, you might consider a previous article of ours:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Enjoy!
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Oranges vs Lemons – Which is Healthier?
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Our Verdict
When comparing oranges to lemons, we picked the oranges.
Why?
In the battle of these popular citrus fruits, there is a clear winner on the nutritional front.
Things were initially promising for lemons when looking at the macros—lemons have a little more fiber while oranges are slightly higher in carbs, but the differences are small and both are very healthy in this regard.
However, alas for this writer who prefers sour fruits to sweet ones (I’m sweet enough already), the micronutrient profiles tell a different story:
In terms of vitamins, oranges have more of vitamins A, B1, B2, B3, B5, B9, E, and choline. In contrast, lemons have a (very) little more vitamin B6. You might be wondering about vitamin C, since both fruits are famous for that—they’re equal on vitamin C. But, with that stack we listed above, oranges clearly win the vitamin category easily.
As for minerals, oranges boast more calcium, copper, magnesium, potassium, selenium, and zinc, while lemons have more iron, manganese, and phosphorus.
Technically lemons also have more sodium, but the numbers are truly miniscule (by coincidence, we discover upon grabbing a calculator, you’d need to eat approximately your own bodyweight in whole lemons to get to the RDA of sodium—and that’s to reach the RDA, not the upper healthy limit) so we’ll overlook the tiny sodium difference as irrelevant. Which means, while closer than the vitamins category, oranges win on minerals with a 6:3 lead over lemons.
Both fruits offer generous helpings of flavonoids and other polyphenols such as naringenin and hesperidin, which have anti-inflammatory properties and more specifically can also reduce allergy symptoms (unless, of course, you are allergic to citrus fruits, which is a relatively rare but extant allergy).
In short: as ever, enjoy both; diversity is great for the health. But if you want to maximize the nutrients you get, it’s oranges.
Want to learn more?
You might like to read:
Lemons vs Limes – Which is Healthier?
Take care!
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How Does Someone Die From Dementia?
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Dementia is most often thought of in terms of the loss of certain cognitive faculties during the disease’s progress. So how does death occur?
A quiet departure
Notwithstanding it being a widely-feared disease (or set of diseases, since we’re using the umbrella term of dementia, and not the most well-known and common kind, Alzheimer’s), death from dementia is usually a peaceful one; any distressing confusions are usually in the past by this point.
Sometimes, it is not the dementia itself that directly causes death; rather, it leaves someone much more vulnerable to infections, with pneumonia being top of the list, and UTIs also ranking highly. And while a younger healthier person might drink some cranberry juice and shrug it off, for an older person with dementia, even a UTI can be much more serious. Pneumonia, of course, is well-known for often being the final straw.
Sometimes, it is the dementia that directly causes death; the disease causes a slow decline until the person stops eating and drinking. At this time, they will also tend to sleep more, and as mentioned, experience much less agitation and confusion than previously.
In terms of caregiving at this late stage, the hospice worker in the video recommends to do one’s best to keep the person clean and safe from falls or infections, check common pressure sore sites for redness, changing their position if necessary and using pillows to relieve any undue pressure.
For more on all of this, see:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
When Planning Is A Matter of Life & Death: Managing Your Mortality
Take care!
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Curing Hiccups And Headaches At Home With Actual Science
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Quick fixes for bodily annoyances
Do you ever find yourself desperately trying to cure hiccups, and advice on the Internet is like “breathe in through your ears while drinking vinegar upside-down through your nose”?
If so, you’re not alone. So, today we’re going to look at some science-based approaches to dealing with common bodily annoyances.
Hiccups
Unfortunately, most popular advices simply don’t work, and the only near-guaranteed way to cure these is with anti-convulsive medications whose side-effects may be worse than the hiccups.
However, before you head to the pharmacy, there is one breathing exercise that has a very simple scientific underpinning: 4:4 breathing. If you’re unfamiliar, it’s just:
- Breathe slowly in through your nose to a count of four
- Hold your breath for a count of four
- Breathe slowly out through your nose to a count of four
- Hold your breath for a count of four
…and repeat. The slower the better. At first, your hiccups will interrupt this, but just “keep calm and carry on”.
The reason this can work is that breathing is an autonomic function (e.g., it happens without us thinking about it) that, unlike most other autonomic functions, we can all control directly. By taking control of one, others will tend to fall into line with it.
For example, it is normal that your heart rate will tend to slow or quicken as your breathing slows or quickens, respectively.
Your hiccups? Autonomic function. Actually a very, very old evolutionary left-over trait, that’s only useful for protecting lungs while breathing underwater. In other words, it’s the bodily function thinks you’re a fish (or a tadpole-like amphibious creature) in the process of developing lungs. Unfortunately, because hiccuping doesn’t harm our chances of passing on our genes, it never got naturally de-selected so we still have it.
Anyway, the bottom line is: take control of your breathing in the aspects you can directly control, and the aspects you can’t directly control will fall into line. You may need to give it some minutes, don’t give up too quickly.
Headaches
If you ever get a headache and you don’t have painkillers or perhaps they’re not helping or you have another reason for not wanting to take them, there’s “one quick trick” that can cure most headaches in seconds.
First, the limitation: this will only cure headaches that have been caused by increased localized blood pressure in the forehead. However, that’s more than half of most common headaches.
Next, how it works…
We’re mentioning this first, because understanding how it works will give you more confidence in using it.
Your body has a wonderful homeostatic system, which is the system by which your body maintains its “Goldilocks zones” of not too hot or cold, not to acidine or alkaline, not too hydrated or dehydrated, blood pressure not too high or too low, etc. Sometimes, however, it can get confused, and needs a nudge back to where it should be.
One of the ways it maintains blood pressure is biofeedback from receptors in blood vessel walls, called baroreceptors. They are what it sounds like; they measure blood pressure internally.
In certain places, there are clusters of baroreceptors in one place. And if we press on that one place, the body will think “Oh no! Super high blood pressure in this bit!” and reduce the blood pressure immediately.
This is called the baroreflex, and that’s what you need to cure a hypertensive headache.
So, what to do:
With your thumb, carefully feel the upper inside corner of your eye socket. So, at the top, and about ¼ of the way out from the bridge of your nose. You should feel a groove. No, not like the Emperor’s New, but, an actual groove in your eye socket. That’s the supraorbital notch (or foramen), and it allows the supraorbital artery, veins, and nerve to run through.
Press it firmly (you can do both sides at once, assuming you have two thumbs) for about three seconds, and then massage it gently. Repeat as necessary, but it shouldn’t take more than about three goes to have cured the headache.
As a bonus, this is a great party trick for curing other people’s headaches, when the need arises!
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Policosanol: A Rival To Statins, Without The Side Effects?
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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:
2001: it works!
After a lot of research in the 1990s, it came out of the gate strong in 2001, with:
❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞
This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.
Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women
Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:
2006–2010: we do not trust the Cubans!
After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):
Heart Beat: Policosanol: A sweet nothing for high cholesterol
And furthermore, US-based labs were unable to replicate the results:
Policosanols as Nutraceuticals: Fact or Fiction
The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.
Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.
Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.
2012: never mind, it does work after all!
An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:
❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞
Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.
Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol
2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba
A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:
- Consumption of Cuban Policosanol Improves Blood Pressure and Lipid Profile via Enhancement of HDL Functionality in Healthy Women Subjects: Randomized, Double-Blinded, and Placebo-Controlled Study
- Long-Term Consumption of Cuban Policosanol Lowers Central and Brachial Blood Pressure and Improves Lipid Profile With Enhancement of Lipoprotein Properties in Healthy Korean Participants
Mystery resolved!
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.
Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎
Enjoy!
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