How to Think Like Leonardo da Vinci – by Michael J. Gelb
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Authors often try to bring forward the best minds of the distant past, and apply them to today’s world. One could fill a library with business advice adaptations from Sun Tzu’s Art of War alone, same goes for Miyamoto Musashi’s Book of Five Rings, and let’s not get started on Niccolò Machiavelli. What makes this book different?
Michael Gelb explores the principles codified and used by the infamous Renaissance Man to do exactly what he did: pretty much everything. Miyamoto Musashi had no interest in business, but Leonardo da Vinci really did care a lot about learning, creating, problem-solving, human connections, and much more. And best of all, he took notes. So many notes, for himself, of which we now enjoy the benefit.
How To Think Like Leonardo da Vinci explores these notes and their application by the man himself, and gives real, practical examples of how you can (and why you should) put them into action in your daily life, no matter whether you are a big business CEO or a local line cook or a reclusive academic, Leonardo has lessons for you.
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Osteoarthritis Of The Knee
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Very informative thank you. And made me think. I am a 72 yr old whitewoman, have never used ( or even been offered) HRT since menopause ~15 yrs ago. Now I’m wondering if it would have delayed the onset of osteoarthritis ( knee) and give me more energy in general. And is it wise to start taking hrt after being without those hormones for so long?❞
(this was in response to our article about menopausal HRT)
Thanks for writing! To answer your first question, obviously we can never know for sure now, but it certainly is possible, per for example a large-ish (n=1003) study of women aged 45–64, in which:
- Those with HRT were significantly less likely to have knee arthritis than those without
- However, to enjoy this benefit depended on continued use (those who used it for a bit and then stopped did not enjoy the same results)
- While it made a big difference to knee arthritis, it made only a small (but still beneficial) difference to wrist/hand arthritis.
We could hypothesize that this is because the mechanism of action is more about strengthening the bones (proofing against osteoporosis is one of the main reasons many people take HRT) and cartilage than it is against inflammation directly.
Since the knee is load-bearing and the hand/wrist joints usually are not, this would mean the HRT strengthening the bones makes a big difference to the “wear and tear” aspect of potential osteoarthritis of the knee, but not the same level of benefit for the hand/wrist, which is less about wear and tear and more about inflammatory factors. But that latter, about it being load-bearing, is just this writer’s hypothesis as to why the big difference.
The researchers do mention:
❝In OA the mechanisms by which HRT might act are highly speculative, but could entail changes in cartilage repair or bone turnover, perhaps with cytokines such as interleukin 6, for example.❞
What is clear though, is that it does indeed appear to have a protective effect against osteoarthritis of the knee.
With regard to the timing, the researchers do note:
❝Why as little as three years of HRT should have a demonstrable effect is unclear. Given the difficulty in ascertaining when the disease starts, it is hard to be sure of the importance of the timing of HRT, and whether early or subclinical disease was present.
These results taken together suggest that HRT has a metabolic action that is only effective if given continuously, perhaps by preventing disease initiation; once HRT is stopped there might be a ‘rebound’ effect, explaining the rapid return to normal risk❞
~ Ibid.
You can read the study here:
On whether it is worth it now…
Again, do speak with an endocrinologist because your situation may vary, but:
- hormones are simply messengers, and your body categorically will respond to those messages regardless of age, or time elapsed without having received such a message. Whether it will repair all damage done is another matter entirely, but it would take a biological miracle for it to have no effect at all.
- anecdotally, many women do enjoy life-changing benefits upon starting HRT at your age and older!
(We don’t like to rely on “anecdotally”, but we couldn’t find studies isolating according to “length of time since menopause”—we’ll keep an eye out and if we find something in the future, we’ll mention it!)
Meanwhile, take care!
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Yes, you do need to clean your tongue. Here’s how and why
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Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health.
The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity.
But there’s no need to wait for a trip to the doctor. Cleaning your tongue twice a day can help you check how your tongue looks and feels – and improve your breath.
luisrsphoto/Shutterstock What does a healthy tongue look like?
Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move.
The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface.
These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0
A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light pink.
A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or other issues.
How should I clean my tongue?
Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine.
Build-up can occur if you stop brushing or scraping your tongue even for a few days. Anthony Shkraba/Pexels You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface.
Or you can use a special tongue scraper. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush.
Your co-workers will thank you as well – cleaning your tongue can help combat stinky breath. Tongue scrapers are particularly effective at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface.
What’s that stuff on my tongue?
So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP.
Here’s what your tongue might be telling you.
White coating
Developing a white coating on the tongue’s surface is one of the most common changes in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days.
In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause serious illnesses.
Scrubbing or scraping your tongue only takes around ten seconds and can be done while brushing your teeth. Ketut Subiyanto/Pexels Yellow coating
This may indicate oral thrush, a fungal infection that leaves a raw surface when scrubbed.
Oral thrush is common in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary suppression of the immune system or antibiotic use.
If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month.
Black coating
Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a black hairy tongue. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene.
Smoking can add to poor oral hygiene and make the tongue look black. Sophon Nawit/Shutterstock Pink patches
Pink patches surrounded by a white border can make your tongue look like a map – this is called “geographic tongue”. It’s not known what causes this condition, which usually doesn’t require treatment.
Pain and inflammation
A red, sore tongue can indicate a range of issues, including:
- nutritional deficiencies such as folic acid or vitamin B12
- diseases including pernicious anaemia, Kawasaki disease and scarlet fever
- inflammation known as glossitis
- injury from hot beverages or food
- ulcers, including cold sores and canker sores
- burning mouth syndrome.
Dryness
Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt.
What about cancer?
White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a higher risk of turning into cancer, compared to other parts of the mouth.
Oral cancers have low survival rates due to delayed detection – and they are on the rise. So checking your tongue for changes in colour, texture, sore spots or ulcers is critical.
Dileep Sharma, Professor and Head of Discipline – Oral Health, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hair-Loss Remedies, By Science
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10almonds Gets Hairy
Hair loss is a thing that at some point affects most men and a large minority of women. It can be a source of considerable dysphoria for both, as it’s often seen as a loss of virility/femininity respectively, and is societally stigmatized in various ways.
Today we’re going to focus on the most common kind: androgenic alopecia, which is called “male pattern baldness” in men and “female pattern baldness” in women, despite being the same thing.
We won’t spend a lot of time on the science of why this happens (we’re going to focus on the remedies instead), but suffice it to say that genes and hormones both play a role, with dihydrogen testosterone (DHT) being the primary villain in this case.
We’ve talked before about the science of 5α-reductase inhibitors to block the conversion of regular testosterone* to DHT, its more potent form:
One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens…
*We all make this to a greater or lesser degree, unless we have had our ovaries/testes removed.
Finasteride
Finasteride is a 5α-reductase inhibitor that performs similarly to saw palmetto, but comes in tiny pills instead of needing to take a much higher dose of supplement (5mg of finasteride is comparable in efficacy to a little over 300mg of saw palmetto).
Does it work? Yes!
Any drawbacks? A few:
- It’ll take 3–6 months to start seeing effects. This is because of the hormonal life-cycle of human hairs.
- Common side-effects include ED.
- It is popularly labelled/prescribed as “only for men”
On that latter point: the warnings about this are severe, detailing how women must not take it, must not even touch it if it has been cut up or crushed.
However… That’s because it can carry a big risk to our unborn fetuses. So, if we are confident we definitely don’t have one of those, it’s not actually applicable to us.
That said, finasteride’s results in women aren’t nearly so clear-cut as in men (though also, there has been less research, largely because of the above). Here’s an interesting breakdown in more words than we have room for here:
Finasteride for Women: Everything You Need to Know
Spironolactone
This one’s generally prescribed to women, not men, largely because it’s the drug sometimes popularly known as a “chemical castration” drug, which isn’t typically great marketing for men (although it can be applied topically, which will have less of an effect on the rest of the body). For women, this risk is simply not an issue.
We’ll be brief on this one, but we’ll just drop this, so that you know it’s an option that works:
❝Spironolactone is an effective and safe treatment of androgenic alopecia which can enhance the efficacy when combined with other conventional treatments such as minoxidil.
Topical spironolactone is safer than oral administration and is suitable for both male and female patients, and is expected to become a common drug for those who do not have a good response to minoxidil❞
Minoxidil
This one is available (to men and women) without prescription. It’s applied topically, and works by shortcutting the hair’s hormonal growth cycle, to reduce the resting phase and kick it into a growth phase.
Does it work? Yes!
Any drawbacks? A few:
- Whereas you’ll remember finasteride takes 3–6 months to see any effect, this one will have an effect very quickly
- Specifically, the immediate effect is: your rate of hair loss will appear to dramatically speed up
- This happens because when hairs are kicked into their growth phase if they were in a resting phase, the first part of that growth phase is to shed each old hair to make room for the new one
- You’ll then need the same 3–6 months as with finasteride, to see the regrowth effects
- If you stop using it, you will immediately shed whatever hair you gained by this method
Why do people choose this over finasteride? For one of three reasons, mainly:
- They are women, and not offered finasteride
- They are men, and do not want the side effects of finasteride
- They just saw an ad and tried it
As to how it works:
Some final notes:
There are some other contraindications and warnings with each of these drugs by the way, so do speak with your doctor/pharmacist. For example:
- Finasteride can tax the liver a little
- Spironolactone can reduce bone turnover
- Minoxidil is a hypotensive; this shouldn’t be an issue for most people, but for some people it could be a problem
There are other hair loss remedies and practices, but the above three are the heavy-hitters, so that’s what we spent our time/space on today. We’ll perhaps cover the less powerful (but less risky) options one of these days.
Meanwhile, take care!
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How To Survive A Heart Attack When You’re Alone
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Dr. Alan Mandel emphasizes the importance of staying calm and following these steps to improve survival chances:
Simple is best
Here’s how you will survive a heart attack alone: briefly.
So, you will need to get help as quickly as possible. 90% of people who make it to a hospital alive, go on to survive their heart attack, so that’s your top priority.
Call emergency services as soon as you suspect you are having a heart attack. Stay on the line, and stay calm.
While having a heart attack is not an experience that’s very conducive to relaxation, heightened emotions will exacerbate things, so focus on breathing calmly. One of the commonly reported symptoms of heart attack that doesn’t often make it to official lists is “a strong sense of impending doom”, and that is actually helpful as it helps separate it from “is this indigestion?” or such, but once you have acknowledged “yes, this is probably a heart attack”, you need to put those feelings aside for later.
If you have aspirin available, Dr. Mandel says that the time to take it is once you have called an ambulance. However, if aspirin is not readily available, do not exert yourself trying to find some; indeed, don’t move more than necessary.
Do not drive yourself to hospital; it will increase the risk of fainting, and you may crash.
While you are waiting, your main job is to remain calm; he recommends deep breathing, and lying with knees elevated or feet on a chair; this latter is to minimize the strain on your heart.
For more on all this, plus the key symptoms and risk factors, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Heart Attack: His & Hers (Be Prepared!)
Take care!
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Ginkgo Biloba, For Memory And, Uh, What Else Again?
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Ginkgo biloba, for memory and, uh, what else again?
Ginkgo biloba extract has enjoyed use for thousands of years for an assortment of uses, and has made its way from Traditional Chinese Medicine, to the world supplement market at large. See:
Ginkgo biloba: A Treasure of Functional Phytochemicals with Multimedicinal Applications
But what does the science say about the specific claims?
Antioxidant & anti-inflammatory
We’re going to lump these two qualities together for examination, since one invariably leads to the other.
A quick note: things that have antioxidant and anti-inflammatory properties, often also help guard against cancer and aging. However, in this case, there are few good studies pertaining to anti-aging, and none that we could find pertaining to anti-cancer potential.
So, does it have antioxidant and anti-inflammatory properties, first?
Yes, it has potent antioxidants that do fight inflammation; this is clear, from an abundance of in vitro and in vivo studies, including with human patients:
- Properties of Ginkgo biloba L.: incl. Antioxidant Characterization
- Anti-inflammatory effects of Ginkgo biloba extract against hippocampal neuronal injury
- Gingko biloba-derived lactone prevents osteoarthritis by activating anti-inflammatory signaling pathway
- The anti-inflammatory properties of Ginkgo biloba for the treatment of pulmonary diseases
In short: it helps, and there’s plenty of science for it.
What about anti-aging effects?
For this, there is science, but a lot of the science is not great. As one team of researchers concluded while doing a research review of their own:
❝Based on the reviewed information regarding EGb’s effects in vitro and in vivo, most have reported very positive outcomes with strong statistical analyses, indicating that EGb must have some sort of beneficial effect.
However, information from the reported clinical trials involving EGb are hardly conclusive since many do not include information such as the participant’s age and physical condition, drug doses administered, duration of drug administered as well as suitable control groups for comparison.
We therefore call on clinicians and clinician-scientists to establish a set of standard and reliable standard operating procedure for future clinical studies to properly evaluate EGb’s effects in the healthy and diseased person since it is highly possible it possesses beneficial effects.❞
Translation from sciencese: “These results are great, but come on, please, we are begging you to use more robust methodology”
If you’d like to read the review in question, here it is:
Advances in the Studies of Ginkgo Biloba Leaves Extract on Aging-Related Diseases
Does it have cognitive enhancement effects?
The claims here are generally that it helps:
- improve memory
- improve focus
- reduce cognitive decline
- reduce anxiety and depression
Let’s break these down:
Does it improve memory and cognition?
Ginkgo biloba was quite popular for memory 20+ years ago, and perhaps had an uptick in popularity in the wake of the 1999 movie “Analyze This” in which the protagonist psychiatrist mentions taking ginkgo biloba, because “it helps my memory, and I forget what else”.
Here are a couple of studies from not long after that:
- A double-blind, placebo-controlled, randomized trial of Ginkgo biloba in cognitively intact older adults: neuropsychological findings
- Effects of Ginkgo biloba on mental functioning in healthy volunteers
In short:
- in the first study, it helped in standardized tests of memory and cognition (quite convincing)
- In the second study, it helped in subjective self-reports of mental wellness (also placebo-controlled)
On the other hand, here’s a more recent research review ten years later, that provides measures of memory, executive function and attention in 1132, 534 and 910 participants, respectively. That’s quite a few times more than the individual studies we cited above, by the way. They concluded:
❝We report that G. biloba had no ascertainable positive effects on a range of targeted cognitive functions in healthy individuals❞
Read: Is Ginkgo biloba a cognitive enhancer in healthy individuals? A meta-analysis
Our (10almonds) conclusion: we can’t say either way, on this one.
Does it have neuroprotective effects (i.e., against cognitive decline)?
Yes—probably by the same mechanism will discuss shortly.
- Ginkgo Biloba for Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Treatment effects of Ginkgo biloba extract on symptoms of dementia: meta-analysis of randomized controlled trials
Can it help against depression and anxiety?
Yes—but probably indirectly by the mechanism we’ll get to in a moment:
- Role of Ginkgo biloba extract as an adjunctive treatment of elderly patients with depression
- Ginkgo biloba in generalized anxiety disorder and adjustment disorder with anxious mood
Likely this helps by improving blood flow, as illustrated better per:
Efficacy of ginkgo biloba extract as augmentation of venlafaxine in treating post-stroke depression
Which means…
Bonus: improved blood flow
This mechanism may support the other beneficial effects.
See: Ginkgo biloba extract improves coronary blood flow in healthy elderly adults
Is it safe?
Ginkgo biloba extract* is generally recognized as safe.
- However, as it improves blood flow, please don’t take it if you have a bleeding disorder.
- Additionally, it may interact badly with SSRIs, so you might want to avoid it if you’re taking such (despite it having been tested and found beneficial as an adjuvant to citalopram, an SSRI, in one of the studies above).
- No list of possible contraindications can be exhaustive, so please consult your own doctor/pharmacist before taking something new.
*Extract, specifically. The seeds and leaves of this plant are poisonous. Sometimes “all natural” is not better.
Where can I get it?
As ever, we don’t sell it (or anything else), but here’s an example product on Amazon
Enjoy!
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The Vagus Nerve (And How You Can Make Use Of It)
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The Vagus Nerve: The Brain-Gut Highway
The longest cranial nerve is the vagus nerve; it runs all the way from your brain to your colon. It’s very important, and (amongst other tasks) it largely regulates your parasympathetic nervous system, and autonomous functions like:
- Breathing
- Heart rate
- Vasodilation & vasoconstriction
- Blood pressure
- Reflex actions (e.g. coughing, sneezing, swallowing, vomiting, hiccuping)
That’s great, but how does knowing about it help us?
Because of vagal maneuvers! This means taking an action to stimulate the vagus nerve, and prompt it to calm down various bodily functions that need calming down. This can take the form of:
- Massage
- Electrostimulation
- Diaphragmatic breathing
Massage is perhaps the simplest; “vagus” means “wandering”, and the nerve is accessible in various places, including behind the ears. That’s the kind of thing that’ easier to show than tell, though, so we’ll include a video at the end.
Electrostimulation is the fanciest, and has been used to treat migraines and cluster headaches. Check out, for example:
Update on noninvasive neuromodulation for migraine treatment-Vagus nerve stimulation
Diaphragmatic breathing means breathing from the diaphragm—the big muscular tissue that sits under your lungs. You might know it as “abdominal breathing”, and refers to breathing “to the abdomen” rather than merely to the chest.
Even though your lungs are obviously in your chest not your abdomen, breathing with a focus on expanding the abdomen (rather than the chest) when breathing in, will result in much deeper breathing as the diaphragm allows the lungs to fill downwards as well as outwards.
Why this helps when it comes to the vagus nerve is simply that the vagus nerve passes by the diaphragm, such that diaphragmatic breathing will massage the vagus nerve deep inside your body.
More than just treating migraines
Vagus nerve stimulation has also been researched and found potentially helpful for managing:
- Depression, inflammation, and heart disease
- Diabetes and glycemic issues in general
- Multiple sclerosis and autoimmune disease in general
- Alzheimer’s disease and dementia in general
- Rheumatoid arthritis (we already mentioned inflammation and autoimmune diseases, but this is an interesting paper so we included it)
All this is particularly important as we get older, because vagal response reduces with age, and vagus nerve stimulation, which improves vagal tone, makes it easier not just to manage the aforementioned maladies, but also simply to relax more easily and more deeply.
See: Influence of age and gender on autonomic regulation of heart
We promised a video for the massage, so here it is:
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