How To Stay A Step Ahead Of Peripheral Artery Disease

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Far less well-known than Coronary Artery Disease, it can still result in loss of life and limb (not in that order). Fortunately, there are ways to be on your guard:

What it is

Peripheral Artery Disease (PAD) is the same thing as Coronary Artery Disease (CAD), just, in the periphery—which by definition means “outside of the heart and brain”, but in practice, it starts with the extremities. And of the extremities, it tends to start with the feet and legs, for the simple reason that if someone’s circulation is sluggish, then because of gravity, that’s where’s going to get blocked first.

In both CAD and PAD, the usual root cause is atherosclerosis, that is to say, the build-up of fatty material inside the arteries, usually commensurate to LDL (“bad”) cholesterol, especially in men (high LDL is still a predictor of cardiovascular disease in women though, just more modestly so, at least pre-menopause or in cases of treated menopause whereby HRT has returned hormones to pre-menopause levels).

See also: Demystifying Cholesterol

And for that about sex differences: His & Hers: The Hidden Complexities of Statins and Cardiovascular Disease (CVD)

Why it is

This one’s straightforward, as it’s the same things as any kind of cardiovascular disease: high blood pressure, high cholesterol, older age, obesity, smoking, drinking, diabetes, and genetic factors (so, a risk factor is: family history of heart disease).

However, while those are the main causes and/or risk factors, it absolutely can still strike other people, so it’s as well to be watch out for…

What to look out for

Many people first notice signs and symptoms that turn out to be PAD when they experience pain or numbness in the foot or feet, and/or a discoloration of the feet (especially toes), and slow wound healing.

At that stage, chances are you will need to go urgently to a specialist, and surgery is a likely necessity. With a little luck, it’ll be a minimally-invasive surgery to unblock an artery; failing that, an amputation will be in order.

At that stage, under 50% will be alive 5 years from diagnosis:

Cardiovascular and all-cause mortality in patients with intermittent claudication and critical limb ischaemia

You probably want to avoid those. Good news is, you can, by catching it earlier!

What to look out for before that

The most common test for PAD is one you can do at home, but enlisting a nurse to do it for you will help ensure accurate readings. It’s called the Ankle-Brachial Index (ABI) test, and it involves comparing the blood pressure in your ankle with the blood pressure in your arm, and expressing them as a ratio.

Here’s how to do it (instructions and a video demonstration if you want it):

Do Try This At Home: ABI Test For Clogged Arteries

If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

  • A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
  • Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
  • High ABI scores (above 1.4) may indicate artery hardening

Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy.

For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

There are other tests that clinicians can do for you, but you can’t do at home unless you have an MRI machine, a CT scanner, an x-ray machine, a doppler-and-ultrasound machine, etc. We’ll not go into those in detail here, but ask your doctor about them if you’re concerned.

What to do about it

In the mid-to-late stages of the disease, the options are medication and surgery, respectively, but your doctor will advise about those in that eventuality.

In the early stages of the disease, the first-line recommend treatment is exercise, of which, especially walking:

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment

Given that this more often happens when someone hasn’t been walking so much, it can be a walk-rest-walk approach at first (a treadmill on a low setting can be very useful for this):

See also: Exercise Comparison Head-to-Head: Treadmill vs Road

Take care!

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  • 13 Things Mentally Strong Couples Don’t Do – by Dr. Amy Morin

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    The saying “happy wife; happy life” indeed goes regardless of gender. One can have every other happiness, but if there’s relational trouble, it brings everything else down.

    This book is not intended, however, only for people whose relationships are one couple’s therapy session away from divorce. Rather, it’s intended as a preventative. Because, in this as in every other aspect of health, prevention is better than cure!

    It is the sign of a strong couple to be proactive about the health of the relationship, and work together to build and reinforce things along the way.

    The style of this book is very accessible pop-science, but the author speaks from a strong professional background in social work, psychology, and psychotherapy, and it shows.

    Bottom line: if you’d like to strengthen your relationship skills, this book gives 13 great ways to do that.

    Click here to check out 13 Things Mentally Strong Couples Don’t Do, and strengthen your relationship(s)!

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  • The Art of Being Unflappable (Tricks For Daily Life)

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    The Art of Being Unflappable

    From Stoicism to CBT, thinkers through the ages have sought the unflappable life.

    Today, in true 10almonds fashion, we’re going to distil it down to some concentrated essentials that we can all apply in our daily lives:

    Most Common/Impactful Cognitive Distortions To Catch (And Thus Avoid)

    These are like the rhetorical fallacies with which you might be familiar (ad hominem, no true Scotsman, begging the question, tu quoque, straw man, etc), but are about what goes on between your own ears, pertaining to your own life.

    If we learn about them and how to recognize them, however, we can catch them before they sabotage us, and remain “unflappable” in situations that could otherwise turn disastrous.

    Let’s take a look at a few:

    Catastrophizing / Crystal Ball

    • Distortion: not just blowing something out of proportion, but taking an idea and running with it to its worst possible conclusion. For example, we cook one meal that’s a “miss” and conclude we are a terrible cook, and in fact for this reason a terrible housewife/mother/friend/etc, and for this reason everyone will probably abandon us and would be right to do so
    • Reality: by tomorrow, you’ll probably be the only one who even remembers it happened

    Mind Reading

    • Distortion: attributing motivations that may or may not be there, and making assumptions about other people’s thoughts/feelings. An example is the joke about two partners’ diary entries; one is long and full of feelings about how the other is surely dissatisfied in their marriage, has been acting “off” with them all day, is closed and distant, probably wants to divorce, may be having an affair and is wondering which way to jump, and/or is just wondering how to break the news—the other partner’s diary entry is short, and reads “motorcycle won’t start; can’t figure out why”
    • Reality: sometimes, asking open questions is better than guessing, and much better than assuming!

    All-or-Nothing Thinking / Disqualifying the Positive / Magnifying the Negative

    • Distortion: having a negative bias that not only finds a cloud in every silver lining, but stretches it out so that it’s all that we can see. In a relationship, this might mean that one argument makes us feel like our relationship is nothing but strife. In life in general, it may lead us to feel like we are “naturally unlucky”.
    • Reality: those negative things wouldn’t even register as negative to us if there weren’t a commensurate positive we’ve experienced to hold them in contrast against. So, find and remember that positive too.

    For brevity, we put a spotlight on (and in some cases, clumped together) the ones we think have the most bang-for-buck to know about, but there are many more.

    So for the curious, here’s some further reading:

    Psychology Today: 50 Common Cognitive Distortions

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  • The Immunostimulant Superfood

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    Eat These Greens!

    Chlorella vulgaris, henceforth “chlorella”, is a simple green algae that has a lot of health benefits.

    Note: most of the studies here are for Chlorella vulgaris specifically. However, some are for other species of the Chlorella genus, of which Chlorella vulgaris is by far the most common, hence the name (vulgaris = common). The relevant phytochemical properties appear to be the same regardless.

    Superfood

    While people generally take it as a supplement rather than a food item in any kind of bulk, it is more than 50% protein and contains all 9 essential amino acids.

    As you might expect of a green superfood, it’s also full of many antioxidants, most of them carotenoids, and these pack a punch, for example against cancer:

    Antiproliferative effects of carotenoids extracted from Chlorella ellipsoidea and Chlorella vulgaris on human colon cancer cells

    It also has a lot of vitamins and minerals, and even omega-3.

    Which latter also means it helps improve lipids and is thus particularly…

    Heart healthy

    ❝Daily consumption of Chlorella supplements provided the potential of health benefits reducing serum lipid risk factors, mainly triglycerides and total cholesterol❞

    ~ Dr. Na Hee Ryu et al.

    Read more: Impact of daily Chlorella consumption on serum lipid and carotenoid profiles in mildly hypercholesterolemic adults: a double-blinded, randomized, placebo-controlled study

    Its heart-healthy benefits don’t stop at lipids though, and include blood pressure management, as in this study that found…

    ❝GABA-rich Chlorella significantly decreased high-normal blood pressure and borderline hypertension, and is a beneficial dietary supplement for prevention of the development of hypertension. ❞

    ~ Dr. Morio Shimada et al.

    Read more: Anti-hypertensive effect of gamma-aminobutyric acid (GABA)-rich Chlorella on high-normal blood pressure and borderline hypertension in placebo-controlled double blind study

    About that GABA, if you’re curious about that, check out:

    GABA Against Stress, Anxiety, & More

    May remove heavy metals

    We’re going with “may” for this one as we could only find animal studies so far (probably because most humans don’t have megadoses of heavy metals in them, which makes testing harder).

    Here’s an example animal study, though:

    Enhanced elimination of tissue methyl mercury in [Chlorella]-fed mice

    Immunostimulant

    This one’s clearer, for example in this 8-week study (with humans) that found…

    ❝Serum concentrations of interferon-γ (p<0.05) and interleukin-1β (p<0.001) significantly increased and that of interleukin-12 (p<0.1) tended to increase in the Chlorella group.

    The increments of these cytokines after the intervention were significantly bigger in the Chlorella group than those in the placebo group. In addition, NK cell activities (%) were significantly increased in Chlorella group, but not in Placebo group.

    The increments of NK cell activities (%) were also significantly bigger in the Chlorella group than the placebo group.

    Additionally, changed levels of NK cell activity were positively correlated with those of serum interleukin-1β (r=0.280, p=0.047) and interferon-γ (r=0.271, p<0.005).❞

    ~ Dr. Jung Hyun Kwak et al.

    tl;dr = it boosts numerous different kinds of immune cells

    Read more: Beneficial immunostimulatory effect of short-term Chlorella supplementation: enhancement of natural killer cell activity and early inflammatory response (randomized, double-blinded, placebo-controlled trial)

    PS, if you click though to the study, you may be momentarily alarmed by the first paragraph of the abstract that says “However, there were no direct evidences for the effect of Chlorella supplementation on immune/inflammation response in healthy humans“

    this is from the “Background” section of the abstract, so what they are saying is “before we did this study, nobody had done this yet”.

    So, be assured that the results are worthwhile and compelling.

    Is it safe?

    Based on the studies, it has a good safety profile. However, as it boosts the immune system, you may want to check with your doctor if you have an autoimmune disorder, and/or you are on immunosuppressants.

    And in general, of course always check with your doctor/pharmacist if unsure about any potential drug interactions.

    Want some?

    We don’t sell it, but here for your convenience is an example product on Amazon

    Enjoy!

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  • What are nootropics and do they really boost your brain?

    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.

    Humans have long been searching for a “magic elixir” to make us smarter, and improve our focus and memory. This includes traditional Chinese medicine used thousands of years ago to improve cognitive function.

    Now we have nootropics, also known as smart drugs, brain boosters or cognitive enhancers.

    You can buy these gummies, chewing gums, pills and skin patches online, or from supermarkets, pharmacies or petrol stations. You don’t need a prescription or to consult a health professional.

    But do nootropics actually boost your brain? Here’s what the science says.

    LuckyStep/Shutterstock

    What are nootropics and how do they work?

    Romanian psychologist and chemist Cornelius E. Giurgea coined the term nootropics in the early 1970s to describe compounds that may boost memory and learning. The term comes from the Greek words nӧos (thinking) and tropein (guide).

    Nootropics may work in the brain by improving transmission of signals between nerve cells, maintaining the health of nerve cells, and helping in energy production. Some nootropics have antioxidant properties and may reduce damage to nerve cells in the brain caused by the accumulation of free radicals.

    But how safe and effective are they? Let’s look at four of the most widely used nootropics.

    1. Caffeine

    You might be surprised to know caffeine is a nootropic. No wonder so many of us start our day with a coffee. It stimulates our nervous system.

    Caffeine is rapidly absorbed into the blood and distributed in nearly all human tissues. This includes the brain where it increases our alertness, reaction time and mood, and we feel as if we have more energy.

    For caffeine to have these effects, you need to consume 32-300 milligrams in a single dose. That’s equivalent to around two espressos (for the 300mg dose). So, why the wide range? Genetic variations in a particular gene (the CYP1A2 gene) can affect how fast you metabolise caffeine. So this can explain why some people need more caffeine than others to recognise any neurostimulant effect.

    Unfortunately too much caffeine can lead to anxiety-like symptoms and panic attacks, sleep disturbances, hallucinations, gut disturbances and heart problems.

    So it’s recommended adults drink no more than 400mg caffeine a day, the equivalent of up to three espressos.

    Two blue coffee cups on wooden table, one with coffee art, the other empty
    Caffeine can make you feel alert and can boost your mood. That makes it a nootropic. LHshooter/Shutterstock

    2. L-theanine

    L-theanine comes as a supplement, chewing gum or in a beverage. It’s also the most common amino acid in green tea.

    Consuming L-theanine as a supplement may increase production of alpha waves in the brain. These are associated with increased alertness and perception of calmness.

    However, it’s effect on cognitive functioning is still unclear. Various studies including those comparing a single dose with a daily dose for several weeks, and in different populations, show different outcomes.

    But taking L-theanine with caffeine as a supplement improved cognitive performance and alertness in one study. Young adults who consumed L-theanine (97mg) plus caffeine (40mg) could more accurately switch between tasks after a single dose, and said they were more alert.

    Another study of people who took L-theanine with caffeine at similar doses to the study above found improvements in several cognitive outcomes, including being less susceptible to distraction.

    Although pure L-theanine is well tolerated, there are still relatively few human trials to show it works or is safe over a prolonged period of time. Larger and longer studies examining the optimal dose are also needed.

    Two clear mugs of green tea, with leaves on wooden table
    The amino acid L-theanine is also in green tea. grafvision/Shutterstock

    3. Ashwaghanda

    Ashwaghanda is a plant extract commonly used in Indian Ayurvedic medicine for improving memory and cognitive function.

    In one study, 225-400mg daily for 30 days improved cognitive performance in healthy males. There were significant improvements in cognitive flexibility (the ability to switch tasks), visual memory (recalling an image), reaction time (response to a stimulus) and executive functioning (recognising rules and categories, and managing rapid decision making).

    There are similar effects in older adults with mild cognitive impairment.

    But we should be cautious about results from studies using Ashwaghanda supplements; the studies are relatively small and only treated participants for a short time.

    Ashwagandha is a plant extract
    Ashwaghanda is a plant extract commonly used in Ayurvedic medicine. Agnieszka Kwiecień, Nova/Wikimedia, CC BY-SA

    4. Creatine

    Creatine is an organic compound involved in how the body generates energy and is used as a sports supplement. But it also has cognitive effects.

    In a review of available evidence, healthy adults aged 66-76 who took creatine supplements had improved short-term memory.

    Long-term supplementation may also have benefits. In another study, people with fatigue after COVID took 4g a day of creatine for six months and reported they were better able to concentrate, and were less fatigued. Creatine may reduce brain inflammation and oxidative stress, to improve cognitive performance and reduce fatigue.

    Side effects of creatine supplements in studies are rarely reported. But they include weight gain, gastrointestinal upset and changes in the liver and kidneys.

    Where to now?

    There is good evidence for brain boosting effects of caffeine and creatine. But the jury is still out on the efficacy, optimal dose and safety of most other nootropics.

    So until we have more evidence, consult your health professional before taking a nootropic.

    But drinking your daily coffee isn’t likely to do much harm. Thank goodness, because for some of us, it is a magic elixir.

    Nenad Naumovski, Professor in Food Science and Human Nutrition, University of Canberra; Amanda Bulman, PhD candidate studying the effects of nutrients on sleep, University of Canberra, and Andrew McKune, Professor, Exercise Science, University of Canberra

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

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  • How To Rebuild Your Neurons’ Myelin Sheaths

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    PS: We Love You

    Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.

    In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).

    For an overview that’s more comprehensive than we have room for here, check out:

    Phosphatidylserine and the human brain

    Many people take it as a supplement.

    Does taking it as a supplement work?

    This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:

    ❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞

    ~ Glade & Smith.

    (“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)

    Why do people take it?

    The health claims for phosphatidylserine fall into two main categories:

    1. Neuroprotection (helping your brain to avoid age-related decline in the long term)
    2. Cognitive enhancement (helping your brain work better in the short term)

    What does the science say?

    There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:

    Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.

    There is no established difference in the efficacy of these.

    There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.

    There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:

    The effects of [phosphatidylserine supplementation] on cognitive function, mood and endocrine response before and following acute exercise

    (as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)

    PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.

    Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.

    Where can we get it?

    We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.

    Enjoy!

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  • Eat to Beat Your Diet – by Dr. William Li

    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.

    We previously reviewed Dr. Li’s excellent “Eat To Beat Disease”, so you may be wondering how much overlap there is. While he does still cover such topics as angiogenesis, organ regeneration, microbiome health, DNA protection, and immunological considerations, and much of the dietary advice is similar, most of the explanation is different.

    Because, this time, rather than looking at beating disease in general, there’s a much stronger focus on metabolic disease in particular, and yes, for those who want to do so, losing fat.

    The scientific explanations are in-depth, such that you come way with not merely “I should eat an avocado once in a while”, but a comprehensive understanding of the body’s metabolic processes, from the chemistry to the organs involved, from the cellular to the systemic.

    The style is on the hard end of pop-science. It’s approachably readable, while having a lot of densely-packed information with minimal fluff. You will be more than getting your money’s worth out of its 496 pages.

    Bottom line: if you’d like to perk up your metabolism with a dietary approach that’s enjoyable and very restrictive, then this book will arm you with the knowledge to do that.

    Click here to check out Eat To Beat Your Diet, and eat to beat your diet!

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