The S.T.E.P.S. To A Healthier Heart
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Stepping Into Better Heart Health
This is Dr. Jennifer H. Mieres, FACC, FAHA, MASNC. she’s an award-winning (we counted 9 major awards) professor of cardiology, and a leading advocate for women’s heart health. This latter she’s done via >70 scientific publications, >100 research presentations at national and international conferences, 3 books so far, and 4 documentaries, including the Emmy-nominated “A Woman’s Heart”.
What does she want us to know?
A lot of her work is a top-down approach, working to revolutionize the field of cardiology in its application, to result in far fewer deaths annually. Which is fascinating, but unless you’re well-placed in that industry, not something too actionable as an individual (if you are well-placed in that industry, do look her up, of course).
For the rest of us…
Dr. Mieres’ S.T.E.P.S. to good heart health
She wants us to do the following things:
1) Stock your kitchen with heart health in mind
This is tied to the third item in the list of course, but it’s a critical step not to be overlooked. It’s all very well to know “eat more fiber; eat less red meat” and so forth, but if you go to your kitchen and what’s there is not conducive to heart health, you’re just going to do the best with what’s available.
Instead, actually buy foods that are high in fiber, and preferably, foods that you like. Not a fan of beans? Don’t buy them. Love pasta? Go wholegrain. Like leafy greens in principle, but they don’t go with what you cook? Look up some recipes, and then buy them.
Love a beef steak? Well we won’t lie to you, that is not good for your heart, but make it a rare option—so to speak—and enjoy it mindfully (see also: mindful eating) once in a blue moon for a special occasion, rather than “I don’t know what to cook tonight, so sizzle sizzle I guess”.
Meal planning goes a long way for this one! And if meal-planning sounds like an overwhelming project to take on, then consider trying one of the many healthy-eating meal kit services that will deliver ingredients (and their recipes) to your door—opting for a plants-forward plan, and the rest should fall into place.
2) Take control of your activity
Choose to move! Rather than focusing on what you can’t do (let’s say, those 5am runs, or your regularly-scheduled, irregularly attended, gym sessions), focus on what you can do, and do it.
See also: No-Exercise Exercise!
3) Eat for a healthier heart
This means following through on what you did on the first step, and keeping it that way. Buying fresh fruit and veg is great, but you also have to actually eat it. Do not let the perishables perish!
For you too, dear reader, are perishable (and would presumably like to avoid perishing).
This item in the list may seem flippant, but actually this is about habit-forming, and without it, the whole plan will grind to a halt a few days after your first heart-health-focused shopping trip.
See also: Where Nutrition Meets Habits!
4) Partner with your doctor, family, and friends
Good relationships, both professional and personal, count for a lot. Draw up a plan with your doctor; don’t just guess at when to get this or that checked—or what to do about it if the numbers aren’t to your liking.
Partnership with your doctor goes both ways, incidentally. Read up, have opinions, discuss them! Doing so will ultimately result in better care than just going in blind and coming out with a recommendation you don’t understand and just trust (but soon forget, because you didn’t understand).
And as for family and friends, this is partly about social factors—we tend to influence, and be influenced by, those around us. It can be tricky to be on a health kick if your partner wants take-out every night, so some manner of getting everyone on the same page is important, be it by compromise or, in an ideal world, gradually trending towards better health. But any such changes must come from a place of genuine understanding and volition, otherwise at best they won’t stick, and at worst they’ll actively create a pushback.
Same goes for exercise as for diet—exercising together is a good way to boost commitment, especially if it’s something fun (dance classes are a fine example that many couples enjoy, for example).
5) Sleep more, stress less, savor life
These things matter a lot! Many people focus on cutting down salt or saturated fat, and that can be good if otherwise consumed to excess, but for most people they’re not the most decisive factors:
Hypertension: Factors Far More Relevant Than Salt ← sleep features here!
Stress is also a huge one, and let’s put it this way: people more often have heart attacks during a moment of excessive emotional stress—not during a moment when they had a bit too much butter on their toast.
It’s not even just that acute stress is the trigger, it’s that chronic stress is a contributory factor that erodes the body’s ability to handle the acute stress.
Changing this may seem “easier said than done” because often the stressors are external (e.g. work pressure, financial worries, caring for a sick relative, relationship troubles, major life change, etc), but it is possible to find peace even in the chaos of life:
Want to know more from Dr. Mieres?
You might like this book of hers, which goes into each of the above items in much more depth than we have room to here:
Heart Smarter for Women: Six Weeks to a Healthier Heart – by Dr. Jennifer Mieres
Enjoy!
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The Snooze-Button Controversy
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To Snooze Or Not To Snooze? (Science Has Answers)
This is Dr. Jennifer Kanaan. She’s a medical doctor with a focus on pulmonary critical care, sleep disorders, and sleep medicine.
What does she want to tell us?
She wants us to be wary of the many news articles that have jumped on a certain recent sleep study, such as:
- Is hitting the snooze button really a bad idea? Study sheds light on the impact of morning alarms on sleep and cognition
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Is it okay to press the snooze button?
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Hitting the snooze button on your alarm doesn’t make you more tired
For the curious, here is the paper itself, by Dr. Tina Sundelin et al. It’s actually two studies, by the way, but one paper:
The authors of this study concluded:
❝There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture.
A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.❞
Notably, people tend to snooze because an alarm clock will, if not “smart” about it, wake us up mid sleep-cycle more often than not, and that will produce a short “sleep hangover”. By snoozing, we are basically re-rolling the dice on being woken up between sleep cycles, and thus feeling more refreshed.
What’s Dr. Kanaan’s counterpoint?
Dr. Kanaan says:
❝If you’re coming in and out of sleep for 30 minutes, after the alarm goes off the first time, you’re costing yourself 30 minutes of uninterrupted, quality, restorative sleep. This study doesn’t change that fact.❞
She advises that rather than snoozing, we should prioritize getting good sleep in the first place, and once we do wake up, mid sleep-cycle or not, get sunlight. That way, our brain will start promptly scrubbing melatonin and producing the appropriate wakefulness hormones instead. That means serotonin, and also a spike of cortisol.
Remember: cortisol is only bad when it’s chronically elevated. It’s fine, and even beneficial, to have a short spike of cortisol. We make it for a reason!
If you’d like to hear more from Dr. Kanaan, you might like this interview with her at the University of Connecticut:
Want the best of both worlds?
A great option to avoid getting woken in the middle of a sleep cycle, and also not needing to hit snooze, is a sunrise alarm clock. Specifics of these devices vary, but for example, the kind this writer has starts gently glowing an hour before the set alarm time,and gradually gets brighter and lighter over the course of the hour.
We don’t sell them, but here’s an example sunrise alarm clock on Amazon, for your convenience
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Ideal Blood Pressure Numbers Explained
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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
❝Maybe I missed it but the study on blood pressure did it say what the 2 numbers should read ideally?❞
We linked it at the top of the article rather than including it inline, as we were short on space (and there was a chart rather than a “these two numbers” quick answer), but we have a little more space today, so:
Category Systolic (mm Hg) Diastolic (mm Hg) Normal < 120 AND < 80 Elevated 120 – 129 AND < 80 Stage 1 – High Blood Pressure 130 – 139 OR 80 – 89 Stage 2 – High Blood Pressure 140 or higher OR 90 or higher Hypertensive Crisis Above 180 AND/OR Above 120 To oversimplify for a “these two numbers” answer, under 120/80 is generally considered good, unless it is under 90/60, in which case that becomes hypotension.
Hypotension, the blood pressure being too low, means your organs may not get enough oxygen and if they don’t, they will start shutting down.
To give you an idea how serious this, this is the closed-circuit equivalent of the hypovolemic shock that occurs when someone is bleeding out onto the floor. Technically, bleeding to death also results in low blood pressure, of course, hence the similarity.
So: just a little under 120/80 is great.
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Toothpastes & Mouthwashes: Which Help And Which Harm?
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Toothpastes and mouthwashes: which kinds help, and which kinds harm?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
For today, let’s look at toothpastes and mouthwashes, to start!
Toothpaste options
Toothpastes may contain one, some, or all of the following, so here are some notes on those:
Fluoride
Most toothpastes contain fluoride; this is generally recognized as safe though is not without its controversies. The fluoride content is the reason it’s recommended not to swallow toothpaste, though.
The fluoride in toothpaste can cause some small problems if overused; if you see unusually white patches on your teeth (your teeth are supposed to be ivory-colored, not truly white), that is probably a case of localized overcalcification because of the fluoride, and yes, you can have too much of a good thing.
Overall, the benefits are considered to far outweigh the risks, though.
Baking soda
Whether by itself or as part of a toothpaste, baking soda is a safe and effective choice, not just for cosmetic purposes, but for boosting genuine oral hygiene too:
- Enhanced plaque removal to improve gingival health: 3-month randomized clinical study of the effects of baking soda toothpaste on plaque and gingivitis
- The effects of two baking-soda toothpastes in enhancing mechanical plaque removal and improving gingival health: A 6-month randomized clinical study
- The efficacy of baking soda dentifrice in controlling plaque and gingivitis: A systematic review
Activated charcoal
Activated charcoal is great at removing many chemicals from things it touches. That includes the kind you might see on your teeth in the form of stains.
A topical aside on safety: activated charcoal is a common ingredient in a lot of black-colored Halloween-themed foods and drinks around this time of year. Beware, if you ingest these, there’s a good chance of it also cleaning out any meds you are taking. Ask your pharmacist about your own personal meds, but meds that (ingested) activated charcoal will usually remove include:
- Oral HRT / contraceptives
- Antidepressants (many kinds)
- Heart medications (at least several major kinds)
Toothpaste, assuming you are spitting-not-swallowing, won’t remove your medications though. Nor, in case you were worrying, will it strip tooth enamel, even if you have extant tooth enamel erosion:
Source: Activated charcoal toothpastes do not increase erosive tooth wear
However, it’s of no special extra help when it comes to oral hygiene itself, just removing stains.
So, if you’d like to use it for cosmetic reasons, go right ahead. If not, no need.
Hydrogen peroxide
This is generally not a good idea, speaking for the health. For whitening, yes, it works. But for health, not so much:
To be clear, when they say “alter”, they mean “in a bad way”. It increases inflammation and tissue damage.
If buying commercially-available whitening toothpaste made with hydrogen peroxide, the academic answer is that it’s a lottery, because brands’ proprietorial compounding processes vary widely and constantly with little oversight and even less transparency:
Is whitening toothpaste safe for dental health?: RDA-PE method
Mouthwash options
In the case of fluoride and hydrogen peroxide, the same advice (for and against) goes as per toothpaste.
Alcohol
There has been some concern about the potential carcinogenic effect of alcohol-based mouthwashes. According to the best current science, this one’s not an easy yes-or-no, but rather:
- If there are no other cancer risk factors, it does not seem to increase cancer risk
- If there are other cancer risk factors, it does make the risk worse
Read more:
- Does the use of alcohol mouthwash increase the risk of developing oral cancer?
- Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review
Non-Alcohol
Non-alcoholic mouthwashes are not without their concerns either. In this case, the potential problem is changing the oral microbiome (we are supposed to have one!), and specifically, that the spread of what it kills and what it doesn’t may result in an imbalance that causes a lowering of the pH of the mouth.
Put differently: it makes your saliva more acidic.
Needless to say, that can cause its own problems for teeth. The research on this is still emerging, with regard to whether the benefits outweigh the problems, but the fact that it has this effect seems to be a consensus. Here’s an example paper; there are others:
Effects of Chlorhexidine mouthwash on the oral microbiome
Flossing, scraping, and alternatives
These are important (and varied, and interesting) enough to merit their own main feature, rather than squeezing them in at the end.
So, watch this space for a main feature on these soon!
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Related Posts
How Ibogaine Can Beat Buprenorphine For Beating Addictions
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Questions?❞
It seems that this week, everyone was so satisfied with our information, that we received no questions! (If you sent one and we somehow missed it, please accept our apologies and do bring our attention to it)
However, we did receive some expert feedback that we wanted to share because it’s so informative:
❝I work at a detox rehab in Mexico, where we can use methods not legal in the United States. Therefore, while much of the linked articles had useful information, I’m in the “trenches” every day, and there’s some information I’d like to share that you may wish to share, with additional information:
- Buprenorphine is widely used and ineffective for addiction because it’s synthetic and has many adverse side effects. For heavy drug users it isn’t enough and they still hit the streets for more opioid, resulting in fentanyl deaths. Depending on length of usage and dose, it can take WEEKS to get off of, and it’s extremely difficult.
- Ibogaine is the medicine we use to detox people off opiates, alcohol, meth as well as my own specialty, bulimia. It’s psychoactive and it temporarily “resets” the brain to a pre-addictive state. Supplemented by behavior and lifestyle changes, as well as addressing the traumas that led to the addiction is extremely effective.
Our results are about 50%, meaning the client is free of the substance or behavior 1 year later. Ibogaine isn’t a “magic pill” or cure, it’s an opening tool that makes the difficult work of reclaiming one’s life easier.
Ibogaine is not something that should be done outside a medical setting. It requires an EKG to ensure the heart is healthy and doesn’t have prolonged QT intervals; also blood testing to ensure organs are functioning (especially the liver) and mineral levels such as magnetic and potassium are where they should be. It is important that this treatment be conducted by experienced doctors or practitioners, and monitoring vital signs constantly is imperative.
I’m taking time to compose this information because it needs to be shared that there is an option available most people have not heard about.❞
~ 10almonds reader (slightly edited for formatting and privacy)
Thank you for that! Definitely valuable information for people to know, and (if applicable for oneself or perhaps a loved one) ask about when it comes to local options.
We see it’s also being studied for its potential against other neurological conditions, too:
❝The combination of ibogaine and antidepressants produces a synergistic effect in reducing symptoms of psychiatric disorders such as bipolar disorder, depression, schizophrenia, paranoia, anxiety, panic disorder, mania, post-traumatic stress disorder (PTSD), and obsessive–compulsive disorder. Though ibogaine and the antidepressant act in different pathways, together they provide highly efficient therapeutic responses compared to when each of the active agents is used alone.❞
Read more: Ibogaine and Their Analogs as Therapeutics for Neurological and Psychiatric Disorders
For those who missed it, today’s information about ibogaine was in response to our article:
Let’s Get Letting Go (Of These Three Things)
…which in turn referenced our previous main feature:
Which Addiction-Quitting Methods Work Best?
Take care!
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The Four Pillar Plan – by Dr. Rangan Chatterjee
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Dr. Rangan Chatterjee, a medical doctor, felt frustrated with how many doctors in his field focus on treating the symptoms of disease, rather than the cause. Sometimes, of course, treating the symptom is necessary too! But neglecting the cause is a recipe for long-term woes.
What he does differently is take lifestyle as a foundation, and even that, he does differently than many authors on the topic. How so, you may wonder?
Rather than look first at exercise and diet, he starts with “relax”. His rationale is reasonable: diving straight in with marathon training or a whole new diet plan can be unsustainable without this as a foundation to fall back on.
Many sources look first at exercise (because it can be a very simple “prescription”) before diet (often more complex)… but how does one exercise well with the wrong fuel in the tank? So Dr. Chatterjee’s titular “Four Pillars” come in the following order:
- Relax
- Eat
- Move
- Sleep
He also goes for “move” rather than “exercise” as the focus here is more on minimizing time spent sitting, and thus involving a lot of much more frequent gentle activities… rather than intensive training programs and the like.
And as for sleep? Yes, that comes last because—no matter how important it is—the other things are easier to directly control. After all, one can improve conditions for sleep, but one cannot simply choose to sleep better! So with the other three things covered first, good sleep is the fourth and final thing to fall into place.
All in all, this is a great book to cut through the catch-22 problem of lifestyle factors negatively impacting each other.
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Track Your Blood Sugars For Better Personalized Health
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There Will Be Blood
Are you counting steps? Counting calories? Monitoring your sleep? Heart rate zones? These all have their merits:
- Steps: One More Resource Against Osteoporosis!
- Calories: Is Cutting Calories The Key To Healthy Long Life?
- Sleep: A Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
- Heart Rate Zones: Heart Rate Zones, Oxalates, & More
About calories: this writer (it’s me, hi) opines that intermittent fasting has the same benefits as caloric restriction, without the hassle of counting, and is therefore superior. I also personally find fasting psychologically more pleasant. However, our goal here is to be informative, not prescriptive, and some people may have reasons to prefer CR to IF!
Examples that come to mind include ease of adherence in the case of diabetes management, especially Type 1, or if one’s schedule (and/or one’s “medications that need to be taken with food” schedule) does not suit IF.
And now for the blood…
A rising trend in health enthusiasts presently is the use of Continuous Glucose Monitors (CGMs), which do exactly what is sounds like they do: they continually monitor glucose. Specifically, the amount of it in your blood.
Of course, these have been in use in diabetes management for years; the technology is not new, but the application of the technology is.
A good example of what benefits a non-diabetic person can gain from the use of a CGM is Jessie Inchauspé, the food scientist of “Glucose Revolution” and “The Glucose Goddess Method” fame.
By wearing a CGM, she was able to notice what things did and didn’t spike her blood sugars, and found that a lot of the things were not stuff that people knew/advised about!
For example, much of diabetes management (including avoiding diabetes in the first place) is based around paying attention to carbs and little else, but she found that it made a huge difference what she ate (or didn’t) with the carbs. By taking many notes over the course of her daily life, she was eventually able to isolate these patterns, showed her working-out in The Glucose Revolution (there’s a lot of science in that book), and distilled that information into bite-size (heh) advice such as:
10 Ways To Balance Blood Sugars
That’s great, but since people like Inchauspé have done the work, I don’t have to, right?
You indeed don’t have to! But you can still benefit from it. For example, fastidious as her work was, it’s a sample size of one. If you’re not a slim white 32-year-old French woman, there may be some factors that are different for you.
All this to say: glucose responses, much like nutrition in general, are not a one-size-fits-all affair.
With a CGM, you can start building up your own picture of what your responses to various foods are like, rather than merely what they “should” be like.
This, by the way, is also one of the main aims of personalized health company ZOE, which crowdsourced a lot of scientific data about personalized metabolic responses to standardized meals:
Not knowing these things can be dangerous
We don’t like to scaremonger here, but we do like to point out potential dangers, and in this case, blindly following standardized diet advice, if your physiology is not standard, can have harmful effects, see for example:
Diabetic-level glucose spikes seen in non-diabetic people
Where can I get a CGM?
We don’t sell them, and neither does Amazon, but you can check out some options here:
The 4 Best CGM Devices For Measuring Blood Sugar in 2024
…and if your doctor is not obliging with a prescription, note that the device that came out top in the above comparisons, will be available OTC soon:
The First OTC Continuous Glucose Monitor Will Be Available Summer 2024
Take care!
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