How Not To Die – by Dr. Michael Greger
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We previously reviewed this book some years ago, but we’re revisiting it now because:
- It really is a book that should be in every healthspan-enjoyer’s collection
- Our book reviews back then were not as comprehensive as now (though we still generally try to fit into the “it takes about one minute to read this review” idea, sometimes we’ll spend a little extra time).
Dr. Greger (of “Dr. Greger’s Daily Dozen” fame) outlines for us in cold hard facts and stats what’s most likely to be our cause of death. While this is not a cheery premise for a book, he then sets out to work back from there—what could have prevented those specific things?
Thus, while the book doesn’t confer immortality (the title is not “how to not die”, after all), it does teach us how not to die—i.e, from heart disease, lung diseases, brain diseases, digestive cancers, infections, diabetes, high blood pressure, liver disease, blood cancers, kidney disease, breast cancer, suicidal depression, prostate cancer, Parkinson’s disease, and even iatrogenic causes.
This it does with a lot of solid science, explained for the layperson, and/but without holding back when it comes to big words, and a lot of them, at that. If you want to add in daily exercises, just lifting the book could be a start; weighing in at 678 pages, it’s an information-dense tome that’s more likely to be sifted through than read cover-to-cover.
The style is thus dense science somewhat editorialized for lay readability, and well-evidenced with around 3,000 citations. That’s not a typo; there are 178 pages of bibliography at the back with about 15–20 scientific references per page.
In terms of practical use, he does also devote chapters to that, it’s not just all textbook. Indeed, he discusses the reasonings behind the items, portion sizes, and quantities of his “daily dozen” foods, so that the reader will understand how much bang-for-buck they deliver, and then it’ll seem a lot less like an arbitrary list, and more likely to be adopted and maintained.
Bottom line: if you care about not getting life-threatening illnesses (which at the end of the day, come to most people at some point), then this book is a must-read.
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Two Things You Can Do To Improve Stroke Survival Chances
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Dr. Andrew’s Stroke Survival Guide
This is Dr. Nadine Andrew. She’s a Senior Research Fellow in the Department of Medicine at Monash University. She’s the Research Data Lead for the National Center of Healthy Aging. She is lead investigator on the NHMRC-funded PRECISE project… The most comprehensive stroke data linkage study to date! In short, she knows her stuff.
We’ve talked before about how sample size is important when it comes to scientific studies. It’s frustrating; sometimes we see what looks like a great study until we notice it has a sample size of 17 or something.
Dr. Andrew didn’t mess around in this regard, and the 12,386 participants in her Australian study of stroke patients provided a huge amount of data!
With a 95% confidence interval because of the huge dataset, she found that there was one factor that reduced mortality by 26%.
And the difference was…
Whether or not patients had a chronic disease management plan set up with their GP (General Practitioner, or “family doctor”, in US terms), after their initial stroke treatment.
45% of patients had this; the other 55% did not, so again the sample size was big for both groups.
Why this is important:
After a stroke, often a patient is discharged as early as it seems safe to do so, and there’s a common view that “it just takes time” and “now we wait”. After all, no medical technology we currently have can outright repair that damage—the body must repair itself! Medications—while critical*—can only support that and help avoid recurrence.
*How critical? VERY critical. Critical critical. Dr. Andrew found, some years previously, that greater levels of medication adherence (ie, taking the correct dose on time and not missing any) significantly improved survival outcomes. No surprise, right? But what may surprise is that this held true even for patients with near-perfect adherence. In other words: miss a dose at your peril. It’s that important.
But, as Dr. Andrew’s critical research shows, that’s no reason to simply prescribe ongoing meds and otherwise cut a patient loose… or, if you or a loved one are the patient, to allow yourself/them to be left without a doctor’s ongoing active support in the form of a chronic disease management plan.
What does a chronic disease management plan look like?
First, what it’s not:
- “Yes yes, I’m here if you need me, just make an appointment if something changes”
- “Let’s pencil in a check-up in three months”
- Etc
What it actually looks like:
It looks like a plan. A personal care plan, built around that person’s individual needs, risks, liabilities… and potential complications.
Because who amongst us, especially at the age where strokes are more likely, has an uncomplicated medical record? There will always be comorbidities and confounding factors, so a one-size-fits-all plan will not do.
Dr. Andrew’s work took place in Australia, so she had the Australian healthcare system in mind… We know many of our subscribers are from North America and other places. But read this, and you’ll see how this could go just as much for the US or Canada:
❝The evidence shows the importance of Medicare financially supporting primary care physicians to provide structured chronic disease management after a stroke.
We also provide a strong case for the ongoing provision of these plans within a universal healthcare system. Strategies to improve uptake at the GP level could include greater financial incentives and mandates, education for patients and healthcare professionals.❞
See her groundbreaking study for yourself here!
The Bottom Line:
If you or a loved one has a stroke, be prepared to make sure you get a chronic health management plan in place. Note that if it’s you who has the stroke, you might forget this or be unable to advocate for yourself. So, we recommend to discuss this with a partner or close friend sooner rather than later!
“But I’m quite young and healthy and a stroke is very unlikely for me”
Good for you! And the median age of Dr. Andrew’s gargantuan study was 70 years. But:
- do you have older relatives? Be aware for them, too.
- strokes can happen earlier in life too! You don’t want to be an interesting statistic.
Some stroke-related quick facts:
Stroke is the No. 5 cause of death and a leading cause of disability in the U.S.
Stroke can happen to anyone—any age, any time—and everyone needs to know the warning signs.
On average, 1.9 million brain cells die every minute that a stroke goes untreated.
Stroke is an EMERGENCY. Call 911 immediately.
Early treatment leads to higher survival rates and lower disability rates. Calling 911 lets first responders start treatment on someone experiencing stroke symptoms before arriving at the hospital.
Source: https://www.stroke.org/en/about-stroke
What are the warning signs for stroke?
Use the letters F.A.S.T. to spot a stroke and act quickly:
- F = Face Drooping—does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
- A = Arm Weakness—is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- S = Speech Difficulty—is speech slurred?
- T = Time to call 911
Source: https://www.stroke.org/en/about-stroke/stroke-symptoms
Last but not least, while we’re sharing resources:
Download the PDF Checklist: 8 Ways To Help Prevent a Second Stroke
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Eat More, Live Well – by Dr. Megan Rossi
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Often, eating healthily can feel restrictive. Don’t eat this, skip that, eliminate the other. Where is the joy?
Dr. Megan Rossi brings a scientific angle on positive dieting, that is to say, looking at what to add, rather than what to subtract. Now, the idea isn’t to have sugar-laden chocolate cake with berries on top and call it a net positive because of the berries, though. Rather, Dr. Rossi lays out how to include as many diverse vegetables and fruits as possible, with tasty recipes so that we’re too busy with those to crave junk food.
Speaking of recipes, there are 80, and they are easy to follow. She describes them as “plant-based”, and by this what she really means is “plant-centric” or such; she does include the use of some animal products.
This is important to note, because general convention is to use “plant-based” to mean functionally vegan, but being about the food rather than the ideology; a relevant distinction in both society and science. In the case of this book, it’s neither, but it is very healthy.
Bottom line: if you’d like to introduce more healthy diversity to your diet, rather than eating the same three fruits and five vegetables, but you’re not sure how, this book will get you where you need to be.
Click here to check out Eat More, Live Well, and diversify your diet!
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Women want to see the same health provider during pregnancy, birth and beyond
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Hazel Keedle, Western Sydney University and Hannah Dahlen, Western Sydney University
In theory, pregnant women in Australia can choose the type of health provider they see during pregnancy, labour and after they give birth. But this is often dependent on where you live and how much you can afford in out-of-pocket costs.
While standard public hospital care is the most common in Australia, accounting for 40.9% of births, the other main options are:
- GP shared care, where the woman sees her GP for some appointments (15% of births)
- midwifery continuity of care in the public system, often called midwifery group practice or caseload care, where the woman sees the same midwife of team of midwives (14%)
- private obstetrician care (10.6%)
- private midwifery care (1.9%).
Given the choice, which model would women prefer?
Our new research, published BMC Pregnancy and Childbirth, found women favoured seeing the same health provider throughout pregnancy, in labour and after they have their baby – whether that’s via midwifery group practice, a private midwife or a private obstetrician.
Assessing strengths and limitations
We surveyed 8,804 Australian women for the Birth Experience Study (BESt) and 2,909 provided additional comments about their model of maternity care. The respondents were representative of state and territory population breakdowns, however fewer respondents were First Nations or from culturally or linguistically diverse backgrounds.
We analysed these comments in six categories – standard maternity care, high-risk maternity care, GP shared care, midwifery group practice, private obstetric care and private midwifery care – based on the perceived strengths and limitations for each model of care.
Overall, we found models of care that were fragmented and didn’t provide continuity through the pregnancy, birth and postnatal period (standard care, high risk care and GP shared care) were more likely to be described negatively, with more comments about limitations than strengths.
What women thought of standard maternity care in hospitals
Women who experienced standard maternity care, where they saw many different health care providers, were disappointed about having to retell their story at every appointment and said they would have preferred continuity of midwifery care.
Positive comments about this model of care were often about a midwife or doctor who went above and beyond and gave extra care within the constraints of a fragmented system.
The model of care with the highest number of comments about limitations was high-risk maternity care. For women with pregnancy complications who have their baby in the public system, this means seeing different doctors on different days.
Some respondents received conflicting advice from different doctors, and said the focus was on their complications instead of their pregnancy journey. One woman in high-risk care noted:
The experience was very impersonal, their focus was my cervix, not preparing me for birth.
Why women favoured continuity of care
Overall, there were more positive comments about models of care that provided continuity of care: private midwifery care, private obstetric care and midwifery group practice in public hospitals.
Women recognised the benefits of continuity and how this included informed decision-making and supported their choices.
The model of care with the highest number of positive comments was care from a privately practising midwife. Women felt they received the “gold standard of maternity care” when they had this model. One woman described her care as:
Extremely personable! Home visits were like having tea with a friend but very professional. Her knowledge and empathy made me feel safe and protected. She respected all of my decisions. She reminded me often that I didn’t need her help when it came to birthing my child, but she was there if I wanted it (or did need it).
However, this is a private model of care and women need to pay for it. So there are barriers in accessing this model of care due to the cost and the small numbers working in Australia, particularly in regional, rural and remote areas, among other barriers.
Women who had private obstetricians were also positive about their care, especially among women with medical or pregnancy complications – this type of care had the second-highest number of positive comments.
This was followed by women who had continuity of care from midwives in the public system, which was described as respectful and supportive.
However, one of the limitations about continuity models of care is when the woman doesn’t feel connected to her midwife or doctor. Some women who experienced this wished they had the opportunity to choose a different midwife or doctor.
What about shared care with a GP?
While shared care between the GP and hospital model of care is widely promoted in the public maternity care system as providing continuity, it had a similar number of negative comments to those who had fragmented standard hospital care.
Considering there is strong evidence about the benefits of midwifery continuity of care, and this model of care appears to be most acceptable to women, it’s time to expand access so all Australian women can access continuity of care, regardless of their location or ability to pay.
Hazel Keedle, Senior Lecturer of Midwifery, Western Sydney University and Hannah Dahlen, Professor of Midwifery, Associate Dean Research and HDR, Midwifery Discipline Leader, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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LGBTQ+ People Relive Old Traumas as They Age on Their Own
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Bill Hall, 71, has been fighting for his life for 38 years. These days, he’s feeling worn out.
Hall contracted HIV, the virus that can cause AIDS, in 1986. Since then, he’s battled depression, heart disease, diabetes, non-Hodgkin lymphoma, kidney cancer, and prostate cancer. This past year, Hall has been hospitalized five times with dangerous infections and life-threatening internal bleeding.
But that’s only part of what Hall, a gay man, has dealt with. Hall was born into the Tlingit tribe in a small fishing village in Alaska. He was separated from his family at age 9 and sent to a government boarding school. There, he told me, he endured years of bullying and sexual abuse that “killed my spirit.”
Because of the trauma, Hall said, he’s never been able to form an intimate relationship. He contracted HIV from anonymous sex at bath houses he used to visit. He lives alone in Seattle and has been on his own throughout his adult life.
“It’s really difficult to maintain a positive attitude when you’re going through so much,” said Hall, who works with Native American community organizations. “You become mentally exhausted.”
It’s a sentiment shared by many older LGBTQ+ adults — most of whom, like Hall, are trying to manage on their own.
Of the 3 million Americans over age 50 who identify as gay, bisexual, or transgender, about twice as many are single and living alone when compared with their heterosexual counterparts, according to the National Resource Center on LGBTQ+ Aging.
This slice of the older population is expanding rapidly. By 2030, the number of LGBTQ+ seniors is expected to double. Many won’t have partners and most won’t have children or grandchildren to help care for them, AARP research indicates.
They face a daunting array of problems, including higher-than-usual rates of anxiety and depression, chronic stress, disability, and chronic illnesses such as heart disease, according to numerous research studies. High rates of smoking, alcohol use, and drug use — all ways people try to cope with stress — contribute to poor health.
Keep in mind, this generation grew up at a time when every state outlawed same-sex relations and when the American Psychiatric Association identified homosexuality as a psychiatric disorder. Many were rejected by their families and their churches when they came out. Then, they endured the horrifying impact of the AIDS crisis.
“Dozens of people were dying every day,” Hall said. “Your life becomes going to support groups, going to visit friends in the hospital, going to funerals.”
It’s no wonder that LGBTQ+ seniors often withdraw socially and experience isolation more commonly than other older adults. “There was too much grief, too much anger, too much trauma — too many people were dying,” said Vincent Crisostomo, director of aging services for the San Francisco AIDS Foundation. “It was just too much to bear.”
In an AARP survey of 2,200 LGBTQ+ adults 45 or older this year, 48% said they felt isolated from others and 45% reported lacking companionship. Almost 80% reported being concerned about having adequate social support as they grow older.
Embracing aging isn’t easy for anyone, but it can be especially difficult for LGBTQ+ seniors who are long-term HIV survivors like Hall.
Related Links
- Americans With HIV Are Living Longer. Federal Spending Isn’t Keeping Up. Jun 17, 2024
- ‘Stonewall Generation’ Confronts Old Age, Sickness — And Discrimination May 22, 2019
- Staying Out Of The Closet In Old Age Oct 17, 2016
Of 1.2 million people living with HIV in the United States, about half are over age 50. By 2030, that’s estimated to rise to 70%.
Christopher Christensen, 72, of Palm Springs, California, has been HIV-positive since May 1981 and is deeply involved with local organizations serving HIV survivors. “A lot of people living with HIV never thought they’d grow old — or planned for it — because they thought they would die quickly,” Christensen said.
Jeff Berry is executive director of the Reunion Project, an alliance of long-term HIV survivors. “Here people are who survived the AIDS epidemic, and all these years later their health issues are getting worse and they’re losing their peers again,” Berry said. “And it’s triggering this post-traumatic stress that’s been underlying for many, many years. Yes, it’s part of getting older. But it’s very, very hard.”
Being on their own, without people who understand how the past is informing current challenges, can magnify those difficulties.
“Not having access to supports and services that are both LGBTQ-friendly and age-friendly is a real hardship for many,” said Christina DaCosta, chief experience officer at SAGE, the nation’s largest and oldest organization for older LGBTQ+ adults.
Diedra Nottingham, a 74-year-old gay woman, lives alone in a one-bedroom apartment in Stonewall House, an LGBTQ+-friendly elder housing complex in New York City. “I just don’t trust people,“ she said. “And I don’t want to get hurt, either, by the way people attack gay people.”
When I first spoke to Nottingham in 2022, she described a post-traumatic-stress-type reaction to so many people dying of covid-19 and the fear of becoming infected. This was a common reaction among older people who are gay, bisexual, or transgender and who bear psychological scars from the AIDS epidemic.
Nottingham was kicked out of her house by her mother at age 14 and spent the next four years on the streets. The only sibling she talks with regularly lives across the country in Seattle. Four partners whom she’d remained close with died in short order in 1999 and 2000, and her last partner passed away in 2003.
When I talked to her in September, Nottingham said she was benefiting from weekly therapy sessions and time spent with a volunteer “friendly visitor” arranged by SAGE. Yet she acknowledged: “I don’t like being by myself all the time the way I am. I’m lonely.”
Donald Bell, a 74-year-old gay Black man who is co-chair of the Illinois Commission on LGBTQ Aging, lives alone in a studio apartment in subsidized LGBTQ+-friendly senior housing in Chicago. He spent 30 years caring for two elderly parents who had serious health issues, while he was also a single father, raising two sons he adopted from a niece.
Bell has very little money, he said, because he left work as a higher-education administrator to care for his parents. “The cost of health care bankrupted us,” he said. (According to SAGE, one-third of older LGBTQ+ adults live at or below 200% of the federal poverty level.) He has hypertension, diabetes, heart disease, and nerve damage in his feet. These days, he walks with a cane.
To his great regret, Bell told me, he’s never had a long-term relationship. But he has several good friends in his building and in the city.
“Of course I experience loneliness,” Bell said when we spoke in June. “But the fact that I am a Black man who has lived to 74, that I have not been destroyed, that I have the sanctity of my own life and my own person is a victory and something for which I am grateful.”
Now he wants to be a model to younger gay men and accept aging rather than feeling stuck in the past. “My past is over,” Bell said, “and I must move on.”
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.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Vision for Life, Revised Edition – by Dr. Meir Schneider
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The “ten steps” would be better called “ten exercises”, as they’re ten things that one can (and should) continue to do on an ongoing basis, rather than steps to progress through and then forget about.
We can’t claim to have tested the ten exercises for improvement (this reviewer has excellent eyesight and merely hopes to maintain such as she gets older) but the rationale is compelling, and the public testimonials abundant.
Dr. Schneider also talks about improving and correcting errors of refraction—in other words, doing the job of any corrective lenses you may currently be using. While he doesn’t claim miracles, it turns out there is a lot that can be done for common issues such as near-sightedness and far-sightedness, amongst others.
There’s a large section on managing more chronic pathological eye conditions than this reviewer previously knew existed; in some cases it’s a matter of making sure things don’t get worse, but in many others, there’s a recurring of theme of “and here’s an exercise for correcting that”.
The writing style is a little more “narrative prose” than we’d have liked, but the quality of the content more than makes up for any style preference issues.
Bottom line: the human body is a highly adaptive organism, and sometimes it just needs a little help to correct itself. This book can help with that.
Click here to check out Vision for Life, and take good care of yours!
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Plant-Based Salmon Recipe
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From Tofu to Salmon
This video (below) by SweetPotatoSoul isn’t just a recipe tutorial; it’s an inspiring journey into the world of vegan cooking, proving that reducing animal products doesn’t have to mean sacrificing flavor.
The key to her vegan salmon is the tofu. However, there’s a trick to the tofu – you have to press it.
Essentially, this involved putting some paper towel on either side of the tofu, and then placing a heavy object on top; this removes excess water and, more importantly, primes the tofu to absorb the flavor of your marinade!
(You’ll want to press the tofu for around 1 hour)
Find the rest of the recipe in the 12-minute video below!
Other Plant-Based Recipes
With there being so many benefits of cutting meat out of your diet, we’ve spent the time reviewing some of the top books on vegan recipes, including The Green Roasting Tin and The Vegan Instant Pot Cookbook. We hope you enjoy them as much as you’ll enjoy this recipe:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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