Ikigai – by Héctor García and Francesc Miralles
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Ikigai is the Japanese term for what in English we often call “raison d’être”… in French, because English is like that.
But in other words: ikigai is one’s purpose in life, one’s reason for living.
The authors of this work spend some chapters extolling the virtues of finding one’s ikigai, and the health benefits that doing so can convey. It is, quite clearly, an important and relevant factor.
The rest of the book goes beyond that, though, and takes a holistic look at why (and how) healthy longevity is enjoyed by:
- Japanese people in general,
- Okinawans in particular,
- Residents of Okinawa’s “blue zone” village with the highest percentage of supercentenarians, most of all.
Covering considerations from ikigai to diet to small daily habits to attitudes to life, we’re essentially looking at a blueprint for healthy longevity.
For a book whose title and cover suggests a philosophy-heavy content, there’s a lot of science in here too, by the way! From microbiology to psychiatry to nutrition science to cancer research, this book covers all bases.
In short: this book gives a lot of good science-based suggestions for adjustments we can make to our lives, without moving to an Okinawan village!
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The Emperor’s New Klotho, Or Something More?
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Unzipping The Genes Of Aging?
Klotho is an enzyme encoded in humans’ genes—specifically, in the KL gene.
It’s found throughout all living parts of the human body (and can even circulate about in its hormonal form, or come to rest in its membranaceous form), and its subgroups are especially found:
- α-klotho: in the brain
- β-klotho: in the liver
- γ-klotho: in the kidneys
Great! Why do we care?
Klotho, its varieties and variants, its presence or absence, are very important in aging.
Almost every biological manifestation of aging in humans has some klotho-related indicator; usually the decrease or mutation of some kind of klotho.
Which way around the cause and effect go has been the subject of much debate and research: do we get old because we don’t have enough klotho, or do we make less klotho because we’re getting old?
Of course, everything has to be tested per variant and per system, so that can take a while (punctuated by research scientists begging for more grants to do the next one). Given that it’s about aging, testing in humans would take an incredibly long while, so most studies so far have been rodent studies.
The general gist of the results of rodent studies is “reduced klotho hastens aging; increased klotho slows it”.
(this can be known by artificially increasing or decreasing the level of klotho expression, again something easier in mice as it is harder to arrange transgenic humans for the studies)
Here’s one example of many, of that vast set of rodent studies:
Suppression of Aging in Mice by the Hormone Klotho
Relevance for Alzheimer’s, and a science-based advice
A few years ago (2020), an Alzheimer’s study was undertaken; they noted that the famous apolipoprotein E4 (apoE4) allele is the strongest genetic risk factor for Alzheimer’s, and that klotho may be another. FGF21 (secreted by the liver, mostly during fasting) binds to its own receptor (FGFR1) and its co-receptor β-klotho. Since this is a known neuroprotective factor, they wondered whether klotho itself may interact with β-amyloid (Aβ), and found:
❝Aβ can enhance the ability of klotho to draw FGF21 to regions of incipient neurodegeneration in AD❞
In other words: β-amyloid, the substance whose accumulation is associated with neurodegeneration in Alzheimer’s disease, is a mediator in klotho bringing a known neuroprotective factor, FGF21, to the areas of neurodegeneration
In fewer words: klotho calls the firefighters to the scene of the fire
Read more: Alignment of Alzheimer’s disease amyloid β-peptide and klotho
The advice based on this? Consider practicing intermittent fasting, if that is viable for you, as it will give your liver more FGF21-secreting time, and the more FGF21, the more firefighters arrive when klotho sounds the alarm.
See also: Intermittent Fasting: What’s the truth?
…and while you’re at it:
Does intermittent fasting have benefits for our brain?
A more recent (2023) study with a slightly different (but connected) purpose, found results consistent with this:
Longevity factor klotho enhances cognition in aged nonhuman primates
…and, for that matter this (2023) study that found:
Associations between klotho and telomere biology in high stress caregivers
…which looks promising, but we’d like to see it repeated with a sounder method (they sorted caregiving into “high-stress” and “low-stress” depending on whether a child was diagnosed with ASD or not, which is by no means a reliable way of sorting this). They did ask for reported subjective stress levels, but to be more objective, we’d like to see clinical markers of stress (e.g. cortisol levels, blood pressure, heart rate changes, etc).
A very recent (April 2024) study found that it has implications for more aspects of aging—and this time, in humans (but using a population-based cohort study, rather than lab conditions):
Can I get it as a supplement?
Not with today’s technology and today’s paucity of clinical trials, you can’t. Maybe in the future!
However… The presence of senescent (old, badly copied, stumbling and staggering onwards when they should have been killed and eaten and recycled already) cells actively reduces klotho levels, which means that taking supplements that are senolytic (i.e., that kill those senescent cells) can increase serum klotho levels:
Orally-active, clinically-translatable senolytics restore α-Klotho in mice and humans
Ok, what can I take for that?
We wrote about a senolytic supplement that you might enjoy, recently:
Fisetin: The Anti-Aging Assassin
Want to know more?
If you have the time, Dr. Peter Attia interviews Dr. Dena Dubal (researcher in several of the above studies) here:
Click Here If The Embedded Video Doesn’t Load Automatically
Enjoy!
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Toxic Gas That Sterilizes Medical Devices Prompts Safety Rule Update
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Over the past two years, Madeline Beal has heard frustration and even bewilderment during public meetings about ethylene oxide, a cancer-causing gas that is used to sterilize half of the medical devices in the U.S.
Beal, senior risk communication adviser for the Environmental Protection Agency, has fielded questions about why the agency took so long to alert people who live near facilities that emit the chemical about unusually high amounts of the carcinogenic gas in their neighborhoods. Residents asked why the EPA couldn’t close those facilities, and they wanted to know how many people had developed cancer from their exposure.
“If you’re upset by the information you’re hearing tonight, if you’re angry, if it scares you to think about risk to your family, those are totally reasonable responses,” Beal told an audience in Laredo, Texas, in September 2022. “We think the risk levels near this facility are too high.”
There are about 90 sterilizing plants in the U.S. that use ethylene oxide, and for decades companies used the chemical to sterilize medical products without drawing much attention. Many medical device-makers send their products to the plants to be sterilized before they are shipped, typically to medical distribution companies.
But people living around these facilities have been jolted in recent years by a succession of warnings about cancer risk from the federal government and media reports, an awareness that has also spawned protests and lawsuits alleging medical harm.
The EPA is expected to meet a March 1 court-ordered deadline to finalize tighter safety rules around how the toxic gas is used. The proposed changes come in the wake of a 2016 agency report that found that long-term exposure to ethylene oxide is more dangerous than was previously thought.
But the anticipated final rules — the agency’s first regulatory update on ethylene oxide emissions in more than a decade — are expected to face pushback. Medical device-makers worry stricter regulation will increase costs and may put patients at higher risk of infection from devices, ranging from surgical kits to catheters, due to deficient sterilization. The new rules are also not likely to satisfy the concerns of environmentalists or members of the public, who already have expressed frustration about how long it took the federal government to sound the alarm.
“We have been breathing this air for 40 years,” said Connie Waller, 70, who lives with her husband, David, 75, within two miles of such a sterilizing plant in Covington, Georgia, east of Atlanta. “The only way to stop these chemicals is to hit them in their pocketbook, to get their attention.”
The EPA says data shows that long-term exposure to ethylene oxide can increase the risk of breast cancer and cancers of the white blood cells, such as non-Hodgkin lymphoma, myeloma, and lymphocytic leukemia. It can irritate the eyes, nose, throat, and lungs, and has been linked to damage to the brain and nervous and reproductive systems. Children are potentially more vulnerable, as are workers routinely exposed to the chemical, EPA officials say. The agency calculates the risk based on how much of the gas is in the air or near the sterilizing facility, the distance a person is from the plant, and how long the person is exposed.
Waller said she was diagnosed with breast cancer in 2004 and that her husband was found to have non-Hodgkin lymphoma eight years later.
A 2022 study of communities living near a sterilization facility in Laredo found the rates of acute lymphocytic leukemia and breast cancer were greater than expected based on statewide rates, a difference that was statistically significant.
Beal, the EPA risk adviser, who regularly meets with community members, acknowledges the public’s concerns. “We don’t think it’s OK for you to be at increased risk from something that you have no control over, that’s near your house,” she said. “We are working as fast as we can to get that risk reduced with the powers that we have available to us.”
In the meantime, local and state governments and industry groups have scrambled to defuse public outcry.
Hundreds of personal injury cases have been filed in communities near sterilizing plants. In 2020, New Mexico’s then-attorney general filed a lawsuit against a plant in Santa Teresa, and that case is ongoing. In a case that settled last year in suburban Atlanta, a company agreed to pay $35 million to 79 people who alleged ethylene oxide used at the plant caused cancer and other injuries.
In Cook County, Illinois, a jury in 2022 awarded $363 million to a woman who alleged exposure to ethylene oxide gas led to her breast cancer diagnosis. But, in another Illinois case, a jury ruled that the sterilizing company was not liable for a woman’s blood cancer claim.
Greg Crist, chief advocacy officer for the Advanced Medical Technology Association, a medical device trade group that says ethylene oxide is an effective and reliable sterilant, attributes the spate of lawsuits to the litigious nature of trial attorneys.
“If they smell blood in the water, they’ll go after it,” Crist said.
Most states have at least one sterilizing plant. According to the EPA, a handful, like California and North Carolina, have gone further than the agency and the federal Clean Air Act to regulate ethylene oxide emissions. After a media and political firestorm raised awareness about the metro Atlanta facilities, Georgia started requiring sterilizing plants that use the gas to report all leaks.
The proposed rules the EPA is set to finalize would set lower emissions limits for chemical plants and commercial sterilizers and increase some safety requirements for workers within these facilities. The agency is expected to set an 18-month deadline for commercial sterilizers to come into compliance with the emissions rules.
That would help at facilities that “cut corners,” with lax pollution controls that allow emissions of the gas into nearby communities, said Richard Peltier, a professor of environmental health sciences at the University of Massachusetts-Amherst. Stronger regulation also prevents the plants from remaining under the radar. “One of the dirty secrets is that a lot of it is self-regulated or self-policed,” Peltier added.
But the proposed rules did not include protections for workers at off-site warehouses that store sterilized products, which can continue to emit ethylene oxide. They also did not require air testing around the facilities, prompting debate about how effective they would be in protecting the health of nearby residents.
Industry officials also don’t expect an alternative that is as broadly effective as ethylene oxide to be developed anytime soon, though they support researching other methods. Current alternatives include steam, radiation, and hydrogen peroxide vapor.
Increasing the use of alternatives can reduce industry dependence on “the crutch of ethylene oxide,” said Darya Minovi, senior analyst with the Union of Concerned Scientists, an advocacy group.
But meeting the new guidelines will be disruptive to the industry, Crist said. He estimates companies will spend upward of $500 million to comply with the new EPA rules and could struggle to meet the agency’s 18-month timetable. Sterilization companies will also have difficulty adjusting to new rules on how workers handle the gas without a dip in efficiency, Crist said.
The Food and Drug Administration, which regulates drugs and medical devices, is also watching the regulatory moves closely and worries the updated emissions rule could “present some unique challenges” if implemented as proposed, said Audra Harrison, an FDA spokesperson. “The FDA is concerned about the rule’s effects on the availability of medical devices,” she added.
Other groups, like the American Chemistry Council and the Texas Commission on Environmental Quality, the state’s environmental agency, assert that ethylene oxide use isn’t as dangerous as the EPA says. The EPA’s toxicity assessment has “severe flaws” and is “overly conservative,” the council said in an emailed statement. Texas, which has several sterilizing plants, has said ethylene oxide isn’t as high a cancer risk as the agency claims, an assessment that the EPA has rejected.
Tracey Woodruff, a researcher at the University of California-San Francisco who previously worked at the EPA, said it can be hard for the agency to keep up with regulating chemicals like ethylene oxide because of constrained resources, the technical complications of rulemaking, and industry lobbying.
But she’s hopeful the EPA can strike a balance between its desire to reduce exposure and the desire of the FDA not to disrupt medical device sterilization. And scrutiny can also help the device sterilization industry think outside the box.
“We continue to discover these chemicals that we’ve already been exposed to were toxic, and we have high exposures,” she said. “Regulation is an innovation forcer.”
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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The Green Roasting Tin – by Rukmini Iyer
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You may be wondering: “do I really need a book to tell me to put some vegetables in a roasting tin and roast them?” and maybe not, but the book offers a lot more than that.
Indeed, the author notes “this book was slightly in danger of becoming the gratin and tart book, because I love both”, but don’t worry, most of the recipes are—as you might expect—very healthy.
As for formatting: the 75 recipes are divided first into vegan or vegetarian, and then into quick/medium/slow, in terms of how long they take.
However, even the “slow” recipes don’t actually take more effort, just, more time in the oven.
One of the greatest strengths of this book is that not only does it offer a wide selection of wholesome mains, but also, if you’re putting on a big spread, these can easily double up as high-class low-effort sides.
Bottom line: if you’d like to eat more vegetables in 2024 but want to make it delicious and with little effort, put this book on your Christmas list!
Click here to check out The Green Roasting Tin, and level-up yours!
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Medical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Vodka vs Beer – Which is Healthier?
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Our Verdict
When comparing vodka to beer, we picked the vodka.
Why?
As you might have guessed, neither are exactly healthy. But one of them is relatively, and we stress relatively, less bad than the other.
In the category of nutrients, vodka is devoid of nutrients, and beer has small amounts of some vitamins and minerals—but the amounts are so small, that you would need to drink yourself to death before benefiting from them meaningfully. And while beer gets touted as “liquid bread”, it really isn’t. A thousand years ago it will have been a lot less alcoholic and more carby, but even then, it wasn’t a health product aside from that it provided a way of making potentially contaminated water safer to drink.
In the category of carbohydrates, vodka nominally has none, due to the distillation process, and beer has some. Glycemic index websites often advise that the GI of beers, wines, and spirits can’t be measured as their carb content is not sufficient to get a meaningful sample, but diabetes research tells a more useful story:
Any alcoholic drink will generally cause a brief drop in blood sugars, followed by a spike. This happens because the liver prioritises metabolizing alcohol over producing glycogen, so it hits pause on the sugar metabolism and then has a backlog to catch up on. In the case of alcoholic drinks that have alcohol and carbs, this will be more pronounced—so this means that the functional glycemic load of beer is higher.
That’s a point in favor of vodka.
Additionally, in terms of the alcohol content, correctly-distilled vodka’s alcohol is pure ethanol, while beer will contain an amount of methanol that will vary per beer, but an illustrative nominal figure could be about 16mg/L. Methanol is more harmful than ethanol.
So that’s another point in favor of vodka.
Once again, neither drink is healthy; both are distinctly unhealthy. But unit for unit, beer is the least healthy of the two, making vodka the lesser of two evils.
Want to learn more?
You might like to read:
- Can We Drink To Good Health? (answer: we cannot, but this was about alcohol’s proposed heart-healthy benefits)
- Guinness Is Good For You* (it isn’t, but this was the long-time slogan and marketing campaign that fooled many)
- How To Reduce Or Quit Alcohol
- How To Unfatty A Fatty Liver
Take care!
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PTSD, But, Well…. Complex.
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PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.
These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.
But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.
This might have been…
- childhood emotional neglect
- a parent with a hair-trigger temper
- bullying at school
- extended financial hardship as a young adult
- “just” being told or shown all too often that your best was never good enough
- the persistent threat (real or imagined) of doom of some kind
- the often-reinforced idea that you might lose everything at any moment
If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.
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Now, we at 10almonds are not doctors or therapists and even if we were, we certainly wouldn’t try to diagnose from afar. But, even if there’s only a partial match, sometimes the same advice can help.
So what are the symptoms of C-PTSD?
- A feeling that nothing is safe; we might suddenly lose what we have gained
- The body keeps the score… And it shows. We may have trouble relaxing, an aversion to exercise for reasons that don’t really add up, or an aversion to being touched.
- Trouble sleeping, born of nagging sense that to sleep is to be vulnerable to attack, and/or lazy, and/or negligent of our duties
- Poor self-image, about our body and/or about ourself as a person.
- We’re often drawn to highly unavailable people—or we are the highly unavailable person to which our complementary C-PTSD sufferers are attracted.
- We are prone to feelings of rage. Whether we keep a calm lid on it or lose our temper, we know it’s there. We’re angry at the world and at ourselves.
- We are not quick to trust—we may go through the motions of showing trust, but we’re already half-expecting that trust to have been misplaced.
- “Hell is other people” has become such a rule of life that we may tend to cloister ourselves away from company.
- We may try to order our environment around us as a matter of safety, and be easily perturbed by sudden changes being imposed on us, even if ostensibly quite minor or harmless.
- In a bid to try to find safety, we may throw ourselves into work—whatever that is for us. It could be literally our job, or passion projects, or our family, or community, and in and of itself that’s great! But the motivation is more of an attempt to distract ourselves from The Horrors™.
“Alright, I scored more of those than I care to admit. What now?”
A lot of the answer lies in first acknowledging to yourself what happened, to make you feel the way you do now. If you, for example, have an abject hatred of Christmas, what were your childhood Christmases like? If you fear losing money that you’ve accumulated, what underpins that fear? It could be something that directly happened to you, but it also could just be repeated messages you received from your parents, for example.
It could even be that you had superficially an idyllic perfect childhood. Health, wealth, security, a loving family… and simply a chemical imbalance in your brain made it a special kind of Hell for you that nobody understood, and perhaps you didn’t either.
Unfortunately, a difficult task now lies ahead: giving love, understanding, compassion, and reassurance to the person for whom you may have the most contempt in the world: yourself.
If you’d like some help with that, here are some resources:
ComplexTrauma.org (a lot of very good free resources, with no need for interaction)
CPTSD Foundation (mostly paid courses and the like)
Some final words about healing…
- You are in fact amazing,
- You can do it, and
- You deserve it.
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