Laziness Does Not Exist – by Dr. Devon Price
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Some cultures prize productivity as an ideal above most other things, and it’s certainly so in the US. Not only is this not great for mental health in general, but also—as Dr. Price explains—it’s based on a lie.
Generally speaking, when a person appears lazy there is something stopping them/you from doing better, and it’s not some mystical unseen force of laziness, not a set character trait, not a moral failing. Rather, the root cause may be physical, psychological, socioeconomic, or something else entirely.
Those causes can in some cases be overcome (for example, a little CBT can often set aside perfectionist anxiety that results in procrastination), and in some cases they can’t, at least on an individual level (disabilities often stubbornly remain disabling, and societal problems require societal solutions).
This matters for our mental health in areas well beyond the labor marketplace, of course, and these ideas extend to personal projects and even personal relationships. Whatever it is, if it’s leaving you exhausted, then probably something needs to be changed (even if the something is just “expectations”).
The book does offer practical solutions to all manner of such situations, improving what can be improved, making easier what can be made easier, and accepting what just needs to be accepted.
The style of this book is casual yet insightful and deep, easy-reading yet with all the acumen of an accomplished social psychologist.
Bottom line: if life leaves you exhausted, this book can be the antidote and cure
Click here to check out Laziness Does Not Exist, and break free!
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The Wim Hof Method – by Wim Hof
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In Wednesday’s main feature, we wrote about the Wim Hof Method, and/but only scratched the surface. Such is the downside of being a super-condensed newsletter! However, it does give us the opportunity to feature the book:
The Wim Hof Method is definitely loudly trumpeted as “up there” with Atomic Habits or How Not To Die in the category of “life-changing” books. Why?
Firstly, it’s a very motivational book. Hof is a big proponent of the notion “if you think you can or you think you can’t, you’re right” idea, practises what he preaches, and makes clear he’s not special.
Secondly, it’s backed up with science. While it’s not a science-heavy book and that’s not the main focus, there are references to studies. Where physiological explanations are given for how certain things work, those explanations are sound. There’s no pseudoscience here, which is especially important for a book of this genre!
What does the book have that our article didn’t? A good few things:
- More about Hof’s own background and where it’s taken him. This is generally not a reason people buy books (unless they are biographies), but it’s interesting nonetheless.
- A lot more advice, data, and information about Cold Therapy and how it can (and, he argues convincingly, should) be built into your life.
- A lot about breathing exercises that we just didn’t cover at all in our article, but is actually an important part of the Wim Hof Method.
- More about stepping through the psychological barriers that can hold us back.
Bottom line: this book offers benefits that stretch into many areas of life, from some simple habits that can be built.
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How To Do HIIT (Without Wrecking Your Body)
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How To Do HIIT (Without Wrecking Your Body)
High-Intensity Interval Training, henceforth “HIIT”, is a well-researched and well-evidenced approach to exercise that gives powerful health benefits.
Specifically, health benefits that we don’t get from moderate exercise (as important as that is too) or endurance training.
Super-quick overview of the benefits first:
- Burns more calories than other forms of exercise
- Boosts your metabolic rate for hours afterwards
- …which means it actually works* for fat loss
- Reduces blood pressure (unless already healthy)
- Can promote muscle growth (depends on other factors)
*remember that most forms of exercise aren’t very good for fat loss, because our metabolism will slow afterwards to compensate. So HIIT flipping this one is quite a big deal.
What actually is it?
HIIT means exercise sessions in which one alternates between high intensity “maximum effort” bursts, and short recovery periods during which more moderate exercise is performed.
An example for runners could be switching between sprinting or jogging, changing mode each time one passes a street light.
❝A total of only two minutes of sprint interval exercise was sufficient to elicit similar responses as 30 minutes of continuous moderate intensity aerobic exercise❞
What did you mean about not wrecking your body? Is that… Likely?
Hopefully not, but it’s a barrier to some! We are not all twenty-something college athletes, after all, and our bodies aren’t always as durable as they used to be.
HIIT relies on intense exercise and short recovery periods, but what if our bodies are not accustomed to intense exercise, and need longer recovery periods? Can we still get the same benefits?
The trick is not to change the intensity or the recovery periods, but the exercise itself.
For HIIT to work the “intense” part has to be best-effort or approaching such. That part’s not negotiable. The recovery periods can be stretched a bit if you need to, but with the right tweaks, you ideally won’t have to do that.
Great! How?
First, note that you can do resistance interval training without impact. For example, if you crank up the resistance on an exercise bike or similar machine, you will be doing resistance training along with your cardio, and you’ll be doing it without the impact on your joints that you would if out pounding the pavement on foot.
(Running is fine if your body is used to it, but please don’t make HIIT your first running exercise in a decade)
Second, consider your environment. That exercise bike? You can get off it any time and you’re already at home (or perhaps your gym, with your car outside). Not so if you took up mountain biking or road racing.
Third, go for what is gentle in motion, even if it’s not resistance work per se. Swimming is a fabulous option for most people, and can absolutely be done with HIIT principles. Since vision is often obscured while swimming, counting strokes can be a good way to do HIIT. For example, ten strokes max effort, ten strokes normal, repeat. Do make sure you are aware of where the end of the pool is, though!
Fourth, make it fun! Ok, this one’s not about the safety quite so much, but it is about sustainability, and that’s critical for practical purposes too. You will only continue an exercise routine that you enjoy, after all.
- Could you curate a musical playlist that shifts tempo to cue your exercise mode intervals?
- Could you train with an exercise partner? Extra fun if this has a “relay race” feel to it, i.e. when one person completes a high intensity interval, the other person must now begin theirs.
Need some pointers getting started?
There are a lot of HIIT apps out there, so you can just search for that on your device of choice.
But!
We at 10almonds have recommended 7-Minute Workout before, which is available for iOS and for Android, and we stand by that as a great starting choice.
Enjoy!
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World Menopause Day Health News Round-Up
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In order to provide variety in this week’s round-up, not all of this is menopause-related, but it is all important:
Menopause & CVD
Untreated menopause is associated with higher incidence of heart disease, and higher mortality. People often forget about how much estrogen does for us (well, for those of us with a physiology running on estrogen, anyway; gentlemen, your testosterone is fine for you), and think it is “just” a sex hormone, but it’s a lot more.
Read in full: Menopause transition linked to increased heart disease risk
Related: What Menopause Does To The Heart
Extraterrestrial medical technology
The much lower gravity in Earth orbit has allowed for tissue engineering techniques that Earth’s normal gravity imposes limitations on. This is big news, because it means that rather than replacing a whole liver, tissue implants could be grafted, allowing the extant liver to repair itself (something livers are famously good at, but they need enough undamaged base material to work with).
Read in full: How liver tissue from the International Space Station may transform tissue engineering
Related: How To Unfatty A Fatty Liver
One thing and then another
As if endometriosis weren’t unpleasant enough in and of itself, the endothelial dysfunction inherent to it also raises cardiovascular disease risk. This is important, because while endometriosis has (like many maladies predominantly affecting women) generally been shrugged off by the medical world as an unhappy inconvenience but not life-threatening, now we know it comes with extra existential risks too:
Read in full: Understanding cardiovascular risks in endometriosis patients
Related: What You Need To Know About Endometriosis
Push-button meditation
Unlike mindfulness meditation, listening to music is a very passive experience, and thus requires less effort from the user. And yet, it has been associated with lower perceived pain levels, lower self-reported anxiety levels, less opioid use, and measurably lower heart-rate.
Read in full: Listening to music may speed up recovery from surgery, research suggests
Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Cholesterol in menopause: quality over quantity
Much like previous research has shown that the quantity of LDL is not nearly so predictive of health outcomes in women as it is in men, this study into HDL and menopausal women shows that quantity of HDL does not matter nearly so much as the quality of it.
Read in full: HDL quality, not quantity, contribute to the first sign of Alzheimer’s disease in women
Related: Statins: His & Hers? ← consistent with the above, statins (to lower LDL cholesterol) generally help more for men and produce more adverse side effects for women. So again, a case of “the actual amount of cholesterol isn’t so important for women as for men”.
Take care!
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From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained
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More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.
However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.
While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.
The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.
Svitlana Hulko/Shutterstock Immunotherapy before surgery
Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.
Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.
Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.
This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.
More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.
The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.
Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.
Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.
Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.
The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.
mRNA vaccines
Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).
While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.
mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).
However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.
The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.
It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.
Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.
It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.
Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When BMI Doesn’t Measure Up
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When BMI Doesn’t Quite Measure Up
Last month, we did a “Friday Mythbusters” edition of 10almonds, tackling many of the misconceptions surrounding obesity. Amongst them, we took a brief look at the usefulness (or lack thereof) of the Body Mass Index (BMI) scale of weight-related health for individuals. By popular subscriber request, we’re now going to dive a little deeper into that today!
The wrong tool for the job
BMI was developed as a tool to look at large-scale demographic trends, stemming from a population study of white European men, who were for the purpose of the study (the widescale health of the working class in that geographic area in that era), considered a reasonable default demographic.
In other words: as a system, it’s now being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
If you want to know yours…
Here’s the magic formula for calculating your BMI:
- Metric: divide your weight in kilograms by your height in square meters
- Imperial: divide your weight in pounds by your height in square inches and then multiply by 703
“What if my height doesn’t come in square meters or square inches, because it’s a height, not an area?”
We know. Take your height and square it anyway. If this seems convoluted and arbitrary, yes, it is.
But!
While on the one hand it’s convoluted and arbitrary… On the other hand, it’s also a gross oversimplification. So, yay for the worst of both worlds?
If you don’t want to grab a calculator, here’s a quick online tool to calculate it for you.
So, how did you score?
According to the CDC, a BMI score…
- Under 18.5 is underweight
- 18.5 to 24.9 is normal
- 25 to 29.9 is overweight
- 30 and over is obese
And, if we’re looking at a representative sample of the population, where the representation is average white European men of working age, that’s not a bad general rule of thumb.
For the rest of us, not so representative
BMI is a great and accurate tool as a rule of thumb, except for…
Women
An easily forgotten demographic, due to being a mere 51% of the world’s population, women generally have a higher percentage of body fat than men, and this throws out BMI’s usefulness.
If pregnant or nursing
A much higher body weight and body fat percentage—note that these are two things, not one. Some of the extra weight will be fat to nourish the baby; some will be water weight, and if pregnant, some will be the baby (or babies!). BMI neither knows nor cares about any of these things. And, this is a big deal, because BMI gets used by healthcare providers to judge health risks and guide medical advice.
People under the age of 16 or over the age of 65
Not only do people below and above those ages (respectively) tend to be shorter—which throws out the calculations and mean health risks may increase before the BMI qualifies as overweight—but also:
- BMI under 23 in people over the age of 65 is associated with a higher health risk
- A meta-analysis showed that a BMI of 27 was the best in terms of decreased mortality risk for the over-65 age group
This obviously flies in the face of conventional standards regards BMI—as you’ll recall from the BMI brackets we listed above.
Read the science: BMI and all-cause mortality in older adults: a meta-analysis
Athletic people
A demographic often described in scientific literature as “athletes”, but that can be misleading. When we say “athletes”, what comes to mind? Probably Olympians, or other professional sportspeople.
But also athletic, when it comes to body composition, are such people as fitness enthusiasts and manual laborers. Which makes for a lot more people affected by this!
Athletic people tend to have more lean muscle mass (muscle weighs more than fat), and heavier bones (can’t build strong muscles on weak bones, so the bones get stronger too, which means denser)… But that lean muscle mass can actually increase metabolism and help ward off many of the very same things that BMI is used as a risk indicator for (e.g. heart disease, and diabetes). So people in this category will actually be at lower risk, while (by BMI) getting told they are at higher risk.
If not white
Physical characteristics of race can vary by more than skin color, relevant considerations in this case include, for example:
- Black people, on average, not only have more lean muscle mass and less fat than white people, but also, have completely different risk factors for diseases such as diabetes.
- Asian people, on average, are shorter than white people, and as such may see increased health risks before BMI qualifies as overweight.
- Hispanic people, on average, again have different physical characteristics that throw out the results, in a manner that would need lower cutoffs to be even as “useful” as it is for white people.
Further reading on this: BMI and the BIPOC Community
In summary:
If you’re an average white European working-age man, BMI can sometimes be a useful general guide. If however you fall into one or more of the above categories, it is likely to be inaccurate at best, if not outright telling the opposite of the truth.
What’s more useful, then?
For heart disease risk and diabetes risk both, waist circumference is a much more universally reliable indicator. And since those two things tend to affect a lot of other health risks, it becomes an excellent starting point for being aware of many aspects of health.
Pregnancy will still throw off waist circumference a little (measure below the bump, not around it!), but it will nevertheless be more helpful than BMI even then, as it becomes necessary to just increase the numbers a little, according to gestational month and any confounding factors e.g. twins, triplets, etc. Ask your obstetrician about this, as it’s beyond the scope of today’s newsletter!
As to what’s considered a risk:
- Waist circumference of more than 35 inches for women
- Waist circumference of more than 40 inches for men
These numbers are considered applicable across demographics of age, sex, ethnicity, and lifestyle.
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Ruminating vs Processing
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When it comes to traumatic experiences, there are two common pieces of advice for being able to move forwards functionally:
- Process whatever thoughts and feelings you need to process
- Do not ruminate
The latter can seem, at first glance, a lot like the former. So, how to tell them apart, and how to do one without the other?
Getting tense
One major difference between the two is the tense in which our mental activity takes place:
- processing starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if possible why, and then asks the question “ok, what now?” and begins work on laying out a path for the future.
- rumination starts with the traumatic event (or perhaps even the events leading up to the traumatic event), analyses what happened and if why, oh why oh why, “I was such an idiot, if only I had…” and gets trapped in a fairly tight (and destructive*) cycle of blame and shame/anger, never straying far from the events in question.
*this may be directly self-destructive, but it can also sometimes be only indirectly self-destructive, for example if the blame and anger is consciously placed with someone else.
This idea fits in, by the way, with Dr. Elisabeth Kübler-Ross’s “five stages of grief” model; rumination here represents the stages “bargaining”, “despair”, and “anger”, while emotional processing here represents the stage “acceptance”. Thus, it may be that rumination does have a place in the overall process—just don’t get stuck there!
For more on healthily processing grief specifically:
What Grief Does To The Body (And How To Manage It)
Grief, by the way, can be about more than the loss of a loved one; a very similar process can play out with many other kinds of unwanted life changes too.
What are the results?
Another way to tell them apart is to look at the results of each. If you come out of a long rumination session feeling worse than when you started, it’s highly unlikely that you just stopped too soon and were on the verge of some great breakthrough. It’s possible! But not likely.
- Processing may be uncomfortable at first, and if it’s something you’ve ignored for a long time, that could be very uncomfortable at first, but there should quite soon be some “light at the end of the tunnel”. Perhaps not even because a solution seems near, but because your mind and body recognize “aha, we are doing something about it now, and thus may find a better way forward”.
- Rumination tends to intensify and prolong uncomfortable emotions, increases stress and anxiety, and likely disrupts sleep. At best, it may serve as a tipping point to seek therapy or even just recognize “I should figure out a way to deal with this, because this isn’t doing me any good”. At worst, it may serve as a tipping point to depression, and/or substance abuse, and/or suicidality.
See also: How To Stay Alive (When You Really Don’t Want To) ← which also has a link back to our article on managing depression, by the way!
Did you choose it, really?
A third way to tell them apart is the level of conscious decision that went into doing it.
- Processing is almost always something that one decides “ok, let’s figure this out”, and sits down to figure it out.
- Rumination tends to be about as voluntary as social media doomscrolling. Technically we may have decided to begin it (we also might not have made any conscious decision, and just acted on impulse), but let’s face it, our hands weren’t at the wheel for long, at all.
A good way to make sure that it is a conscious process, is to schedule time for it in advance, and then do it only during that time. If thoughts about it come up at other times, tell yourself “no, leave that for later”, and then deal with it when (and only when) the planned timeslot arrives.
It’s up to you and your schedule what time you pick, but if you’re unsure, consider an hour in the early evening. That means that the business of the day is behind you, but it’s also not right before bed, so you should have some decompression time as a buffer. So for example, perhaps after dinner you might set a timer* for an hour, and sit down to journal, brainstorm, or just plain think, about the matter that needs processing.
*electronic timers can be quite jarring, and may distract you while waiting for the beeps. So, consider investing in a relaxing sand timer like this one instead.
Is there any way to make rumination less bad?
As we mentioned up top, there’s a case to be made for “rumination is an early part of the process that gets us where we need to go, and may not be skippable, or may not be advisable to skip”.
So, if you are going to ruminate, then firstly, we recommend again bordering it timewise (with a timer as above) and having a plan to pull yourself out when you’re done rather than getting stuck there (such as: The Off-Button For Your Brain: How To Stop Negative Thought Spirals).
And secondly, you might want to consider the following technique, which allows one to let one’s brain know that the thing we’re thinking about / imagining is now to be filed away safely; not lost or erased, but sent to the same place that nightmares go after we wake up:
A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing (EMDR)
What if I actually do want to forget?
That’s not usually recommendable; consider talking it through with a therapist first. However, for your interest, there is a way:
The Dark Side Of Memory (And How To Forget)
Take care!
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