Lifespan vs Healthspan, And The Spice Of Life
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝Great newsletter. Am taking turmeric for inflammation of hips and feet. Works like magic. Would like to know how it works, and what tumeric is best combined with – also whether there any risks in longterm use.❞
Glad you’re enjoying! As for turmeric, it sure is great, isn’t it? To answer your questions in a brief fashion:
- How it works: it does a lot of things, but perhaps its most key feature is its autoxidative metabolites that mediate its anti-inflammatory effect. This, it slows or inhibits oxidative stress that would otherwise cause inflammation, increase cancer risk, and advance aging.
- Best combined with: black pepper
- Any risks in long-term use: there are no known risks in long-term use ← that’s just one study, but there are lots. Some studies were prompted by reported hepatotoxicity of curcumin supplements, but a) the reports themselves seem to be without evidence b) the reported hepatoxicity was in relation to contaminants in the supplements, not the curcumin itself c) clinical trials were unable to find any hepatotoxicity (or other) risks anyway. Here’s an example of such a study.
You might also like our previous main feature: Why Curcumin (Turmeric) Is Worth Its Weight In Gold
❝This push for longevity is appealing but watching my mother in her nineties is a life I’m not looking forward to. Healthy longevity, yes, but longevity for the sake of a longer life? No thank you.❞
Yes, you’re quite right, that’s exactly the point! Assuming we live to die of age-related conditions (i.e., we do not suffer a fatal accident or incident in our younger years), those unfun last years are coming whether they come at 75 or 95. Or earlier or later, because that can absolutely happen too!
For example: nearly 10% of Americans over 65 have difficulty with self-care
As a rule, and we’ve covered some of the science of this previously, having at least 4 out of 5 of the “big 5” lifestyle factors (diet, exercise, sleep, low-or-zero alcohol, not smoking) not only extends life, but specifically extends the healthspan, i.e. the count of healthy life-years that precedes final age-related decline.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Think you’re good at multi-tasking? Here’s how your brain compensates – and how this changes with age
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’re all time-poor, so multi-tasking is seen as a necessity of modern living. We answer work emails while watching TV, make shopping lists in meetings and listen to podcasts when doing the dishes. We attempt to split our attention countless times a day when juggling both mundane and important tasks.
But doing two things at the same time isn’t always as productive or safe as focusing on one thing at a time.
The dilemma with multi-tasking is that when tasks become complex or energy-demanding, like driving a car while talking on the phone, our performance often drops on one or both.
Here’s why – and how our ability to multi-task changes as we age.
Doing more things, but less effectively
The issue with multi-tasking at a brain level, is that two tasks performed at the same time often compete for common neural pathways – like two intersecting streams of traffic on a road.
In particular, the brain’s planning centres in the frontal cortex (and connections to parieto-cerebellar system, among others) are needed for both motor and cognitive tasks. The more tasks rely on the same sensory system, like vision, the greater the interference.
This is why multi-tasking, such as talking on the phone, while driving can be risky. It takes longer to react to critical events, such as a car braking suddenly, and you have a higher risk of missing critical signals, such as a red light.
The more involved the phone conversation, the higher the accident risk, even when talking “hands-free”.
Generally, the more skilled you are on a primary motor task, the better able you are to juggle another task at the same time. Skilled surgeons, for example, can multitask more effectively than residents, which is reassuring in a busy operating suite.
Highly automated skills and efficient brain processes mean greater flexibility when multi-tasking.
Adults are better at multi-tasking than kids
Both brain capacity and experience endow adults with a greater capacity for multi-tasking compared with children.
You may have noticed that when you start thinking about a problem, you walk more slowly, and sometimes to a standstill if deep in thought. The ability to walk and think at the same time gets better over childhood and adolescence, as do other types of multi-tasking.
When children do these two things at once, their walking speed and smoothness both wane, particularly when also doing a memory task (like recalling a sequence of numbers), verbal fluency task (like naming animals) or a fine-motor task (like buttoning up a shirt). Alternately, outside the lab, the cognitive task might fall by wayside as the motor goal takes precedence.
Brain maturation has a lot to do with these age differences. A larger prefrontal cortex helps share cognitive resources between tasks, thereby reducing the costs. This means better capacity to maintain performance at or near single-task levels.
The white matter tract that connects our two hemispheres (the corpus callosum) also takes a long time to fully mature, placing limits on how well children can walk around and do manual tasks (like texting on a phone) together.
For a child or adult with motor skill difficulties, or developmental coordination disorder, multi-tastking errors are more common. Simply standing still while solving a visual task (like judging which of two lines is longer) is hard. When walking, it takes much longer to complete a path if it also involves cognitive effort along the way. So you can imagine how difficult walking to school could be.
What about as we approach older age?
Older adults are more prone to multi-tasking errors. When walking, for example, adding another task generally means older adults walk much slower and with less fluid movement than younger adults.
These age differences are even more pronounced when obstacles must be avoided or the path is winding or uneven.
Older adults tend to enlist more of their prefrontal cortex when walking and, especially, when multi-tasking. This creates more interference when the same brain networks are also enlisted to perform a cognitive task.
These age differences in performance of multi-tasking might be more “compensatory” than anything else, allowing older adults more time and safety when negotiating events around them.
Older people can practise and improve
Testing multi-tasking capabilities can tell clinicians about an older patient’s risk of future falls better than an assessment of walking alone, even for healthy people living in the community.
Testing can be as simple as asking someone to walk a path while either mentally subtracting by sevens, carrying a cup and saucer, or balancing a ball on a tray.
Patients can then practise and improve these abilities by, for example, pedalling an exercise bike or walking on a treadmill while composing a poem, making a shopping list, or playing a word game.
The goal is for patients to be able to divide their attention more efficiently across two tasks and to ignore distractions, improving speed and balance.
There are times when we do think better when moving
Let’s not forget that a good walk can help unclutter our mind and promote creative thought. And, some research shows walking can improve our ability to search and respond to visual events in the environment.
But often, it’s better to focus on one thing at a time
We often overlook the emotional and energy costs of multi-tasking when time-pressured. In many areas of life – home, work and school – we think it will save us time and energy. But the reality can be different.
Multi-tasking can sometimes sap our reserves and create stress, raising our cortisol levels, especially when we’re time-pressured. If such performance is sustained over long periods, it can leave you feeling fatigued or just plain empty.
Deep thinking is energy demanding by itself and so caution is sometimes warranted when acting at the same time – such as being immersed in deep thought while crossing a busy road, descending steep stairs, using power tools, or climbing a ladder.
So, pick a good time to ask someone a vexed question – perhaps not while they’re cutting vegetables with a sharp knife. Sometimes, it’s better to focus on one thing at a time.
Peter Wilson, Professor of Developmental Psychology, Australian Catholic University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
-
Dentists Are Pulling ‘Healthy’ and Treatable Teeth To Profit From Implants, Experts Warn
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.
Becky Carroll was missing a few teeth, and others were stained or crooked. Ashamed, she smiled with lips pressed closed. Her dentist offered to fix most of her teeth with root canals and crowns, Carroll said, but she was wary of traveling a long road of dental work.
Then Carroll saw a TV commercial for another path: ClearChoice Dental Implant Centers. The company advertises that it can give patients “a new smile in as little as one day” by surgically replacing teeth instead of fixing them.
So Carroll saved and borrowed for the surgery, she said. In an interview and a lawsuit, Carroll said that at a ClearChoice clinic in New Jersey in 2021, she agreed to pay $31,000 to replace all her natural upper teeth with pearly-white prosthetic ones. What came next, Carroll said, was “like a horror movie.”
Carroll alleged that her anesthesia wore off during implant surgery, so she became conscious as her teeth were removed and titanium screws were twisted into her jawbone. Afterward, Carroll’s prosthetic teeth were so misaligned that she was largely unable to chew for more than two years until she could afford corrective surgery at another clinic, according to a sworn deposition from her lawsuit.
ClearChoice has denied Carroll’s claims of malpractice and negligence in court filings and did not respond to requests for comment on the ongoing case.
“I thought implants would be easier, and all at once, so you didn’t have to keep going back to the dentist,” Carroll, 52, said in an interview. “But I should have asked more questions … like, Can they save these teeth?”
Dental implants have been used for more than half a century to surgically replace missing or damaged teeth with artificial duplicates, often with picture-perfect results. While implant dentistry was once the domain of a small group of highly trained dentists and specialists, tens of thousands of dental providers now offer the surgery and place millions of implants each year in the U.S.
Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry’s fundamental goal of preserving natural teeth and have become too willing to remove teeth to make room for expensive implants, according to a months-long investigation by KFF Health News and CBS News. In interviews, 10 experts said they had each given second opinions to multiple patients who had been recommended for mouths full of implants that the experts ultimately determined were not necessary. Separately, lawsuits filed across the country have alleged that implant patients like Carroll have experienced painful complications that have required corrective surgery, while other lawsuits alleged dentists at some implant clinics have persuaded, pressured, or forced patients to remove teeth unnecessarily.
The experts warn that implants, for a single tooth or an entire mouth, expose patients to costs and surgery complications, plus a new risk of future dental problems with fewer treatment options because their natural teeth are forever gone.
“There are many cases where teeth, they’re perfectly fine, and they’re being removed unnecessarily,” said William Giannobile, dean of the Harvard School of Dental Medicine. “I really hate to say it, but many of them are doing it because these procedures, from a monetary standpoint, they’re much more beneficial to the practitioner.”
Giannobile and nine other experts say they are combating a false public perception that implants are more durable and longer-lasting than natural teeth, which some believe stems in part from advertising on TV and social media. Implants require upkeep, and although they can’t get cavities, studies have shown that patients can be susceptible to infections in the gums and bone around their implants.
“Just because somebody can afford implants doesn’t necessarily mean that they’re a good candidate,” said George Mandelaris, a Chicago-area periodontist and member of the American Academy of Periodontology Board of Trustees. “When an implant has infection, or when an implant has bone loss, an implant dies a much quicker death than do teeth.”
In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use “full-arch” or “All-on-4” implants to replace all their upper or lower teeth — or all their teeth.
For this story, KFF Health News and CBS News sought interviews with large dental chains whose clinics offer implant surgery — ClearChoice, Aspen Dental, Affordable Care, and Dental Care Alliance — each of which declined to be interviewed or did not respond to multiple requests for comment. The Association of Dental Support Organizations, which represents these companies and others like them, also declined an interview request.
ClearChoice, which specializes in full-arch implants, did not answer more than two dozen questions submitted in writing. In an emailed statement, the company said full-arch implants “have become a well-accepted standard of care for patients with severe tooth loss and teeth with poor prognosis.”
“The use of full-arch restorations reflects the evolution of modern dentistry, offering patients a solution that restores their ability to eat, speak, and live comfortably — far beyond what traditional dentures can provide,” the company said.
Carroll said she regrets not letting her dentist try to fix her teeth and rushing to ClearChoice for implants.
“Because it was a nightmare,” she said.
‘They Are Not Teeth’
Dental implant surgery can be a godsend for patients with unsalvageable teeth. Several experts said implants can be so transformative that their invention should have contended for a Nobel Prize. And yet, these experts still worry that implants are overused, because it is generally better for patients to have their natural teeth.
Paul Rosen, a Pennsylvania periodontist who said he has worked with implants for more than three decades, said many patients believe a “fallacy” that implants are “bulletproof.”
“You can’t just have an implant placed and go off riding into the sunset,” Rosen said. “In many instances, they need more care than teeth because they are not teeth.”
Generally, a single implant costs a few thousand dollars while full-arch implants cost tens of thousands. Neither procedure is well covered by dental insurance, so many clinics partner with credit companies that offer loans for implant surgeries. At ClearChoice, for example, loans can be as large as $65,000 paid off over 10 years, according to the company’s website.
Despite the price, implants are more popular than ever. Sales increased by more than 6% on average each year since 2010, culminating in more than 3.7 million implants sold in the U.S. in 2022, according to a 2023 report produced by iData Research, a health care market research firm.
Some worry implant dentistry has gone too far. In 10 interviews, dentists and dental specialists with expertise in implants said they had witnessed the overuse of implants firsthand. Each expert said they’d examined multiple patients in recent years who were recommended for full-arch implants by other dentists despite their teeth being treatable with conventional dentistry.
Giannobile, the Harvard dean, said he had given second opinions to “dozens” of patients who were recommended for implants they did not need.
“I see many of these patients now that are coming in and saying, ‘I’ve been seen, and they are telling me to get my entire dentition — all of my teeth — extracted.’ And then I’ll take a look at them and say that we can preserve most of your teeth,” Giannobile said.
Tim Kosinski, who is a representative of the Academy of General Dentistry and said he has placed more than 19,000 implants, said he examines as many as five patients a month who have been recommended for full-arch implants that he deems unnecessary.
“There is a push in the profession to remove teeth that could be saved,” Kosinski said. “But the public isn’t aware.”
Luiz Gonzaga, a periodontist and prosthodontist at the University of Florida, said he, too, had turned away patients who wanted most or all their teeth extracted. Gonzaga said some had received implant recommendations that he considered “an atrocity.”
“You don’t go to the hospital and tell them ‘I broke my finger a couple of times. This is bothering me. Can you please cut my finger off?’ No one will do that,” Gonzaga said. “Why would I extract your tooth because you need a root canal?”
Jaime Lozada, director of an elite dental implant residency program at Loma Linda University, said he’d not only witnessed an increase in dentists extracting “perfectly healthy teeth” but also treated a rash of patients with mouths full of ill-fitting implants that had to be surgically replaced.
Lozada said in August that he’d treated seven such patients in just three months.
“When individuals just make a decision of extracting teeth to make it simple and make money quick, so to speak, that’s where I have a problem,” Lozada said. “And it happens quite often.”
When full-arch implants fail, patients sometimes don’t have enough jawbone left to anchor another set. These patients have little choice but to get implants that reach into cheekbones, said Sohail Saghezchi, an oral and maxillofacial surgeon at the University of California-San Francisco.
“It’s kind of like a last resort,” Saghezchi said. “If those fail, you don’t have anywhere else to go.”
‘It Was Horrendous Dentistry’
Most of the experts interviewed for this article said their rising alarm corresponded with big changes in the availability of dental implants. Implants are now offered by more than 70,000 dental providers nationwide, two-thirds of whom are general dentists, according to the iData Research report.
Dentists are not required to learn how to place implants in dental school, nor are they required to complete implant training before performing the surgery in nearly all states. This year, Oregon started requiring dentists to complete 56 hours of hands-on training before placing any implants. Stephen Prisby, executive director of the Oregon Board of Dentistry, said the requirement — the first and only of its kind in the U.S. — was a response to dozens of investigations in the state into botched surgeries and other implant failures, split evenly between general dentists and specialists.
“I was frankly stunned at how bad some of these dentists were practicing,” Prisby said. “It was horrendous dentistry.”
Many dental clinics that offer implants have consolidated into chains owned by private equity firms that have bought out much of implant dentistry. In health care, private equity investment is sometimes criticized for overtreatment and prioritizing short-term profit over patients.
Private equity firms have spent about $5 billion in recent years to buy large dental chains that offer implants at hundreds of clinics owned by individual dentists and dental specialists. ClearChoice was bought for an estimated $1.1 billion in 2020 by Aspen Dental, which is owned by three private equity firms, according to PitchBook, a research firm focused on the private equity industry. Private equity firms also bought Affordable Care, whose largest clinic brand is Affordable Dentures & Implants, for an estimated $2.7 billion in 2021, according to PitchBook. And the private equity wing of the Abu Dhabi government bought Dental Care Alliance, which offers implants at many of its affiliated clinics, for an estimated $1 billion in 2022, according to PitchBook.
ClearChoice and Aspen Dental each said in email statements that the companies’ private equity owners “do not have influence or control over treatment recommendations.” Both companies said dentists or dental specialists make all clinical decisions.
Private equity deals involving dental practices increased ninefold from 2011 to 2021, according to an American Dental Association study published in August. The study also said investors showed an interest in oral surgery, possibly because of the “high prices” of implants.
“Some argue this is a negative thing,” said Marko Vujicic, vice president of the association’s Health Policy Institute, who co-authored the study. “On the other hand, some would argue that involvement of private equity and outside capital brings economies of scale, it brings efficiency.”
Edwin Zinman, a San Francisco dental malpractice attorney and former periodontist who has filed hundreds of dental lawsuits over four decades, said he believed many of the worst fears about private equity owners had already come true in implant dentistry.
“They’ve sold a lot of [implants], and some of it unnecessarily, and too often done negligently, without having the dentists who are doing it have the necessary training and experience,” Zinman said. “It’s for five simple letters: M-O-N-E-Y.”
Hundreds of Implant Clinics With No Specialists
For this article, journalists from KFF Health News and CBS News analyzed the webpages for more than 1,000 clinics in the nation’s largest private equity-owned dental chains, all of which offer some implants. The analysis found that more than 70% of those clinics listed only general dentists on their websites and did not appear to employ the specialists — oral surgeons, periodontists, or prosthodontists — who traditionally have more training with implants.
Affordable Dentures & Implants listed specialists at fewer than 5% of its more than 400 clinics, according to the analysis. The rest were staffed by general dentists, most of whom did not list credentialing from implant training organizations, according to the analysis.
ClearChoice, on the other hand, employs at least one oral surgeon or prosthodontist at each of its more than 100 centers, according to the analysis. But its new parent company, Aspen Dental, which offers implants in many of its more than 1,100 clinics, does not list any specialists at many of those locations.
Not everyone is worried about private equity in implant dentistry. In interviews arranged by the American Academy of Implant Dentistry, which trains dentists to use implants, two other implant experts did not express concerns about private equity firms.
Brian Jackson, a former academy president and implant specialist in New York, said he believed dentists are too ethical and patients are too smart to be pressured by private equity owners “who will never see a patient.”
Jumoke Adedoyin, a chief clinical officer for Affordable Care, who has placed implants at an Affordable Dentures & Implants clinic in the Atlanta suburbs for 15 years, said she had never felt pressure from above to sell implants.
“I’ve actually felt more pressure sometimes from patients who have gone around and been told they need to take their teeth out,” she said. “They come in and, honestly, taking a look at them, maybe they don’t need to take all their teeth out.”
Still, lawsuits filed across the country have alleged that dentists at implant clinics have extracted patients’ teeth unnecessarily.
For example, in Texas, a patient alleged in a 2020 lawsuit that an Affordable Care dentist removed “every single tooth from her mouth when such was not necessary,” then stuffed her mouth with gauze and left her waiting in the lobby as he and his staff left for lunch. In Maryland, a patient alleged in a 2021 lawsuit that ClearChoice “convinced” her to extract “eight healthy upper teeth,” by “greatly downplay[ing] the risks.” In Florida, a patient alleged in a 2023 lawsuit that ClearChoice provided her with no other treatment options before extracting all her teeth, “which was totally unnecessary.”
ClearChoice and Affordable Care denied wrongdoing in their respective lawsuits, then privately settled out of court with each patient. ClearChoice and Affordable Care did not respond to requests for comment submitted to the companies or attorneys. Lawyers for all three plaintiffs declined to comment on these lawsuits or did not respond to requests for comment.
Fred Goldberg, a Maryland dental malpractice attorney who said he has represented at least six clients who sued ClearChoice, said each of his clients agreed to get implants after meeting with a salesperson — not a dentist.
“Every client I’ve had who has gone to ClearChoice has started off meeting a salesperson and actually signing up to get their financing through ClearChoice before they ever meet with a dentist,” Goldberg said. “You meet with a salesperson who sells you on what they like to present as the best choice, which is almost always that they’re going to take out all your natural teeth.”
Becky Carroll, the ClearChoice patient from New Jersey, told a similar story.
Carroll said in her lawsuit that she met first with a ClearChoice salesperson referred to as a “patient education consultant.” In an interview, Carroll said the salesperson encouraged her to borrow money from family members for the surgery and it was not until after she agreed to a loan and passed a credit check that a ClearChoice dentist peered into her mouth.
“It seems way backwards,” Carroll said. “They just want to know you’re approved before you get to talk to a dentist.”
CBS News producer Nicole Keller contributed to this report.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
Share This Post
-
Undo It! – by Dr. Dean Ornish & Anne Ornish
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.
Of course, no lifestyle changes will magically undo Type 1 Diabetes or Cerebral Palsy.But for many chronic diseases, a lot can be done. The question is,how does one book cover them all?
As authors Dr. Dean Ornish and Anne Ornish explain, very many chronic diseases are exacerbated, or outright caused, by the same factors:
- Gene expression
- Inflammation
- Oxidative stress
This goes for chronic disease from heart disease to type 2 diabetes to cancer and many autoimmune diseases.
We cannot change our genes, but we can change our gene expression (the authors explain how). And certainly, we can control inflammation and oxidative stress.
Then first part of the book is given over to dietary considerations. If you’re a regular 10almonds reader, you won’t be too surprised at their recommendations, but you may enjoy the 70 recipes offered.
Attention is also given to exercising in ways optimized to beat chronic disease, and to other lifestyle factors.
Limiting stress is important, but the authors go further when it comes to psychological and sociological factors. Specifically, what matters most to health, when it comes to intimacy and community.
Bottom line: this is a very good guide to a comprehensive lifestyle overhaul, especially if something recently has given you cause to think “oh wow, I should really do more to avoid xyz disease”.
Click here to check out Undo It, and better yet, prevent it in advance!
Share This Post
Related Posts
-
Neurologists Debunk 11 Brain Myths
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.
Neuroscientists Dr. Santoshi Billakota and Dr. Brad Kamitaki debunk 11 myths about the brain. How many did you know?
From the top
Without further ado, the myths are…
- “We only use 10% of our brains”: False! We use most parts of our brain at different times, depending on the activity. PET/MRI scans show widespread usage.
- “The bigger the brain, the smarter the creature”: False! While there’s often a correlation, intelligence depends on brain complexity and development of specific regions, not overall size. For this reason get, for example, some corvids that are more intelligent than some dogs.
- “IQ tests are an accurate measure of intelligence”: False! IQ tests measure limited aspects of intelligence and are influenced by external factors like test conditions and education.
- “Video games rot your brain”: False! Video games can improve problem-solving, strategy, and team-building skills when played in moderation.
- “Memory gets worse as you age”: Partly false. While episodic memory may decline, semantic and procedural memory often improve with age.
- “Left-brained people are logical, and right-brained people are creative”: False! Both hemispheres work together, and personality or skills are influenced by environment and experiences, not brain hemispheres.
- “You can’t prevent a stroke”: False! Strokes can often be prevented by managing risk factors like blood pressure, cholesterol, and lifestyle choices.
- “Eating fish makes you smarter”: False! Eating fish, especially those rich in omega-3s, can support brain health but won’t increase intelligence.
- “You can always trust your senses”: False! Senses can be deceptive and influenced by emotions, memories, or neurological conditions.
- “Different sexes have different brains”: False! Structurally, brains are the same regardless of chromosomal sex; differences arise from environmental (including hormonal) and experiential factors—and even there, there’s more than enough overlap that we are far from categorizable as sexually dimorphic.
- “If you have a seizure, you have epilepsy”: False! A seizure can occur from various causes, but epilepsy is defined by recurrent unprovoked seizures and requires specific diagnosis and treatment.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Dopamine Myth ← a bonus 12th myth!
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Great Cholesterol Myth, Revised and Expanded – by Dr. Jonny Bowden and Dr. Stephen Sinatra
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.
The topic of cholesterol, and saturated fat for that matter, is a complex and often controversial one. How does this book treat it?
With strong opinions, is how—but backed by good science. The authors, a nutritionist and a cardiologist, pull no punches about outdated and/or cherry-picked science, and instead make the case for looking at what, statistically speaking, appear to be the real strongest risk factors.
So, are they advocating for Dave Asprey-style butter-guzzling, or “the carnivore diet”? No, no they are not. Those things remain unhealthy, even if they give some short-term gains (of energy levels, weight loss, etc).
They do advocate, however, for enjoying saturated fats in moderation, and instead of certain polyunsaturated seed oils that do far worse. They also advocate strongly for avoiding sugar, stress, and (for different reasons) statins (in most people’s cases).
They also demystify in clear terms, and often with diagrams and infographics, the various kinds of fats and their components, broken down in far more detail than any other pop-science source this reviewer has seen.
Bottom line: if you want to take a scientific approach to heart health, this book can help you to focus on what will actually make the biggest difference.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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.
Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
