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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Red Lentils vs Oats – Which is Healthier?
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Our Verdict
When comparing red lentils to oats, we picked the oats.
Why?
In terms of macros, oats have more protein, carbs, fiber, and even a little fat—mostly healthy mono- and polyunsaturated fats, thus making them the more nutritionally dense. That said, red lentils have the lower glycemic index, (low GI compared to oats’ medium GI) which offsets that, so we’ll call this category a tie.
In the category of vitamins, red lentils have more of vitamins B6, B9, and choline, while oats have more of vitamins B1, B2, and B5. Another tie!
When it comes to minerals, however, we have a tiebreaker category: red lentils have more selenium, while oats have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An easy win for oats this time!
So, thanks to the minerals, oats are the clear winner in total. But by all means, enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
The Best Kind Of Fiber For Overall Health? ← it’s β-glucan, the kind find in oats!
Enjoy!
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Four Ways To Upgrade The Mediterranean Diet
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Four Ways To Upgrade The Mediterranean Diet
The Mediterranean Diet is considered by many to be the current “gold standard” of healthy eating, and with good reason. With 10,000+ studies underpinning it and counting, it has a pretty hefty weight of evidence.
(For contrast, the Ketogenic Diet for example has under 5,000 studies at time of writing, and many of those include mentioning the problems with it. That’s not to say the Keto is without its merits! It certainly can help achieve some short term goals, but that’s a topic for another day)
Wondering what the Mediterranean Diet consists of? We outlined it in a previous main feature, so here it is for your convenience 😎
To get us started today, we’ll quickly drop some links to a few of those Mediterranean Diet studies from the top:
- Definition of the Mediterranean Diet; a Literature Review
- Mediterranean Diet In Healthy Aging
- Cancer and Mediterranean Diet: A Review
- Impact of Mediterranean Diet on Chronic Non-Communicable Diseases and Longevity
- Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies
- Adherence to Mediterranean diet and health status: meta-analysis
The short version is: it glows, in a good way.
The anti-inflammatory upgrade
One thing about the traditional Mediterranean Diet is… where are the spices?!
A diet focusing on fruits and non-starchy vegetables, healthy oils and minimal refined carbs, can be boosted by adding uses of spices such as chili, turmeric, cumin, fenugreek, and coriander:
The gut-healthy upgrade:
The Mediterranean Diet already gives for having a small amount of dairy, mostly in the form of cheeses, but this can be tweaked:
Mediterranean diet with extra dairy could be a gut gamechanger
The heart-healthy upgrade
The Mediterranean Diet is already highly recommended for heart health, and it offers different benefits to different parts of cardiovascular health:
The DASH (Dietary Approaches to Stop Hypertension) diet can boost it further, specifically in the category of, as the name suggests, lowering blood pressure.
It’s basically the Mediterranean Diet with a few tweaks. Most notably, red meat no longer features (the Mediterranean Diet allows for a small amount of red meat), and fish has gone up in the list:
Description of the DASH Eating Plan
The brain-healthy upgrade:
The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet combines several elements from the above, as the name suggests. It also adds extra portions of specific brain-foods, that already exist in the above diets, but get a more substantial weighting in this one:
MIND and Mediterranean diets linked to fewer signs of Alzheimer’s brain pathology
See also: The cognitive effects of the MIND diet
Enjoy!
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Dealing with Thirst!
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Busting The Myth of “Eight Glasses Of Water A Day”
Everyone knows we must drink 8 glasses of water a day, or else we’re going to get a failing grade at being a healthy human—like not flossing, or not using adequate sunscreen.
But… Do we? And does tea count? How about (we dare but whisper it) coffee? And soda drinks are mostly water, right? But aren’t some drinks dehydrating? Are special electrolyte drinks really better? There are so many things to consider, so many differing advices, and it’s easy to give up, or just choose what to believe in as a leap of faith.
A quick brain-teaser for you first, though:
If coffee and soda don’t count because they’re dehydrating, then what if you were to take:
– A concentrated tiny cup of espresso, and then a glass of water, would the glass of water count?
– Or (we don’t relish the thought) what if you took a spoonful of soda syrup, and then a glass of water, would the glass of water count?
If your answer was “yes, it’s a glass of water”, then why would it not count if it were taken all at once (e.g. as an Americano coffee, or a regular soda)?
If your answer was “yes, but that water might only offset the dehydration caused by the coffee/syrup, so I might only be breaking even”, then you were thinking about this the right way:
How much water you need depends on many factors that can be affected by what else you are consuming and what else you are doing. Science loves averages, so eight glasses a day may be great if you are of average health, and average body size, in a temperate climate, doing moderate exercise, and so on and so on.
If you’re not the most average person of all time? You may need to take into account a lot of factors, ranging from what you ate for dinner to how much you perspired during your morning exercises. As you (probably) don’t live in laboratory conditions, this can become an impossible task—and if you missed (or guessed incorrectly) even one factor, the whole calculation will be thrown off. But is there any other way to know?
What of the infamous pee test? Drink enough to make your urine as clear as possible, and if it’s dark, you’re dehydrated, common wisdom says.
In reality, however, that tells you not what’s in your body, but rather, what got ejected from your body. If your urine is dark, it might mean you had too little water, but it also could just mean you had the right amount of water but too much sodium, for instance. A study of this was done on athletes, and found no correlation between urine color and actual bodily hydration when measured directly via a blood test.
So, if we can’t just have an app tell us “drink this many glasses of water”, and we can’t trust urine color, what can we do?
What we can do is trust that our body comes with (for free!) a wonderful homeostatic system and it will try to correct any imbalances. If you are thirsty, you’re dehydrated. Drink something with plenty of water in, if not plain water.
But what about special electrolyte drinks? If you need salts, you will crave them. Craving a salty snack? Go for it! Or if you prefer not to snack, do a salt lick test (just put a little salt on your finger, and taste it; if it tastes good, wait a minute or two, and then have a little more, and repeat until it doesn’t).
Bonus Tip:
- Make sure you always have a source of hydration (that you enjoy!) to hand. Maybe it’s chilled water, maybe it’s a pot of tea, maybe it’s a sports drink, it doesn’t matter too much. Even coffee is actually fine, by the way (but don’t overdo it).
- Make a personal rule: “I will always make time for hydration”. That means, if you’re thirsty, have something with water in it now. Not when you’ve finished what you’re doing (unless you really can’t stop, because you are a racecar driver mid-race, or a surgeon mid-operation, or something), but now. Do not postpone it until after you’ve done some other thing first; you will forget and it will keep getting postponed. Always make time for water.
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Apple Cider Vinegar vs Apple Cider Vinegar Gummies – Which is Healthier?
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.
Our Verdict
When comparing apple cider vinegar (bottled) to apple cider vinegar (gummies), we picked the bottled.
Why?
There are several reasons!
The first reason is about dosage. For example, the sample we picked for apple cider vinegar gummies, boasts:
❝2 daily chewable gummies deliver 800 mg of Apple Cider Vinegar a day, equivalent to a teaspoon of liquid apple cider vinegar❞
That sounds good until you note that it’s recommended to take 1–2 tablespoons (not teaspoons) of apple vinegar. So this would need more like 4–8 gummies to make the dose. Suddenly, either that bottle of gummies is running out quickly, or you’re just not taking a meaningful dose and your benefits will likely not exceed placebo.
The other is reason about sugar. Most apple cider vinegar gummies are made with some kind of sugar syrup, often even high-fructose corn syrup, which is one of the least healthy foodstuffs (in the loosest sense of the word “foodstuffs”) known to science.
The specific brand we picked today was the best we can find; it used maltitol syrup.
Maltitol syrup, a corn derivative (and technically a sugar alcohol), has a Glycemic Index of 52, so it does raise blood sugars but not as much as sucrose would. However (and somewhat counterproductive to taking apple cider vinegar for gut health) it can cause digestive problems for many people.
And remember, you’re taking 4–8 gummies, so this is amounting to several tablespoons of the syrup by now.
On the flipside, apple cider vinegar itself has two main drawbacks, but they’re much less troublesome issues:
- many people don’t like the taste
- its acidic nature is not good for teeth
To this the common advice for both is to dilute it with water, thus diluting the taste and the acidity.
(this writer shoots hers from a shot glass, thus not bathing the teeth since it passes them “without touching the sides”; as for the taste, well, I find it invigorating—I do chase it with water, though to be sure of not leaving vinegar in my mouth)
Want to check them out for yourself?
Here they are:
Apple cider vinegar | Apple cider vinegar gummies
Want to know more about apple cider vinegar?
Check out:
- An Apple (Cider Vinegar) A Day…
- 10 Ways To Balance Blood Sugars
- How To Recover Quickly From A Stomach Bug
Take care!
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What Is Making The Ringing In Your Ears Worse?
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Dr. Rachael Cook, an audiologist at Applied Hearing Solutions in Phoenix, Arizona, shares her professional insights into managing tinnitus.
If you’re unfamiliar with Tinnitus, it is an auditory condition characterized by a ringing, buzzing, or humming sound, and ffects nearly 10% of the population. We’ve written on Tinnitus, and how it can disrupt your life, in this article.
Key Triggers for Tinnitus
Several everyday habits can make your tinnitus louder. Caffeine and nicotine increase blood pressure, restricting blood flow to the cochlea and worsening tinnitus. Common medications, such as pain relievers, high-dose antibiotics, and antidepressants, can also exacerbate tinnitus, especially with higher or long-term dosages.
Impact of Diet and Sleep
Dietary choices significantly impact tinnitus. Alcohol and salt alter the fluid balance in the cochlea, increasing tinnitus perception. Alcohol changes blood flow patterns and neurotransmitter production, while high salt intake has similar effects. Poor sleep quality elevates stress levels, making it harder to ignore tinnitus signals. Addressing sleep disorders like sleep apnea and insomnia can help manage tinnitus symptoms.
Importance of Treating Hearing Loss
Untreated hearing loss worsens tinnitus. Nearly 90% of individuals with tinnitus have some hearing loss. Hearing aids can reduce tinnitus perception by restoring missing sounds and reducing the brain’s internal compensatory signals. Combining hearing aids with sound therapy is said to provide even greater relief.
Read more about hearing loss in our article on the topic.
Otherwise, for a great guide on managing tinnitus, we recommend watching Dr. Cook’s video:
Here’s hoping your ear’s aren’t ringing too much whilst watching the video!
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California Becomes Latest State To Try Capping Health Care Spending
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California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending.
The goal of the agency, established in 2022, is to make care more affordable and accessible while improving health outcomes, especially for the most disadvantaged state residents. That will require a sustained wrestling match with a sprawling, often dysfunctional health system and powerful industry players who have lots of experience fighting one another and the state.
Can the new agency get insurers, hospitals, and medical groups to collaborate on containing costs even as they jockey for position in the state’s $405 billion health care economy? Can the system be transformed so that financial rewards are tied more to providing quality care than to charging, often exorbitantly, for a seemingly limitless number of services and procedures?
The jury is out, and it could be for many years.
California is the ninth state — after Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington — to set annual health spending targets.
Massachusetts, which started annual spending targets in 2013, was the first state to do so. It’s the only one old enough to have a substantial pre-pandemic track record, and its results are mixed: The annual health spending increases were below the target in three of the first five years and dropped beneath the national average. But more recently, health spending has greatly increased.
In 2022, growth in health care expenditures exceeded Massachusetts’ target by a wide margin. The Health Policy Commission, the state agency established to oversee the spending control efforts, warned that “there are many alarming trends which, if unaddressed, will result in a health care system that is unaffordable.”
Neighboring Rhode Island, despite a preexisting policy of limiting hospital price increases, exceeded its overall health care spending growth target in 2019, the year it took effect. In 2020 and 2021, spending was largely skewed by the pandemic. In 2022, the spending increase came in at half the state’s target rate. Connecticut and Delaware, by contrast, both overshot their 2022 targets.
It’s all a work in progress, and California’s agency will, to some extent, be playing it by ear in the face of state policies and demographic realities that require more spending on health care.
And it will inevitably face pushback from the industry as it confronts unreasonably high prices, unnecessary medical treatments, overuse of high-cost care, administrative waste, and the inflationary concentration of a growing number of hospitals in a small number of hands.
“If you’re telling an industry we need to slow down spending growth, you’re telling them we need to slow down your revenue growth,” says Michael Bailit, president of Bailit Health, a Massachusetts-based consulting group, who has consulted for various states, including California. “And maybe that’s going to be heard as ‘we have to restrain your margins.’ These are very difficult conversations.”
Some of California’s most significant health care sectors have voiced disagreement with the fledgling affordability agency, even as they avoid overtly opposing its goals.
In April, when the affordability office was considering an annual per capita spending growth target of 3%, the California Hospital Association sent it a letter saying hospitals “stand ready to work with” the agency. But the proposed number was far too low, the association argued, because it failed to account for California’s aging population, new investments in Medi-Cal, and other cost pressures.
The hospital group suggested a spending increase target averaging 5.3% over five years, 2025-29. That’s slightly higher than the 5.2% average annual increase in per capita health spending over the five years from 2015 to 2020.
Five days after the hospital association sent its letter, the affordability board approved a slightly less aggressive target that starts at 3.5% in 2025 and drops to 3% by 2029. Carmela Coyle, the association’s chief executive, said in a statement that the board’s decision still failed to account for an aging population, the growing need for mental health and addiction treatment, and a labor shortage.
The California Medical Association, which represents the state’s doctors, expressed similar concerns. The new phased-in target, it said, was “less unreasonable” than the original plan, but the group would “continue to advocate against an artificially low spending target that will have real-life negative impacts on patient access and quality of care.”
But let’s give the state some credit here. The mission on which it is embarking is very ambitious, and it’s hard to argue with the motivation behind it: to interject some financial reason and provide relief for millions of Californians who forgo needed medical care or nix other important household expenses to afford it.
Sushmita Morris, a 38-year-old Pasadena resident, was shocked by a bill she received for an outpatient procedure last July at the University of Southern California’s Keck Hospital, following a miscarriage. The procedure lasted all of 30 minutes, Morris says, and when she received a bill from the doctor for slightly over $700, she paid it. But then a bill from the hospital arrived, totaling nearly $9,000, and her share was over $4,600.
Morris called the Keck billing office multiple times asking for an itemization of the charges but got nowhere. “I got a robotic answer, ‘You have a high-deductible plan,’” she says. “But I should still receive a bill within reason for what was done.” She has refused to pay that bill and expects to hear soon from a collection agency.
The road to more affordable health care will be long and chock-full of big challenges and unforeseen events that could alter the landscape and require considerable flexibility.
Some flexibility is built in. For one thing, the state cap on spending increases may not apply to health care institutions, industry segments, or geographic regions that can show their circumstances justify higher spending — for example, older, sicker patients or sharp increases in the cost of labor.
For those that exceed the limit without such justification, the first step will be a performance improvement plan. If that doesn’t work, at some point — yet to be determined — the affordability office can levy financial penalties up to the full amount by which an organization exceeds the target. But that is unlikely to happen until at least 2030, given the time lag of data collection, followed by conversations with those who exceed the target, and potential improvement plans.
In California, officials, consumer advocates, and health care experts say engagement among all the players, informed by robust and institution-specific data on cost trends, will yield greater transparency and, ultimately, accountability.
Richard Kronick, a public health professor at the University of California-San Diego and a member of the affordability board, notes there is scant public data about cost trends at specific health care institutions. However, “we will know that in the future,” he says, “and I think that knowing it and having that information in the public will put some pressure on those organizations.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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