Heart Health vs Systemic Stress

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At The Heart Of Good Health

This is Dr. Michelle Albert. She’s a cardiologist with a decades-long impressive career, recently including a term as the president of the American Heart Association. She’s the current Admissions Dean at UCSF Medical School. She’s accumulated enough awards and honors that if we list them, this email will not fit in your inbox without getting clipped.

What does she want us to know?

First, lifestyle

Although Dr. Albert is also known for her work with statins (which found that pravastatin may have anti-inflammatory effects in addition to lipid-lowering effects, which is especially good news for women, for whom the lipid-lowering effects may be less useful than for men), she is keen to emphasize that they should not be anyone’s first port-of-call unless “first” here means “didn’t see the risk until it was too late and now LDL levels are already ≥190 mg/dL”.

Instead, she recommends taking seriously the guidelines on:

  • getting plenty of fruit, vegetables, whole grains, lean protein
  • avoiding red meat, processed meats, refined carbohydrates, and sweetened beverages
  • getting your 150 minutes per week of moderate exercise
  • avoiding alcohol, and definitely abstaining from smoking

See also: These Top Five Things Make The Biggest Difference To Health

Next, get your house in order

No, not your home gym—though sure, that too!

But rather: after the “Top Five Things” we linked just above, the sixth on the list would be “reduce stress”. Indeed, as Dr. Albert says:

❝Heart health is not just about the physical heart but also about emotional well-being. Stress management is crucial for a healthy heart❞

~ Dr. Michelle Albert

This is where a lot of people would advise mindfulness meditation, CBT, somatic therapies, and the like. And these things are useful! See for example:

No-Frills, Evidence-Based Mindfulness

…and:

How To Manage Chronic Stress

However, Dr. Albert also advocates for awareness of what some professionals have called “Shit Life Syndrome”.

This is more about socioeconomic factors. There are many of those that can’t be controlled by the individual, for example:

Adverse maternal experiences such as depression, economic issues and low social status can lead to poor cognitive outcomes as well as cardiovascular disease.

Many jarring statistics illuminate a marked wealth gap by race and ethnicity… You might be thinking education could help bridge that gap. But it is not that simple.

While education does increase wealth, the returns are not the same for everyone. Black persons need a post-graduate degree just to attain similar wealth as white individuals with a high school degree.

~ Dr. Michelle Albert

Read in full: AHA president: The connection between economic adversity and cardiovascular health

What this means in practical terms (besides advocating for structural change to tackle the things such as the racism that has been baked into a lot of systems for generations) is:

Be aware not just of your obvious health risk factors, but also your socioeconomic risk factors, if you want to have good general health outcomes.

So for example, let’s say that you, dear reader, are wealthy and white, in which case you have some very big things in your favor, but are you also a woman? Because if so…

Women and Minorities Bear the Brunt of Medical Misdiagnosis

See also, relevant for some: Obesity Discrimination In Healthcare Settings ← you’ll need to scroll to the penultimate section for this one.

In other words… If you are one of the majority of people who is a woman and/or some kind of minority, things are already stacked against you, and not only will this have its own direct harmful effect, but also, it’s going to make your life harder and that stress increases CVD risk more than salt.

In short…

This means: tackle not just your stress, but also the things that cause that. Look after your finances, gather social support, know your rights and be prepared to self-advocate / have someone advocate for you, and go into medical appointments with calm well-prepared confidence.

Take care!

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  • Mythbusting Moldy Food

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    Most Food Should Not Be Fuzzy

    In yesterday’s newsletter, we asked you for your policy when it comes to mold on food (aside from intentional mold, e.g. blue cheese etc), and the responses were interesting:

    • About 49% said “throw the whole thing away no matter what it is; it is dangerous
    • About 24% said “cut the mold off and eat the rest of whatever it is
    • The remainder were divided equally between “eat it all; keep the immune system on its toes” and “cut the mold off bread, but moldy animal products are dangerous

    So what does the science say?

    Some molds are safe to eat: True or False?

    True! We don’t think this is contentious so we’ll not spend much time on it, but just for the sake of being methodical: foods that are supposed to have mold on, including many kinds of cheese and even some kinds of cured meat (salami is an example; that powdery coating is mold).

    We could give a big list of safe and unsafe molds, but that would be a list of names and let’s face it, they don’t introduce themselves by name.

    However! The litmus test of “is it safe to eat” is:

    Did you acquire it with this mold already in place and exactly as expected and advertised?

    • If so, it is safe to eat (unless you have an allergy or such)
    • If not, it is almost certainly not safe to eat

    (more on why, later)

    The “sniff test” is a good way to tell if moldy food is bad: True or False?

    False. Very false. Because of how the sense of smell works.

    You may feel like smell is a way of knowing about something at a distance, but the only way you can smell something is if particles of it are physically connecting with your olfactory receptors inside you. Yes, that has unfortunate implications about bathroom smells, but for now, let’s keep our attention in the kitchen.

    If you sniff a moldy item of food, you will now have its mold spores inside your respiratory system. You absolutely do not want them there.

    If we cut off the mold, the rest is safe to eat: True or False?

    True or False, depending on what it is:

    • Hard vegetables (e.g carrots, cabbage), and hard cheeses (e.g. Gruyère, Gouda) – cut off with an inch margin, and it should be safe
    • Soft vegetables (e.g. tomatoes, and any vegetables that were hard but are now soft after cooking) – discard entirely; it is unsafe
    • Anything elsediscard entirely; it is unsafe

    The reason for this is because in the case of the hard products mentioned, the mycelium roots of the mold cannot penetrate far.

    In the case of the soft products mentioned, the surface mold is “the tip of the iceberg”, and the mycelium roots, which you will not usually be able to see, will penetrate the rest of it.

    Anything else” seems like quite a sweeping statement, but fruits, soft cheeses, yogurt, liquids, jams and jellies, cooked grains and pasta, meats, and yes, bread, are all things where the roots can penetrate deeply and easily. Regardless of you only being able to see a small amount, the whole thing is probably moldy.

    The USDA has a handy downloadable factsheet:

    Molds On Food: Are They Dangerous?

    Eating a little mold is good for the immune system: True or False?

    False, generally. There are of course countless types of mold, but not only are many of them pathogenic (mycotoxins), but also, a food that has mold will usually also have pathogenic bacteria along with the mold.

    See for example: Occurrence, Toxicity, and Analysis of Major Mycotoxins in Food

    Food poisoning will never make you healthier.

    But penicillin is safe to eat: True or False?

    False, and also penicillin is not the mold on your bread (or other foods).

    Penicillin, an antibiotic* molecule, is produced by some species of Penicillium sp., a mold. There are hundreds of known species of Penicillium sp., and most of them are toxic, usually in multiple ways. Take for example:

    Penicillium roqueforti PR toxin gene cluster characterization

    *it is also not healthy to consume antibiotics unless it is seriously necessary. Antibiotics will wipe out most of your gut’s “good bacteria”, leaving you vulnerable. People have died from C. diff infections for this reason. So obviously, if you really need to take antibiotics, take them as directed, but if not, don’t.

    See also: Four Ways Antibiotics Can Kill You

    One last thing…

    It may be that someone reading this is thinking “I’ve eaten plenty of mold, and I’m fine”. Or perhaps someone you tell about this will say that.

    But there are two reasons this logic is flawed:

    • Survivorship bias (like people who smoke and live to 102; we just didn’t hear from the 99.9% of people who smoke and die early)
    • Being unaware of illness is not being absent of illness. Anyone who’s had an alarming diagnosis of something that started a while ago will know this, of course. It’s also possible to be “low-level ill” often and get used to it as a baseline for health. It doesn’t mean it’s not harmful for you.

    Stay safe!

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  • Fix Your Upper Back With These Three Steps

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    When it comes to back pain, the lower back gets a lot of attention, but what about when it’s nearer the neck and shoulders?

    Reaching for better health

    In this short video, Liv describes and shows three exercises:

    Exercise 1: Thoracic Pullover (Dumbbell Pullover)

    Purpose: Improves overhead reach and shoulder mobility.
    Equipment: light weight, yoga block, or foam roller.
    Steps:

    1. Lie on the floor with the foam roller/block beneath the upper back.
    2. Hold the weight in both hands, arms extended upward.
    3. Inhale deeply and reach the weight toward the ceiling.
    4. Exhale and arc your spine over the block, moving the weight backward.
    5. Keep core tension to maintain a neutral lower back position.
    6. Perform 10 repetitions.

    Exercise 2: Rotational Mobility Stretch

    Purpose: enhances torso rotation, core strength, and hip mobility.
    Equipment: none (or a mat)
    Steps:

    1. Lie on your side with knees stacked at 90° and arms extended in front.
    2. Hold a weight in the top hand.
    3. Inhale and lift the top arm toward the ceiling, extending the shoulder blade.
    4. Exhale and twist your torso, allowing the arm to move toward the floor.
    5. Modify by extending the bottom leg for a deeper twist if needed.
    6. Perform 6 reps per side, switching legs and repeating on the other side.

    Exercise 3: Doorway/Pole Side Stretch

    Purpose: targets multiple areas for a deep, satisfying stretch.
    Equipment: door frame, pole, or wall.
    Steps:

    1. Stand at arm’s length from the wall or frame.
    2. Cross the outer leg (furthest from the wall) behind the inner leg.
    3. Place the closest hand on the wall and reach the other arm overhead.
    4. Grip the wall or frame with the top hand, pressing away with the bottom hand.
    5. Lean into a banana-shaped curve and rotate your chest upward for a deeper stretch.
    6. Hold for 20–30 seconds per side and repeat 2–3 times.

    For more on all of these, plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    Easing Lower Back Pain

    Take care!

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  • But First, Inner Peace – by Case Kenny

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    Thinking positively and vividly imagining a Ferrari parked in your driveway will not, in fact, cause it to manifest there.

    You know what that method does work for, though? Feelings.

    This book is essentially a guided thought-and-feeling modelling system that, consisting of 60 chapters to be taken one-per-day, aims to rewire your mind for inner peace.

    This is not, however, just a matter of “imagine peacefulness”, or nice-sounding platitudes. Rather, at the end of each chapter there is an exercise and journaling prompts; effectively, work to do along the way.

    Weighing in at 438 pages, this is a sizeable book, but part of that is because of the space to write answers to journaling prompts. Still, it’s not exactly a pamphlet, either—there is serious and extensive content here too.

    Like any daily reader, you can zip through it all at once if you like, but a benefit to doing the chapter-a-day approach is that it sets a habit of mindful reflection, and gives you a chance to implement each thing, one per day, building up new habits in that regard, too. In contrast, reading it all in one sitting wouldn’t give that.

    Bottom line: without inner peace, we don’t have much. Treat yourself—you deserve it.

    Click here to check out But First, Inner Peace, and enjoy inner peace!

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  • Prevention Is Better Than Cure

    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.

    Preventative healthcare is the theme this week:

    New year, new risks

    The start of a new year is a great time to update adult vaccinations, including the flu shot, any COVID-19 boosters, and vaccines for pneumonia, shingles, and tetanus—when was your last booster, after all? Vaccination recommendations vary by age and health conditions, so do check what’s appropriate in your case. Key vaccines include the pneumonia vaccine for those 65 and older, the shingles vaccine for adults over 50, and the Tdap vaccine every 10 years to protect against tetanus, diphtheria, and pertussis (whooping cough), especially for new parents and grandparents, to protect infants:

    Read in full: Why it’s important to update adult vaccinations for a new year

    Related: The Truth About Vaccines

    The heart-healthiest swap you can do

    Based on a large (n=202,863, of which 160,123 women and 42,740 men) dataset, a higher plant-to-animal protein ratio is associated with significantly lower risks of cardiovascular disease (CVD) and coronary artery disease (CAD), with diets lower in meat (especially if lower in red meat) and instead rich in plant-based proteins like legumes, nuts, and whole grains reducing CVD risk by 19% and coronary artery disease risk by 27%. Which is quite considerable.

    Substituting even small amounts of animal protein (especially if it’s red meat) with plant protein further enhances heart health:

    Read in full: Higher plant-to-animal protein ratio linked to lower risk for CVD, CAD among U.S. adults

    Related: Plant vs Animal Protein: Head to Head

    Let’s keep pan-resistant superbugs at bay

    Researchers want to warn us about the threat of pan-resistant bacteria, which could render all known antibiotics ineffective, leading to a sharp rise in global infection-related deaths.

    To be clear, we don’t have anything pan-resistant yet, but antibiotic-resistant superbugs are getting close, and in the long term, are likely to win the evolutionary arms race if we don’t change things to diverge considerably from our current path. Modeling a hypothetical pan-resistant E. coli strain, researchers predicted U.S. sepsis deaths could increase 18- to 46-fold within five years of its emergence.

    The study calls for urgent action, including stricter antibiotic stewardship, new drug development, and monitoring technologies, emphasizing that without intervention, the global impact could be catastrophic:

    Read in full: A public health emergency is waiting at the bottom of the antibiotic resistance cliff

    Related: Stop Sabotaging Your Immune System ← see also (linked therein), 4 ways antibiotics can kill you

    Take care!

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  • How To Engage Your Whole Brain

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    The Stroke Of Insight That Nobody Wants

    This is Dr. Jill Bolte Taylor. She’s a neuroanatomist, who, at the age of 37 (when she was a post-doctoral fellow at Harvard Medical School), had what she refers to as her “stroke of insight”.

    That is to say, she had a massive stroke, and after a major brain surgery to remove a clot the size of a golf ball, she spent the next 8 years re-learning to do everything.

    Whereas previously she’d been busy mapping the brain to determine how cells communicate with each other, now she was busy mapping whether socks or shoes should go on first. Needless to say, she got an insight into neuroplasticity that few people would hope for.

    What does she want us to know?

    Dr. Taylor (now once again a successful scientist, lecturer, and author) advocates for “whole brain living”, which involves not taking parts of our brain for granted.

    About those parts…

    Dr. Taylor wants us to pay attention to all the parts regardless of size, ranging from the two hemispheres, all the way down to the billions of brain cells, and yet even further, to the “trillions of molecular geniuses”—because each brain cell is itself reliant on countless molecules of the many neurochemicals that make up our brain.

    For a quick refresher on some of the key players in that latter category, see our Neurotransmitter Cheatsheet 😎

    When it comes to the hemispheres, there has historically been a popular belief that these re divided into:

    • The right brain: emotional, imaginative, creative, fluid feeling
    • The left brain: intellectual, analytical, calculating, crystal thinking

    …which is not true, anatomically speaking, because there are cells on both sides doing their part of both of these broad categories of brain processes.

    However, Dr. Taylor found, while one hemisphere of her brain was much more damaged than the other, that nevertheless she could recover some functions more quickly than others, which, once she was able to resume her career, inspired her model of four distinct ways of cogitating that can be switched-between and played with or against each other:

    Meet The Four Characters Inside Your Brain

    Why this matters

    As she was re-learning everything, the way forward was not quick or easy, and she also didn’t know where she was going, because for obvious reasons, she couldn’t remember, much less plan.

    Looking backwards after her eventual full recovery, she noted a lot of things that she needed during that recovery, some of which she got and some of which she didn’t.

    Most notably for her, she needed the right kind of support that would allow all four of the above “characters” as she puts it, to thrive and grow. And, when we say “grow” here we mean that literally, because of growing new brain cells to replace the lost ones (as well as the simple ongoing process of slowly replacing brain cells).

    For more on growing new brain cells, by the way, see:

    How To Grow New Brain Cells (At Any Age)

    In order to achieve this in all of the required brain areas (i.e., and all of the required brain functions), she also wants us to know… drumroll please

    When to STFU

    Specifically, the ability to silence parts of our brain that while useful in general, aren’t necessarily being useful right now. Since it’s very difficult to actively achieve a negative when it comes to brain-stuff (don’t think of an elephant), this means scheduling time for other parts of our brain to be louder. And that includes:

    • scheduling time to feel (emotionally)
    • scheduling time to feel (gut feelings)
    • scheduling time to feel (kinesthetically)

    …amongst others.

    Note: those three are presented in that order, from least basic to most basic. And why? Because, clever beings that we are, we typically start from a position that’s not remotely basic, such as “overthinking”, for example. So, there’s a wind-down through thinking just the right amount, thinking through simpler concepts, feeling, noticing one’s feelings, noticing noticing one’s feelings, all the way down to what, kinesthetically, are we actually physically feeling.

    ❝It is interesting to note that although our limbic system fucntions throughout our lifetime, it does not mature. As a result, when our emotional “buttons” are pushed, we retain the ability to react to incoming stimulation as though we were a two-year-old, even when we are adults.❞

    ~ Dr. Jill Taylor

    Of course, sometimes the above is not useful, which is why the ability to switch between brain modes is a very important and useful skill to develop.

    And how do we do that? By practising. Which is something that it’s necessary to take up consciously, and pursue consistently. When children are at school, there are (hopefully, ideally) curricula set out to ensure they engage and train all parts of their brain. As adults, this does not tend to get the same amount of focus.

    “Children’s brains are still developing”—indeed, and so are adult brains:

    The Brain As A Work-In-Progress

    Dr. Taylor had the uncommon experience of having to, in many ways, neurologically speaking, redo childhood. And having had a second run at it, she developed an appreciation of the process that most of us didn’t necessarily get when doing childhood just the once.

    In other words: take the time to feel stuff; take the time to quiet down your chatty mind, take the time engage your senses, and take it seriously! Really notice, as though for the first time, what the texture of your carpet is like. Really notice, as though for the first time, what it feels like to swallow some water. Really notice, as though for the first time, what it feels like to experience joy—or sadness, or comfort, or anger, or peace. Exercise your imagination. Make some art (it doesn’t have to win awards; it just has to light up your brain!). Make music (again, it’s about wiring your brain in your body, not about outdoing Mozart in composition and/or performance). Make changes! Make your brain work in the ways it’s not in the habit of doing.

    If you need a little help switching off parts of your brain that are being too active, so that you can better exercise other parts of your brain that might otherwise have been neglected, you might want to try:

    The Off-Button For Your Brain

    Enjoy!

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  • Pine Nuts vs Pecans – Which is Healthier?

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    Our Verdict

    When comparing pine nuts to pecans, we picked the pine nuts.

    Why?

    Both have their merits!

    In terms of macros, pine nuts have more protein while pecans have more fiber. They’re about equal on fats, although pine nuts have more polyunsaturated fat and pecans have more monounsaturated fat, of which, both are healthy. They’re also about equal on carbs. So really it comes down to the subjective choice between prioritizing protein and prioritizing fiber. On principle, we pick fiber, which gives the win to pecans, but your preference in this regard may differ; prioritizing the protein would give the win to pine nuts.

    In the category of vitamins, pine nuts have more of vitamins B2, B3, B9, E, K, and choline, while pecans have more of vitamins A, B1, B5, B6, and C. Thus, a 6:5 marginal win for pine nuts.

    Looking at the minerals, pine nuts have more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while pecans have more calcium and selenium. An easy win for pine nuts this time.

    Adding up the sections makes for a win for pine nuts, but of course, enjoy either or (preferably) both; diversity is good!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Enjoy!

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