Heart Rate Zones, Oxalates, & More
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I think the heart may be an issue for lots of us. I know it is for me due to AFib. When I’m in my training zone like on a treadmill, I’m usually around 110 to 120. But there are occasionally times when I’m at 140 or 150. How dangerous is that? If I use that formula of 180 minus age, thats 103. I get nothing from that. My resting heart rate is in the 50 to 60 range.❞
First, for safety, let us draw attention to our medical disclaimer at the bottom of each email, and also specifically note that we are not cardiologists here, let alone your cardiologist. There’s a lot we can’t know or advise about. However, as general rules of thumb:
For people without serious health conditions, it is considered good and healthful for one’s heart rate to double (from its resting rate) during exercise, with even more than 2.5x resting rate being nothing more than a good cardio workout.
As for “180 minus age” (presuming you mean: to calculate the safe maximum heart rate), more common (and used by the American Heart Association) is 220 minus age. In your case, that’d give 143.
Having atrial fibrillation may change this however, and we can’t offer medical advice.
We can point to this AHA “AFib Resources For Patients and Professionals”, including this handy FAQ sheet which says:
“Am I able to exercise?” / “Yes, as long as you’re cleared by your doctor, you can perform normal activities of daily living that you can tolerate” (accompanied by a little graphic of a person using an exercise bike)
You personally probably know this already, of course, but it’s quite an extensive collection of resources, so we thought we’d include it.
It’s certainly a good idea for everyone to be aware of their healthy heart rate ranges, regardless of having a known heart condition or not, though!
American Heart Association: Target Heart Rates Chart
❝I would like to see some articles on osteoporosis❞
You might enjoy this mythbusting main feature we did a few weeks ago!
The Bare-Bones Truth About Osteoporosis
❝Interesting, but… Did you know spinach is high in oxylates? Some people are sensitive and can cause increased inflammation, joint pain or even kidney stones. Moderation is key. My sister and I like to eat healthy but found out by experience that too much spinach salad caused us joint and other aches.❞
It’s certainly good to be mindful of such things! For most people, a daily serving of spinach shouldn’t cause ill effects, and certainly there are other greens to eat.
We wondered whether there was a way to reduce the oxalate content, and we found:
How to Reduce Oxalic Acid in Spinach: Neutralizing Oxalates
…which led us this product on Amazon:
Nephure Oxalate Reducing Enzyme, Low Oxalate Diet Support
We wondered what “nephure” was, and whether it could be trusted, and came across this “Supplement Police” article about it:
Nephure Review – Oxalate Reducing Enzyme Powder Health Benefits?
…which honestly, seems to have been written as a paid advertisement. But! It did reference a study, which we were able to look up, and find:
In vitro and in vivo safety evaluation of Nephure™
…which seems to indicate that it was safe (for rats) in all the ways that they checked. They did not, however, check whether it actually reduced oxalate content in spinach or any other food.
The authors did declare a conflict of interest, in that they had a financial relationship with the sponsor of the study, Captozyme Inc.
All in all, it may be better to just have kale instead of spinach:
- 20 Foods High in Oxalates to Limit if You Have Kidney Stones
- The Kidney Dietician: The Best Low Oxalate Greens
We turn the tables and ask you a question!
We’ll then talk about this tomorrow:
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Cognitive Enhancement Without Drugs
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Cognitive Enhancement Without Drugs
This is Elizabeth Ricker. She’s a Harvard-and-MIT-trained neuroscientist and researcher, who now runs the “Citizen Science” DIY-neurohacking organization, NeuroEducate.
Sounds fun! What’s it about?
The philosophy that spurs on her research and practice can be summed up as follows:
❝I’m not going to leave my brain up to my doctor or [anyone else]… My brain is my own responsibility, and I’m going to do the best that I can to optimize it❞
Her goal is not just to optimize her own brain though; she wants to make the science accessible to everyone.
What’s this about Citizen Science?
“Citizen Science” is the idea that while there’s definitely an important role in society for career academics, science itself should be accessible to all. And, not just the conclusions, but the process too.
This can take the form of huge experiments, often facilitated these days by apps where we opt-in to allow our health metrics (for example) to be collated with many thousands of others, for science. It can also involve such things as we talked about recently, getting our own raw genetic data and “running the numbers” at home to get far more comprehensive and direct information than the genetic testing company would ever provide us.
For Ricker, her focus is on the neuroscience side of biohacking, thus, neurohacking.
I’m ready to hack my brain! Do I need a drill?
Happily not! Although… Bone drills for the skull are very convenient instruments that make it quite hard to go wrong even with minimal training. The drill bit has a little step/ledge partway down, which means you can only drill through the thickness of the skull itself, before the bone meeting the wider part of the bit stops you from accidentally drilling into the brain. Still, please don’t do this at home.
What you can do at home is a different kind of self-experimentation…
If you want to consider which things are genuinely resulting in cognitive enhancement and which things are not, you need to approach the matter like a scientist. That means going about it in an organized fashion, and recording results.
There are several ways cognitive enhancement can be measured, including:
- Learning and memory
- Executive function
- Emotional regulation
- Creative intelligence
Let’s look at each of them, and what can be done. We don’t have a lot of room here; we’re a newsletter not a book, but we’ll cover one of Ricker’s approaches for each:
Learning and memory
This one’s easy. We’re going to leverage neuroplasticity (neurons that fire together, wire together!) by simple practice, and introduce an extra element to go alongside your recall. Perhaps a scent, or a certain item of clothing. Tell yourself that clinical studies have shown that this will boost your recall. It’s true, but that’s not what’s important; what’s important is that you believe it, and bring the placebo effect to bear on your endeavors.
You can test your memory with word lists, generated randomly by AI, such as this one:
You’ll soon find your memory improving—but don’t take our word for it!
Executive function
Executive function is the aspect of your brain that tells the other parts how to work, when to work, and when to stop working. If you’ve ever spent 30 minutes thinking “I need to get up” but you were stuck in scrolling social media, that was executive dysfunction.
This can be trained using the Stroop Color and Word Test, which shows you words, specifically the names of colors, which will themselves be colored, but not necessarily in the color the word pertains to. So for example, you might be shown the word “red”, colored green. Your task is to declare either the color of the word only, ignoring the word itself, or the meaning of the word only, ignoring its appearance. It can be quite challenging, but you’ll get better quite quickly:
The Stroop Test: Online Version
Emotional Regulation
This is the ability to not blow up angrily at the person with whom you need to be diplomatic, or to refrain from laughing when you thought of something funny in a sombre situation.
It’s an important part of cognitive function, and success or failure can have quite far-reaching consequences in life. And, it can be trained too.
There’s no online widget for this one, but: when and if you’re in a position to safely* do so, think about something that normally triggers a strong unwanted emotional reaction. It doesn’t have to be something life-shattering, but just something that you feel in some way bad about. Hold this in your mind, sit with it, and practice mindfulness. The idea is to be able to hold the unpleasant idea in your mind, without becoming reactive to it, or escaping to more pleasant distractions. Build this up.
*if you perchance have PTSD, C-PTSD, or an emotional regulation disorder, you might want to talk this one through with a qualified professional first.
Creative Intelligence
Another important cognitive skill, and again, one that can be cultivated and grown.
The trick here is volume. A good, repeatable test is to think of a common object (e.g. a rock, a towel, a banana) and, within a time constraint (such as 15 minutes) list how many uses you can think of for that item.
Writer’s storytime: once upon a time, I was sorting through an inventory of medical equipment with a colleague, and suggested throwing out our old arterial clamps, as we had newer, better ones—in abundance. My colleague didn’t want to part with them, so I challenged him “Give me one use for these, something we could in some possible world use them for that the new clamps don’t do better, and we’ll keep them”. He said “Thumbscrews”, and I threw my hands up in defeat, saying “Fine!”, as he had technically fulfilled my condition.
What’s the hack to improve this one? Just more volume. Creativity, as it turns out, isn’t something we can expend—like a muscle, it grows the more we use it. And because the above test is repeatable (with different objects), you can track your progress.
And if you feel like using your grown creative muscle to write/paint/compose/etc your magnum opus, great! Or if you just want to apply it to the problem-solving of everyday life, also great!
In summary…
Our brain is a wonderful organ with many functions. Society expects us to lose these as we get older, but the simple, scientific truth is that we can not only maintain our cognitive function, but also enhance and grow it as we go.
Want to know more from today’s featured expert?
You might enjoy her book, “Smarter Tomorrow”, which we reviewed back in March
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The Magic of L-theanine
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All The Benefits Of Caffeine And More, Without The Drawbacks? What’s The Catch?
It just takes one extra supplement.
For many of us, our morning brew is practically a ritual, but caffeine can also cause all kinds of problems ranging from caffeine jitters to caffeine crashes to caffeine addiction and withdrawal. Surely, something could be better?
Well, yes it could! You doubtlessly know about green tea’s antioxidant properties, but its amino acid, l-theanine (which can be taken as a supplement with coffee, if you don’t enjoy green tea) has so much more to offer:
- L-theanine has been found to reduce stress responses—and let’s face it, when we most want/need a coffee is often when facing stress
- It also reduces anxiety, making it a very safe “downer” without the problems of, for example, alcohol—or other potentially addictive substances
- It’s far more than just that, though! Paradoxically, l-theanine also improves alertness (what other calming things promote alertness? Not so many)
- Part of its trick is that it also improves accuracy—whereas stimulants like caffeine may produce a twitchy, jumpy, responsiveness, l-theanine’s signature effect is a calm state of sharp readiness. Caffeine works by stimulating the adrenal gland and increasing blood pressure, while simultaneously blocking adenosine receptors so that your body doesn’t notice its own tiredness—which is why you’re likely to crash later, when the tiredness that had been masked, all hits at once. Instead, l-theanine taken with caffeine acts as a moderator of that, making for a longer, gentler curve. In terms of subjective experience, what this can mean for many people is: no more caffeine jitters!
- All this means that while l-theanine can boost all kinds of cognitive function, including alertness and accuracy, many like to take in the evening as it can also promote a good night’s sleep, ready to be at your best the next day.
- How much to take? 200mg is a commonly used dosage, which in supplement terms is usually a single capsule. A lot easier to take than the 40 cups of green tea that this dosage would otherwise be!
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Bushfire smoke affects children differently. Here’s how to protect them
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Bushfires are currently burning in Australian states including Victoria, Tasmania, Western Australia and South Australia. In some areas, fire authorities have warned residents about the presence of smoke.
Bushfire smoke is harmful to our health. Tiny particles of ash can lodge deep in the lungs.
Exposure to this type of smoke may worsen existing conditions such as asthma, and induce a range of health effects from irritation of the eyes, nose and throat to changes in the cardiovascular system.
Public health recommendations during smoke events tend to provide general advice, and don’t often include advice specifically geared at children. But children are not just little adults. They are uniquely vulnerable to environmental hazards such as bushfire smoke for a number of reasons.
Different physiology, different behaviour
Children’s lungs are still developing and maturing.
Airways are smaller in children, especially young children, which is associated with greater rates of particle deposition – when particles settle on the surfaces of the airways.
Children also breathe more air per kilogram of body weight compared with adults, and therefore inhale more polluted air relative to their size.
Further, children’s detoxification systems are still developing, so environmental toxins take longer to effectively clear from their bodies.
Meanwhile, children’s behaviour and habits may expose them to more environmental toxins than adults. For example, they tend to do more physical activity and spend more time outdoors. Higher levels of physical activity lead to more air inhaled per kilogram of body weight.
Also, a normal and important part of children’s early play is exploring their environment, including by putting things in their mouth. This can result in kids ingesting soil, dust and dirt, which often contain environmental contaminants.
For these reasons, it’s important to consider the specific needs of children when providing advice on what to do when there’s smoke in the air.
Keeping our environments healthy
The Australian government offers recommendations for minimising the health risks from exposure to bushfire smoke. The main advice includes staying indoors and keeping doors and windows closed.
This is great advice when the smoke is thick outside, but air pollutants may still accumulate inside the home. So it’s important to air your home once the smoke outside starts to clear. Take advantage of wind changes to open up and get air moving out of the house with a cross breeze.
Kids are natural scientists, so get them involved. For example, you and your child can “rate” the air each hour by looking at a landmark outside your home and rating how clearly you can see it. When you notice the haze is reducing, open up the house and clear the air.
Because air pollutants settle onto surfaces in our home and into household dust, an easy way to protect kids during smoky periods is to do a daily dust with a wet cloth and vacuum regularly. This will remove pollutants and reduce ingestion by children as they play. Frequent hand washing helps too.
Healthy bodies and minds
Research exploring the effects of bushfire smoke exposure on children’s health is sparse. However, during smoke events, we do see an increase in hospital visits for asthma, as well as children reporting irritation to their eyes, nose and throat.
If your child has asthma or another medical condition, ensure they take any prescribed medications on a regular schedule to keep their condition well controlled. This will minimise the risk of a sudden worsening of their symptoms with bushfire smoke exposure.
Make sure any action plans for symptom flare-ups are up to date, and ensure you have an adequate supply of in-date medication somewhere easy to locate and access.
Children may be anxious during a bushfire.
Media_Photos/ShutterstockKids can get worried during bushfires, and fire emergencies have been linked with a reduction in children’s mental health. Stories such as the Birdie’s Tree books can help children understand these events do pass and people help one another in times of difficulty.
Learning more about air pollution can help too. Our group has a children’s story explaining how air pollution affects our bodies and what can help.
It’s also important for parents and caregivers not to get too stressed, as children cope better when their parents manage their own anxiety and help their children do the same. Try to strike a balance between being vigilant and staying calm.
What about masks?
N95 masks can protect the wearer from fine particles in bushfire smoke, but their use is a bit complicated when it comes to kids. Most young children won’t be able to fit properly into an N95 mask, or won’t tolerate the tight fit for long periods. Also, their smaller airways make it harder for young children to breathe through a mask.
If you choose to use an N95 mask for your children, it’s best to save them for instances when high-level outdoor exposure is unavoidable, such as if you’re going outside when the smoke is very thick.
N95 masks should be replaced after around four hours or when they become damp.
If your child has an existing heart or lung condition, consult their doctor before having them wear an N95 mask.
Our team is currently recruiting for a study exploring the effects of bushfire smoke in children. If you live in south east Queensland and are interested in participating in the event of a bushfire or hazard reduction burn near your home, please express your interest here.
Dwan Vilcins, Group leader, Environmental Epidemiology, Children’s Health Environment Program, The University of Queensland; Nicholas Osborne, Associate Professor, School of Public Health, The University of Queensland, and Paul D. Robinson, Conjoint Professor in Respiratory and Sleep Medicine, Child Health Research Centre, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How does the drug abemaciclib treat breast cancer?
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The anti-cancer drug abemaciclib (also known as Vernezio) has this month been added to the Australian Pharmaceutical Benefits Scheme (PBS) to treat certain types of breast cancer.
This significantly reduces the cost of the drug. A patient can now expect to pay A$31.60 for a 28-day supply ($7.70 with a health care concession card). The price of abemaciclib without government subsidy is $4,250.
So what is abemaciclib, and how did we get to this point?
It stops cells dividing
Researchers at the pharmaceutical company Eli Lilly developed abemaciclib and published the first study on the drug (then known as LY2835219) in 2014.
Abemaciclib is a type of drug known as a “cyclin-dependent kinase inhibitor”. It’s taken as a pill twice a day.
To maintain our health, many of the cells in our bodies need to grow and divide to produce new cells. Cancers develop when cells grow and divide out of control. Therefore, stopping cells from dividing into new cells is one way that cancer can be fought.
When cells divide, they have to make a copy of their DNA to pass onto the new cell. “Cyclin-dependent kinases” (CDKs for short) are essential for this process. So, if you stop the CDKs, you stop the DNA copying, you stop cells dividing, and you fight the cancer.
However, there are different types of CDKs, and not all cancers need them all to grow. Abemaciclib specifically targets CDK4 and CDK6. Thankfully, a lot of cancers do need these CDKs, including some breast cancers.
The drug targets CDK4 and CDK6. Photoroyalty/Shutterstock But abemaciclib will only be effective against cancers that rely on CDK4 and CDK6 for continued growth. This specificity also means abemaciclib is fairly unique, so it can’t easily be replaced with a different drug.
Two other CDK4/6 inhibitors were developed around the same time as abemaciclib, and are called ribociclib and palbociclib. Both of these drugs are also on the PBS for specific types of breast cancer. As the drugs differ in their chemical structures, they have slight differences in the way they are taken up and processed by the body. The preferred drug given to a breast cancer patient will depend on their unique circumstances.
What are the side effects?
Research is still ongoing into the differences between each of these CDK4/6 inhibitors, but it is known that the side effects are largely similar, but can differ in severity.
The most common side effects of abemaciclib are fatigue, diarrhoea and neutropenia (reduced white blood cells). The gastrointestinal issues are generally more severe with abemaciclib.
If these side effects are too severe, abemaciclib treatment can be stopped.
What types of cancer has abemaciclib been approved for?
In 2017, the United States Food and Drug Administration (FDA) approved abemaciclib for the treatment of patients with metastatic HR+/HER2- (hormone receptor-positive and human epidermal growth factor receptor 2-negative) breast cancer who did not respond to standard endocrine therapy.
Australia’s Therapeutic Goods Administration (TGA) similarly approved abemaciclib in 2022 as an “adjuvant” therapy (after the initial surgery to remove the tumour) for patients with HR+/HER2- invasive early breast cancer which had spread to lymph nodes and was at high risk of returning.
The drug is approved for people with early breast cancer which is at high risk of returning. PeopleImages.com – Yuri A/Shutterstock As of May 1 2024, the PBS covers this use of abemaciclib in combination with endocrine therapy such as fulvestrant, which is also listed on the PBS. Endocrine therapy, also known as hormonal therapy, blocks hormone receptor positive (HR+) cancers from receiving the hormones they need to survive.
Could abemaciclib be used for other cancers in the future?
Abemaciclib is of great interest to scientists and medical practitioners, and testing is ongoing to assess the effectiveness of abemaciclib in treating a range of other cancers, including gastrointestinal cancers and blood cancers.
Abemaciclib may even be usable in brain cancers, as it has long been known to be capable of crossing the blood-brain barrier, a common stumbling block for potential anti-cancer drugs.
Time will tell whether the role of abemaciclib in health care will be expanded. But for now, its inclusion on the PBS is sure to bring some relief to breast cancer patients nationwide.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Which Comes First, Cardio or Weights? – by Alex Hutchinson
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This is a book of questions and answers, myths and busts, and in short, all things exercise.
It’s laid out as many micro-chapters with questions as headers. The explanations are clear and easy to understand, with several citations (of studies and other academic papers) per question.
While it’s quite comprehensive (weighing in at a hefty 300+ pages), it’s not the kind of book where one could just look up any given piece of information that one wants.
Its strength, rather, lies in pre-emptively arming the reader with knowledge, and correcting many commonly-believed myths. It can be read cover-to-cover, or just dipped into per what interests you (the table of contents lists all questions, so it’s easy to flip through).
Bottom line: if you’ve found the world of exercise a little confusing and would like it demystifying, this book will result in a lot of “Oooooh” moments.
Click here to check out Which Comes First, Cardio or Weights?, and know your stuff!
PS: the short answer to the titular question is “mix it up and keep it varied”
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Health & Happiness From Outside & In
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A friend in need…
In a recent large (n=3,486) poll across the US:
- 90% of people aged 50 and older say they have at least one close friend
- 75% say they have enough close friends
- 70% of those with a close friend say they can definitely count on them to provide health-related support
However, those numbers shrink by half when it comes to people whose physical and/or mental health is not so great, resulting in a negative feedback loop of fewer close friends whom one sees less often, and progressively worse physical and/or mental health. In other words, the healthier you are, the more likely you are to have a friend who’ll support you in your health:
Read in full: Friendships promote healthier living in older adults, says new survey
Related: How To Beat Loneliness & Isolation
Kindness makes a difference to healthcare outcomes
Defining kindness as action-oriented, positively focused, and purposeful in nature, this sets kindness apart from compassion and empathy, when it’s otherwise often been conflated with those, and thus overlooked. This also means that kindness can still be effected when clinicians are too burned-out to be compassionate, and/or when patients are not in a state of mind where empathy is useful.
Furthermore, unkindness (again, as defined by this review) was found in large studies to be the root cause of ¾ of patient harm events in hospital settings. This means that far from being a wishy-washy abstraction, kindness/unkindness can be a very serious factor when it comes to healthcare outcomes:
Read in full: Review suggests kindness could make for better health care
Related: The Human Touch vs AI, The Doctor That Never Tires
The gift of health?
🎵 Last Christmas, I gave you my heart
Which turned out to be a silly idea
This year, to save me from tears
I’ll just get you a Fitbit or something🎵Health & happiness go hand in hand, so does that make health stuff a good gift? It can do! But there are also plenty of opportunities for misfires.
For example, getting someone a gym membership when they don’t have time for that may not help them at all, and sports equipment that they’ll use once and then leave to gather dust might not be great either. In contrast, the American Heart Association recommends to first consider what they enjoy doing, and work with that, and ideally make it something versatile and/or portable. Wearable gadgets are a fine option for many, but a gift doesn’t have to be fancy to be good—with a blood pressure monitoring cuff being a suggestion from Dr. Sperling (a professor of preventative cardiology):
Read in full: Oh, there’s no gift like health for the holidays
Related: Here’s Where Activity Trackers Help (And Also Where They Don’t)
How you use social media matters more than how much
A study commissioned by the European Commission’s Joint Research Centre found that while the quantity of time one spends on social media is not associated (positively or negatively) with loneliness, they did find a correlation between passive (as opposed to engaged) use of social media, and loneliness. In other words, people who were chatting with friends less, were more lonely! Shocking news.
While the findings may seem obvious, it does present a call-to-action for anyone who is feeling lonely: to use social media not just to see what everyone else is up to, but also, to reach out to people.
Read in full: Unpacking the link between social media and loneliness
Related: Make Social Media Work For Your Mental Health Rather Than Against It
Gut-only antidepressants
Many antidepressants work by increasing serotonin levels in the brain; a new study suggests that targeting antidepressants to work only in the gut (which is where serotonin is made, not the brain) could not only be an effective treatment for mood disorders, but also cause fewer adverse side-effects:
Read in full: Antidepressants may act in gut to reduce depression and anxiety
Related: Antidepressants: Personalization Is Key!
Take care!
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