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:

How To Manage Chronic Stress

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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  • Why do I keep getting urinary tract infections? And why are chronic UTIs so hard to treat?

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    Dealing with chronic urinary tract infections (UTIs) means facing more than the occasional discomfort. It’s like being on a never ending battlefield against an unseen adversary, making simple daily activities a trial.

    UTIs happen when bacteria sneak into the urinary system, causing pain and frequent trips to the bathroom.

    Chronic UTIs take this to the next level, coming back repeatedly or never fully going away despite treatment. Chronic UTIs are typically diagnosed when a person experiences two or more infections within six months or three or more within a year.

    They can happen to anyone, but some are more prone due to their body’s makeup or habits. Women are more likely to get UTIs than men, due to their shorter urethra and hormonal changes during menopause that can decrease the protective lining of the urinary tract. Sexually active people are also at greater risk, as bacteria can be transferred around the area.

    Up to 60% of women will have at least one UTI in their lifetime. While effective treatments exist, about 25% of women face recurrent infections within six months. Around 20–30% of UTIs don’t respond to standard antibiotic. The challenge of chronic UTIs lies in bacteria’s ability to shield themselves against treatments.

    Why are chronic UTIs so hard to treat?

    Once thought of as straightforward infections cured by antibiotics, we now know chronic UTIs are complex. The cunning nature of the bacteria responsible for the condition allows them to hide in bladder walls, out of antibiotics’ reach.

    The bacteria form biofilms, a kind of protective barrier that makes them nearly impervious to standard antibiotic treatments.

    This ability to evade treatment has led to a troubling increase in antibiotic resistance, a global health concern that renders some of the conventional treatments ineffective.

    Underpants hanging on a clothesline
    Some antibiotics no longer work against UTIs.
    Michael Ebardt/Shutterstock

    Antibiotics need to be advanced to keep up with evolving bacteria, in a similar way to the flu vaccine, which is updated annually to combat the latest strains of the flu virus. If we used the same flu vaccine year after year, its effectiveness would wane, just as overused antibiotics lose their power against bacteria that have adapted.

    But fighting bacteria that resist antibiotics is much tougher than updating the flu vaccine. Bacteria change in ways that are harder to predict, making it more challenging to create new, effective antibiotics. It’s like a never-ending game where the bacteria are always one step ahead.

    Treating chronic UTIs still relies heavily on antibiotics, but doctors are getting crafty, changing up medications or prescribing low doses over a longer time to outwit the bacteria.

    Doctors are also placing a greater emphasis on thorough diagnostics to accurately identify chronic UTIs from the outset. By asking detailed questions about the duration and frequency of symptoms, health-care providers can better distinguish between isolated UTI episodes and chronic conditions.

    The approach to initial treatment can significantly influence the likelihood of a UTI becoming chronic. Early, targeted therapy, based on the specific bacteria causing the infection and its antibiotic sensitivity, may reduce the risk of recurrence.

    For post-menopausal women, estrogen therapy has shown promise in reducing the risk of recurrent UTIs. After menopause, the decrease in estrogen levels can lead to changes in the urinary tract that makes it more susceptible to infections. This treatment restores the balance of the vaginal and urinary tract environments, making it less likely for UTIs to occur.

    Lifestyle changes, such as drinking more water and practising good hygiene like washing hands with soap after going to the toilet and the recommended front-to-back wiping for women, also play a big role.

    Some swear by cranberry juice or supplements, though researchers are still figuring out how effective these remedies truly are.

    What treatments might we see in the future?

    Scientists are currently working on new treatments for chronic UTIs. One promising avenue is the development of vaccines aimed at preventing UTIs altogether, much like flu shots prepare our immune system to fend off the flu.

    Gynaecologist talks to patient
    Emerging treatments could help clear chronic UTIs.
    guys_who_shoot/Shutterstock

    Another new method being looked at is called phage therapy. It uses special viruses called bacteriophages that go after and kill only the bad bacteria causing UTIs, while leaving the good bacteria in our body alone. This way, it doesn’t make the bacteria resistant to treatment, which is a big plus.

    Researchers are also exploring the potential of probiotics. Probiotics introduce beneficial bacteria into the urinary tract to out-compete harmful pathogens. These good bacteria work by occupying space and resources in the urinary tract, making it harder for harmful pathogens to establish themselves.

    Probiotics can also produce substances that inhibit the growth of harmful bacteria and enhance the body’s immune response.

    Chronic UTIs represent a stubborn challenge, but with a mix of current treatments and promising research, we’re getting closer to a day when chronic UTIs are a thing of the past.The Conversation

    Iris Lim, Assistant Professor, Bond University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Remember – by Dr. Lisa Genova

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Memory is often viewed as one thing—either you have a good memory, or you don’t. At best, a lot of people have a vague idea of selective memory. But, the reality is much more complex—and much more interesting.

    Dr. Genova lays out clearly and simply the various different kinds of memory, how they work, and how they fail. Some of these kinds of memory operate on completely different principles than others, and/or in different parts of the brain. And, it’s not just “a memory for faces” or a “memory for names”, nor even “short term vs long term”. There’s working memory, explicit and implicit memory, semantic memory, episodic memory, muscle memory, and more.

    However, this is not just an interesting book—it’s also a useful one. Dr. Genova also looks at how we can guard against failing memory in later years, and how we can expand and grow the kinds of memory that are most important to us.

    The style of the book is very conversational, and not at all textbook-like. It’s certainly very accessible, and pleasant to read too.

    Bottom line: memory is a weird and wonderful thing, and this book shines a clear light on many aspects of it—including how to improve the various different kinds of memory.

    Click here to check out Remember (we recommend to do it now before you forget!

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  • Make Your Vegetables Work Better Nutritionally

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Most people know that boiling vegetables to death is generally not best for them, but raw isn’t always best either, and if we want to not sabotage our food, then there’s more to bear in mind than “just steam them, then”.

    So, what should we keep in mind?

    Water solubility

    Many nutrients are water-soluble, including vitamin C, vitamin B-complex (as in, the collection of B-vitamins), and flavonoids, as well as many other polyphenols.

    This means that if you cook your vegetables (which includes beans, lentils, etc) in water, a lot of the nutrients will go into the water, and be lost if you then drain that.

    There are, thus, options;

    • Steaming, yes
    • Use just enough water to slow-cook or pressure-cook things that are suitable for slow-cooking, or pressure-cooking such as those beans and lentils. That way, when it’s done, there’s no excess water to drain, and all the nutrients are still in situ.
    • Use as much water as you like, but then keep the excess water to make a soup, sauce, or broth.
    • Use a cooking method other than water, where appropriate. For example, roasting peppers is a much better idea than roasting dried pulses.
    • Consume raw, where appropriate.

    Fat solubility

    Many nutrients are fat-soluble, including vitamins A, D, E, and K, as well as a lot of carotenoids (including heavy-hitters lycopene and β-carotene) and many other polyphenols.

    We’re now going to offer almost the opposite advice to that we had about water solubility. This is because unless they are dried, vegetables already contain water, whereas many contain only trace amounts of fat. Consequently, the advice this time is to add fat.

    There are options:

    • Cook with a modest amount of your favorite healthy cooking oil (our general go-to is extra-virgin olive oil, but avocado oil is great especially for higher temperature cooking, and an argument can be made for coconut oil sometimes)
    • Remember that this goes for roasting, too. Brush those vegetables with a touch of olive oil, and not only will they be delicious, they’ll be more nutritious, too.
    • Drizzle some the the above, if you’re serving things raw and it’s appropriate. This goes also for things like salads, so dress them!
    • Enjoy your vegetables alongside healthy fatty foods such as nuts and seeds (or fatty animal products, if you eat those; fatty fish is a fine option here, in moderation, as are eggs, or fermented dairy products).

    For a deeper understanding: Can Saturated Fats Be Healthy?

    Do not, however, deep-fry your foods unless it’s really necessary and then only for an occasional indulgence that you simply accept will be unhealthy. Not only is deep-frying terrible for the health in a host of ways (ranging from an excess of oil in the resultant food, to acrylamide, to creating Advanced Glycation End-products*), but also those fat-soluble nutrients? Guess where they’ll go. And unlike with the excess vegetable-cooking water that you can turn into soup or whatever, we obviously can’t recommend doing that with deep-fryer oil.

    *see also: Are You Eating AGEs?

    Temperature sensitivity

    Many nutrients are sensitive to temperature, including vitamin C (breaks down when exposed to high temperatures) and carotenoids (are released when exposed to higher temperatures). Another special case is ergothioneine, “the longevity vitamin” that’s not a vitamin, found in mushrooms, which is also much more bioavailable when cooked.

    So, if you’re eating something for vitamin C, then raw is best if that’s a reasonable option.

    And if it’s not a reasonable option? Well, then you can either a) just cope with the fact it’s going to have less vitamin C in it, or b) cook it as gently and briefly as reasonably possible.

    On the other hand, if you’re eating something for carotenoids (especially including lycopene and β-carotene), or ergothioneine, then cooked is best.

    Additionally, if your food is high in oxalates (such as spinach), and you don’t want it to be (for example because you have kidney problems, which oxalates can exacerbate, or would like to get more calcium out of the spinach and into your body, which which oxalic acid would inhibit), then cooked is best, as it breaks down the oxalates.

    Same goes for phytates, another “anti-nutrient” found in some whole grains (such as rice and wheat); cooking breaks it down, therefore cooked is best.

    This latter is not, however, applicable in the case of brown rice protein powder, for those who enjoy that—because phytates aren’t found in the part of the rice that’s extracted to make that.

    And as for brown rice itself? Does contain phytates… Which can be reduced by soaking and heating, preferably both, to the point that the nutritional value is better than it would have been had there not been phytic acid present in the first place; in other words: cooked is best.

    You may be wondering: “who is eating rice raw?” and the answer is: people using rice flour.

    See: Brown Rice Protein: Strengths & Weaknesses

    Want to know more?

    Here’s a great rundown from Dr. Rosalind Gibson, Dr. Leah Perlas, and Dr. Christine Hotz:

    Improving the bioavailability of nutrients in plant foods at the household level

    Enjoy!

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  • Yes, you do need to clean your tongue. Here’s how and why

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health.

    The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity.

    But there’s no need to wait for a trip to the doctor. Cleaning your tongue twice a day can help you check how your tongue looks and feels – and improve your breath.

    luisrsphoto/Shutterstock

    What does a healthy tongue look like?

    Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move.

    The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface.

    These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0

    A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light pink.

    A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or other issues.

    How should I clean my tongue?

    Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine.

    A toothbrush and a silver tongue scraper on an orange background.
    Build-up can occur if you stop brushing or scraping your tongue even for a few days. Anthony Shkraba/Pexels

    You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface.

    Or you can use a special tongue scraper. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush.

    Your co-workers will thank you as well – cleaning your tongue can help combat stinky breath. Tongue scrapers are particularly effective at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface.

    What’s that stuff on my tongue?

    So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP.

    Here’s what your tongue might be telling you.

    White coating

    Developing a white coating on the tongue’s surface is one of the most common changes in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days.

    In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause serious illnesses.

    Two young men laughing while they brush their teeth.
    Scrubbing or scraping your tongue only takes around ten seconds and can be done while brushing your teeth. Ketut Subiyanto/Pexels

    Yellow coating

    This may indicate oral thrush, a fungal infection that leaves a raw surface when scrubbed.

    Oral thrush is common in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary suppression of the immune system or antibiotic use.

    If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month.

    Black coating

    Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a black hairy tongue. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene.

    Smoke wafting from a cigarette in a woman's hand.
    Smoking can add to poor oral hygiene and make the tongue look black. Sophon Nawit/Shutterstock

    Pink patches

    Pink patches surrounded by a white border can make your tongue look like a map – this is called “geographic tongue”. It’s not known what causes this condition, which usually doesn’t require treatment.

    Pain and inflammation

    A red, sore tongue can indicate a range of issues, including:

    Dryness

    Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt.

    What about cancer?

    White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a higher risk of turning into cancer, compared to other parts of the mouth.

    Oral cancers have low survival rates due to delayed detection – and they are on the rise. So checking your tongue for changes in colour, texture, sore spots or ulcers is critical.

    Dileep Sharma, Professor and Head of Discipline – Oral Health, University of Newcastle

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Life Is in the Transitions – by Bruce Feiler

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    Change happens. Sometimes, because we choose it. More often, we don’t get a choice.

    Our bodies change; with time, with illness, with accident or incident, or even, sometimes, with effort. People in our lives change; they come, they go, they get sick, they die. Our working lives change; we get a job, we lose a job, we change jobs, our jobs change, we retire.

    Whether we’re undergoing cancer treatment or a religious conversion, whether our families are growing or down to the last few standing, change is inescapable.

    Our author makes the case that on average, we each undergo at least 5 major “lifequakes”; changes that shake our lives to the core. Sometimes one will come along when we’ve barely got back on our feet from the previous—if we have at all.

    What, then, to do about this? We can’t stop change from occurring, and some changes aren’t easy to “roll with”. Feiler isn’t prescriptive about this, but rather, descriptive:

    By looking at the stories of hundreds of people he interviewed for this book, he looks at how people pivoted on the spot (or picked up the pieces!) and made the best of their situation—or didn’t.

    Bottom line: zooming out like this, looking at many people’s lives, can remind us that while we don’t get to choose what winds we get swept by, we at least get to choose how we set the sails. The examples of others, as this book gives, can help us make better decisions.

    Click here to check out Life Is In The Transitions, and get conscious about how you handle yours!

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  • Diet Tips for Crohn’s Disease

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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

    ❝Doctors are great at saving lives like mine. I’m a two time survivor of colon cancer and have recently been diagnosed with Chron’s disease at 62. No one is the health system can or is prepared to tell me an appropriate diet to follow or what to avoid. Can you?❞

    Congratulations on the survivorship!

    As to Crohn’s, that’s indeed quite a pain, isn’t it? In some ways, a good diet for Crohn’s is the same as a good diet for most other people, with one major exception: fiber

    …and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.

    What stays the same:

    • You still ideally want to eat a lot of plants
    • You definitely want to avoid meat and dairy in general
    • Eating fish is still usually* fine, same with eggs
    • Get plenty of water

    What needs to change:

    • Consider swapping grains for potatoes or pasta (at least: avoid grains)
    • Peel vegetables that are peelable; discard the peel or use it to make stock
    • Consider steaming fruit and veg for easier digestion
    • Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)

    Much of this latter list is opposite to the advice for people without Crohn’s Disease.

    *A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.

    But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.

    We hope the above pointers at least help you get going on the right foot, though!

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