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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Radical Longevity – by Dr. Ann Gittleman
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Dr. Gittleman takes a comprehensive approach, advising us about avoiding AGEs, freeing up fascia, stimulating cellular rejuvenation, the mind-gut connection, keeping the immune system healthy, and more.
The “plan” promised by the subtitle involves identifying the key factors of nutrition and lifestyle most impactful to you, and adjusting them accordingly, in a multistep, author-walks-the-reader-by-the-hand process.
There’s also, for those who prefer it, a large section (seven chapters) on a body part/system by body part/system approach, e.g. brain health, heart health, revitalizing skin, reversing hair loss, repairing bones, muscles, joints, etc.
The writing style is quite casual,butalso with a mind to education, with its call-out boxes, bullet-point summaries, and so forth. There is a “select references” section, but if one wants to find studies, it’s often necessary to go looking, as there aren’t inline citations.
Bottom line: we’d love to see better referencing, but otherwise this is a top-tier anti-aging book, and a lot more accessible than most, without skimping on depth and breadth.
Click here to check out Radical Longevity, and get rejuvenating radically!
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5 Surprising Benefits Of Exercise After 50 (More Than Just Fitness)
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It’s easy to want to do less as we get older, but the benefits of continuing to actively exercise, pushing oneself even just a little, can be far-reaching.
Direct and indirect benefits
As well as the obvious fitness benefits, keeping up good levels of exercise can also offer:
Healthy Skin
Exercise improves circulation, bringing growth factors (thus: regeneration, because it’s replacing cells), oxygen, and nutrients to the skin. Accordingly, it can lead to healthier, more youthful-looking skin as a low-cost alternative to a lot of skincare products. That said, it also encourages good skin habits, like daily sunscreen use.
Bone Health
Weight-bearing and resistance exercises (which between them, encompasses most forms of exercise) improve bone density. This is because physical stress signals bones to strengthen, reducing the risk of fractures. This includes activities like walking, hiking, and using resistance bands or weights. Note however that it is on a “per bone” basis. So for example, hiking will improve your lower body and spine, but do nothing for your arms. On the other hand, doing a daily groceries trip on foot, if local geography makes that practicable, can do the whole body, if one is then carrying groceries home (this writer lives about 2 miles from where she buys groceries, and does this pretty much daily).
Mental Health
Exercise, especially outdoors, has well-established positive effects on mental well-being, and can relieve stress and improve mood. As a bonus, community engagement and shared experiences can enhance mental health benefits for many people—but if you prefer it as peaceful time for yourself, that’s beneficial in its own way too!
Better Sleep
Physical activity helps promote better sleep quality, which is important for so many aspects of health—because fatiguing the body through exercise can lead to a more restful night, which is often harder to achieve with age.
Visibility and Confidence
Staying active and taking on challenges (e.g. training for some event) can boost visibility in social and family settings, countering “invisibility” often felt from midlife onwards. And even if one doesn’t do those things, exercise fosters confidence and helps people carry themselves with more self-assurance, which has a lot of knock-on benefits too.
For more on all of these things, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Are There Any Sensible Age Limits To Exercise?
Take care!
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Avoiding Razor Burn, Ingrown Hairs & Other Shaving Irritation
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How Does The Video Help?
Dr. Simi Adedeji’s incredibly friendly persona makes this video (below) on avoiding skin irritation, ingrown hairs, and razor burn after shaving a pleasure to watch.
To keep things simple, she breaks down her guide into 10 simple tips.
What Are The 10 Simple Tips?
Tip 1: Prioritize Hydration. Shaving dry hair can lead to increased skin irritation, so Dr. Simi recommends moistening the hair by showering or using a warm, wet towel for 2-4 minutes before getting the razor out.
Tip 2: Avoid Dry Shaving. Dry shaving not only removes hair but can also remove the protective upper layer of skin, which contributes to razor burn. To prevent this, simply use some shaving gel or cream.
Tip 3: Keep Blades New and Sharp. This one’s simple: dull blades can cause skin irritation, whilst a sharp blade ensures a smoother and more comfortable shaving experience.
Tip 4: Avoid Shaving the Same Area Repeatedly. Multiple passes over the same area can remove skin layers, leading to cuts and irritation. Aim to shave each area only once for safer results.
Tip 5: Consider Hair Growth Direction. Shaving in the direction of hair growth results in less irritation, although it may not provide the closest shave.
Tip 6: Apply Gentle Pressure While Shaving. Excessive pressure can lead to cuts and nicks. Use a gentle touch to reduce these risks.
Tip 7: Incorporate Exfoliation into Your Routine. Exfoliating helps release trapped hairs and reduces the risk of ingrown hairs. For those with sensitive skin, it’s recommended to exfoliate either two days before or after shaving.
Tip 8: Avoid Excessive Skin Stretching. Over-stretching the skin during shaving can cause hairs to become ingrown.
Tip 9: Moisturize After Shaving. Shaving can compromise the skin barrier, leading to dryness. Using a moisturizer can be a simple fix.
Tip 10: Regularly Rinse Your Blade. Make sure that, during the shaving process, you are rinsing your blade frequently to remove hair and skin debris. This keeps it sharp during your shave.
If this summary doesn’t do it for you, then you can watch the full video here:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Stretching for 50+ – by Dr. Karl Knopf
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Dr. Knopf explores in this book the two-way relationship between aging and stretching (i.e., each can have a large impact on the other). Thinking about stretching in those terms is an important reframe for going into any stretching program. We’d say “after the age of 50”, but honestly, at any age. But this book is written with over-50s in mind, as the title goes.
There’s an extensive encyclopedic section on stretches per body part, which is exactly as you might expect from any book of this kind. There is also a flexibility self-assessment, so that progress can be measured easily, and so that the reader knows where might need more improvement.
Perhaps this book’s greatest strength is the section on specialized programs based on things ranging from working to improve symptoms of any chronic conditions you may have (or at least working around them, if outright improvement is not possible by stretching), to your recreational activities of importance to you—so, what kinds of flexibilities will be important to you, and also, what kinds of injury you are most likely to need to avoid.
Bottom line: if you’re 50 and would like to do more stretching and less aging, then this book can help with that.
Click here to check out Stretching for 50+, and extend your healthspan!
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What you need to know about the new weight loss drug Zepbound
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In a recent poll, KFF found that nearly half of U.S. adults were interested in taking a weight management drug like the increasingly popular Ozempic, Wegovy, and Mounjaro.
“I can understand why there would be widespread interest in these medications,” says Dr. Alyssa Lampe Dominguez, an endocrinologist and clinical assistant professor at the University of Southern California. “Obesity is a chronic disease that is very difficult to treat. And a lot of the medications that we previously used weren’t as effective.”
Now, there’s a new option available: In November 2023, the FDA approved Zepbound, another weight management medication, developed by the pharmaceutical company Eli Lilly. Zepbound is different from other drugs in many ways, including the fact that it’s proven to be the most effective option so far.
Keep reading to find out more about Zepbound, including who can take it, its side effects, and more.
What is Zepbound?
Zepbound, one of the brand names for tirzepatide, is an injectable drug with a maximum dosage of 15 mg per week. It’s based on incretin, a hormone that’s naturally released in the gut after a meal. (Mounjaro is another brand name for tirzepatide.)
Tirzepatide is considered a dual agonist because it activates the two primary incretin hormones: the glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP) hormones.
According to Dr. Katherine H. Saunders, an obesity medicine physician at Weill Cornell Medicine and co-founder of Intellihealth, tirzepatide is involved with several processes that regulate blood sugar, slow the removal of food from the stomach, and affect brain areas involved in appetite.
This means that people taking the medication feel less hungry and get fuller faster, leading to less food intake and, ultimately, weight loss.
How is Zepbound different from Ozempic?
The medications are different in many ways. Ozempic and Wegovy, which are both brand names for semaglutide, only target the GLP-1 hormone. Studies have shown that Zepbound can lead to a higher percentage of total body weight loss than semaglutide medications. In addition to being more effective, there is some evidence that Zepbound is overall more tolerable than Ozempic or Wegovy.
“I have seen overall lower rates in severity of side effects with the tirzepatide medications. Mounjaro [tirzepatide] in particular is the one that I’ve used up until this point, but there’s a thought that the GIP component of the medication actually decreases nausea,” adds Lampe Dominguez. “Anecdotally, patients that I have switched from semaglutide or Ozempic to Mounjaro say that they have less side effects with Mounjaro.”
How is Zepbound different from Mounjaro?
Zepbound and Mounjaro are the same medication—tirzepatide—but they’re approved for different conditions. Zepbound is FDA-approved for weight loss, while Mounjaro is approved for type 2 diabetes. (However, Mounjaro is also at times prescribed off-label for weight loss.)
What are some of Zepbound’s side effects?
According to the FDA, side effects include nausea, vomiting, diarrhea, constipation, stomach discomfort and pain, fatigue, and burping. See a more comprehensive list of side effects here.
Who can take Zepbound?
Zepbound is FDA-approved for adults with obesity (a BMI of 30 or greater) or who have a BMI of 27 or greater with at least one weight-related condition, like high blood pressure, type 2 diabetes, or high cholesterol.
“I tend to advise patients who don’t meet those criteria to not take these medications because we really don’t know what the risks are,” says Lampe Dominguez, adding that people with lower BMI weren’t included in the medication’s studies. “We don’t know if there are specific risks to using this medication at a lower body mass index [or] if there might be some negative outcomes.”
Both doctors agree that it’s important for people who are interested in starting any weight loss medication to talk to their doctors about the potential risks and benefits. For instance, the FDA notes that Zepbound has caused thyroid tumors in rats, and while it’s unknown if this could also happen to humans, the agency said the medication shouldn’t be used in patients with a personal or family history of medullary thyroid cancer.
“Zepbound is a powerful medication that can lead to severe side effects, vitamin deficiencies, a complete lack of appetite, or too much weight loss if prescribed without the appropriate personalization, education, and close monitoring,” says Saunders.
“With all of these medications, and particularly with Zepbound, we would want to make sure that [patients] don’t have a family history of a specific type of thyroid cancer called medullary thyroid cancer,” says Lampe Dominguez.
How long should people take Zepbound for?
“Anti-obesity medications like Zepbound are not meant for short-term weight loss, but long-term treatment of obesity, which is a chronic disease,” explains Saunders. “We prepare our patients to be on the medication (or some type of medical obesity treatment) long term for their chronic disease, which is only controlled for the duration of time they’re being treated.”
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Voluntary assisted dying is different to suicide. But federal laws conflate them and restrict access to telehealth
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Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.
However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.
A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?
What’s wrong with the current laws?
Voluntary assisted dying doesn’t meet the definition of suicide under state laws.
But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.
This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.
Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.
This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.
In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.
Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.
Not all patients can physically see a doctor
Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.
Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.
The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.
Some people aren’t able to attend doctors’ appointments in person.
Jeffrey M Levine/ShutterstockDoctors don’t want to be involved in ‘suicide’
Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.
Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.
The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.
It misclassifies deaths
In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.
In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.
In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.
The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.
There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.
So what is the solution?
The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.
Chaney’s private member’s bill is yet to be debated in federal parliament.
If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.
A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.
Failure to change this will cause unnecessary suffering for patients and doctors alike.
Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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