Live Forever? – by Dr. John Tregoning
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The author, a research scientist, investigates our mortality, and what can (and can’t) be done about it.
His conclusions are mostly grim and fatalistic (have a good diet and exercise, don’t drink or smoke, get your vaccines, and anything else is merely changing what you’ll die of), but the real value of the book lies in how he gets there.
Dr. Tregoning is an immunologist, and as such he places the greatest stock in epidemiological studies, which can and if reasonable should be followed up with randomized controlled trials (RCTs). Why the “if reasonable”, you ask?
He gives the example of a study that was undertaken precisely to illustrate this: volunteers were sought for a RCT to test the efficacy of using a parachute vs using a placebo backpack. However, given that the intervention group (parachute) is a well-established lifesaver, and the control group (placebo backpack) means a wildly unethical risk of letting half the study population die, this study being performed as an RCT is of course absurd.
The reader who understands how that is a problem, will understand how asking for RCTs for many kinds of “…or the patient will suffer horribly and/or die” medical interventions is also the same problem.
That illustrative parachute study was conducted, by the way; however for safety reasons (acknowledged in the “limitations” section of the paper) they used a stationary aircraft on the ground, and concluded “the results may be cautiously extrapolated to high-altitude use” (highlighting another problem—that experimental conditions often cannot usefully replicate real-world conditions).
The point here, and indeed the main thesis of the book, is: examine the evidence for yourself and do not just trust headlines, including:
- when there headlines say there is evidence (does the evidence really say what the headlines are saying?)
- when the headlines are saying there is not enough evidence (are they asking for placebo-controlled trials for something that cannot be ethically placebo-controlled—like vaccines, HRT, cancer drugs, or surgeries, all of which are better suited to intervention studies without a control group?)
The style is—for all the grim fatalism we mentioned—entertaining and personable, making this bleak topic an engaging and even enjoyable read. There’s an extensive bibliography, and separately, many per-chapter footnotes.
Bottom line: will this book help you to live longer? If you’re currently on-the-fence about vaccines (in which case, maybe it’ll motivate you to get them as appropriate), then yes, quite possibly. Otherwise, probably not. However, what it will do is two things: 1) entertain you 2) give you a great insight into how to understand science itself, so as to not be at the mercy of headlines. For those reasons, we recommend this book.
Click here to check out “Live Forever?”, and understand the science behind the headlines!
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Before You Take Amlodipine, The Most Popular Blood Pressure Medication…
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Dr. Alex Wibberley talks about its pros and cons:
Under pressure
Amlodipine is a calcium channel blocker, meaning that it blocks calcium from entering smooth muscle cells, which prevents tightening, widens your arteries, and reduces the force your heart needs to pump.
For this reason, it’s commonly prescribed to treat hypertension and angina.
A note about when you start: blood pressure starts dropping within 24–48 hours, but the full effect takes about 7–8 days because the drug builds up gradually. For this reason, it’s important to take it once daily at a consistent time—morning or evening doesn’t matter, consistency does.
Now for some negatives:
- Common side effects: ankle swelling, flushing, and early headaches are all side effects, though they are usually mild and caused by widened blood vessels.
- Important limitations: it controls blood pressure directly, but doesn’t address underlying the causes like diet, weight, inactivity, or stress.
Consequently, it may be worth considering the DASH diet, which can lower systolic blood pressure by around 5–10 mmHg, which is similar to a standard dose of amlodipine.
For more on all of this, enjoy:
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Which Diet? Top Diets Ranked By Experts
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Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Ron Lach/Pexels Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.
Eating a meal with medicine will delay its onset. Farhad/Pexels Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isn’t enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.
If it doesn’t upset your stomach, ibuprofen can be taken with water. Tbel Abuseridze/Unsplash A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How Often Do You Eat Fries?
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“Fries are not a health food” is not breaking news, but how often can you get away with them before it starts impacting health outcomes?
Researchers (Dr. Seyed Mousavi et al.) investigated the effects of fries, various kinds of non-fried potatoes, and white vs whole grains, on diabetes risk.
This was done over the course of three US cohort studies involving a total of a total of 205,107 participants, mostly women, whose diet and health outcomes were followed for 4 decades. Of these participants, 22,299 developed type 2 diabetes.
Here’s what they found:
❝After adjustment for updated body mass index and other diabetes related risk factors, higher intakes of total potatoes and French fries were associated with increased risk of T2D.
For every increment of three servings weekly of total potato, the rate for T2D increased by 5% (hazard ratio 1.05, 95% confidence interval (CI) 1.02 to 1.08) and for every increment of three servings weekly of French fries the rate increased by 20% (1.20, 1.12 to 1.28). Intake of combined baked, boiled, or mashed potatoes was not significantly associated with T2D risk (pooled hazard ratio 1.01, 95% CI 0.98 to 1.05).
In substitution analyses, replacing three servings weekly of potatoes with whole grains was estimated to lower T2D rates by 8% (95% CI 5% to 11%) for total potatoes, 4% (1% to 8%) for baked, boiled, or mashed potatoes, and 19% (14% to 25%) for French fries. In contrast, replacing total potatoes or baked, boiled, or mashed potatoes with white rice was associated with an increased risk of T2D.
In a meta-analysis of 13 cohorts (587 081 participants and 43 471 diagnoses of T2D), the pooled hazard ratio for risk of T2D with each increment of three servings weekly of total potato was 1.03 (95% CI 1.02 to 1.05) and of fried potatoes was 1.16 (1.09 to 1.23). In substitution meta-analyses, replacing three servings weekly of total, non-fried, and fried potatoes with whole grains was estimated to lower the risk of T2D by 7% (95% CI 5% to 9%), 5% (3% to 7%), and 17% (12% to 22%), respectively.❞
That’s a lot of numbers, so let’s break it down, translate it from sciencese, and look at some of the key points.
In order, we have, for the emprical data:
- Every extra three servings of total potatoes per week increased risk by 5%
- Every extra three servings of French fries per week increased risk by 20%
- Baked, boiled, or mashed potatoes gave no significant change in risk
- Replacing three weekly servings of total potatoes with whole grains lowered risk by 8%
- Replacing baked, boiled, or mashed potatoes with whole grains lowered risk by 4%
- Replacing French fries with whole grains lowered risk by 19%
- Replacing total potatoes or baked, boiled, or mashed potatoes with white rice increased risk by 15%*
And now for the meta-analysis** numbers:
- Every extra three servings of total potatoes per week increased risk by 3%
- Every extra three servings of fried potatoes per week increased risk by 16%
- Replacing total potatoes with whole grains lowered risk by 7%
- Replacing non-fried potatoes with whole grains lowered risk by 5%
- Replacing fried potatoes with whole grains lowered risk by 17%
*This figure wasn’t in the abstract we quoted above, but we found it in the full substitutions table lower down in the paper, where it’s expressed as a Hazard Ratio of 1.15, which equates to a 15% increase in risk.
**A meta-analysis can be thought of as an “imaginary experiment” performed by collated existing data from other studies, running it through statistical models, and seeing what comes out. As you can see, the resultant numbers are slightly different, but the associations remain the same (i.e. the same additions/substitutions still give approximately the same relative increase/decrease in risk), which means the meta-analysis also supports the conclusions drawn from the empirical data.
On which note, the full paper itself can be found here: Total and specific potato intake and risk of type 2 diabetes: results from three US cohort studies and a substitution meta-analysis of prospective cohorts
That’s a lot of information; what’s most important?
In few words:
- Whole grains are the best
- Non-fried potatoes are ok
- White grains are bad
- Fried potatoes are the worst
Thus, substituting between those four categories will yield changes in risk proportional to how far apart they are from each other on that list.
Furthermore, to answer the question posed in our introduction today (how often can one eat fries before it starts impacting health outcomes), the honest answer is: never, technically.
See for example: Is Fast Food Really All That Bad? ← we realize that fries do not necessarily have to be fast food, but they share the nutritional profile being examined there.
And while “one bad meal” will not impact long-term health, it will have an immediate negative impact on short-term health, due to its gut-disrupting activity. If it really was just a one-off meal, an otherwise healthy gut will bounce back just fine, but it’s another argument for the case of “the negative health effects do start immediately”.
However, the dose does make the poison, and in this case, increments of 3 portions per week increased risk by 20%. We can say, therefore, that each portion per week increases the risk by 6.6%, and this risk is cumulative.
On which note: what is a portion?
- A portion is not: “however much you eat at once”
- A portion is: “a 4–6 oz serving”
So, if you have twice that at a sitting, that’s two portions. Thrice that at a sitting, and that’s the weekly 3 portions that increase the risk by 20%, already, in one day, and if you have more in the rest of the week, it will continue to add to the risk cumulatively.
If you’d like to dial down the portion sizes while simultaneously enjoying what you eat more, there are two useful approaches you might want to consider (you can do both if you want; there’s no conflict between them, and in fact, they can go quite well together):
- Some Surprising Truths About Hunger And Satiety
- Mindful Eating: How To Get More Out Of What’s On Your Plate
Want to learn more?
Check out:
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Is TikTok right? Should I avoid matcha if I have low iron?
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The popularity of matcha continues to boom. But recent videos on social media have suggested it could be bad for you if you have low iron.
One Sydney woman recently told media she had “no idea” her daily matcha latte could affect her health until she started experiencing headaches, and noticed her hair and nails were brittle and she was bruising easily. Blood tests found she was severely low in iron.
Similar videos on TikTok show women in hospital getting iron transfusions – and blaming their matcha habit.
So, let’s unpack this. How healthy is matcha? And can it really cause low iron?
Tom Werner/Getty What is matcha?
Matcha is a fine powder made from dried and ground-up green tea (Camellia sinensis) leaves. It has recently gained popularity as a drink and a flavour variety in many different foods.
Matcha contains many beneficial compounds (for example, dietary fibre and polyphenols) as well as being a source of caffeine.
Including matcha, or green tea, as part of a balanced diet may provide health benefits such as supporting healthy brain function and blood pressure.
However despite its health benefits, research has shown that drinking a lot of green tea is linked to lower levels of iron in the blood.
We need iron – but can’t make it
Iron is an essential micronutrient that helps transport oxygen around the body, as well as supporting many other important biological processes.
Our bodies can’t make iron, so we need to get it from our diet to support these functions. But even if we eat a lot of iron-rich foods, other things in our diet – such as coffee, red wine, calcium-rich foods and yes, matcha – can interfere with absorbing the iron.
So people with low iron levels need to be careful.
In particular, women who menstruate have an increased risk of low iron because of iron lost through bleeding.
You may have an iron deficiency if your iron falls below certain levels – typically for adults, less than 30 micrograms of iron per litre of blood. There are different cut offs for children.
Iron deficiency anaemia is a condition where very low levels of iron affect the functioning of red blood cells. It is diagnosed based on levels of haemoglobin in the blood (these cutoffs vary by age, sex and pregnancy status).
What does matcha do to iron levels?
There are two main components in green tea that stop us absorbing iron. These are polyphenols and phytic acid (also known as phytate).
Both polyphenols and phytic acid have their own health benefits, for example, protecting against chronic diseases such as type 2 diabetes. But they also bind to iron and prevent it from being absorbed into the body.
So, if you have a lot of food or drink that contains these components – especially in combination with iron-rich foods – they can reduce iron absorption.
However, it’s not only matcha that can interfere. Phytic acids are also found in other teas and many plant foods, such as nuts, cereals and legumes. Tea, coffee, berries, and other fruits and vegetables are also high in polyphenols.
How much matcha will affect your iron levels?
This varies between people.
One study showed people who drink three or more cups of green tea a day had lower blood iron levels than those who drink less than one a day. But they didn’t experience iron deficiency any more often.
However other research has linked moderate green tea consumption (two cups a day) to iron deficiency anaemia.
Whether or not your matcha latte will contribute to an iron deficiency depends on many other factors, including your existing iron levels.
So, what about matcha-flavoured foods?
In these – for example, matcha ice cream – the actual amount of green tea powder is very low. This means it’s unlikely to significantly affect iron absorption.
But it’s not just about quantity – when you drink your matcha also matters.
To reduce the impact on iron absorption, it’s recommended you have green tea separately from meals – at least one hour between eating and drinking tea.
What else to keep an eye on
Multiple other factors in your diet can influence iron absorption. What you eat may either exacerbate or counteract the effects of your matcha latte on iron absorption.
Overall, balance is key to ensure you are getting the full spectrum of nutrients the body requires.
To support iron levels, you can incorporate iron-rich foods (such as beans, lentils, meat, fish and fortified cereals) into a healthy diet.
Eating vitamin C-rich foods (such as capsicum, broccoli, kiwifruit and other fruit and vegetables) along with foods that contain iron can help to enhance iron absorption.
If you are concerned about your iron levels, you should speak to a health-care professional – especially if experiencing symptoms of iron deficiency (such as tiredness, weakness or dizziness).
A blood test can diagnose low iron levels. If you have an iron deficiency, your GP or dietitian will help you manage symptoms and work out what is right for you.
Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Who Initiates Sex & Why It Matters
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In an ideal world, it wouldn’t matter any more than who first says “let’s get something to eat” when hungry. But in reality, it can cause serious problems on both sides:
Fear and loathing?
The person who initiates gets the special prize of an n% chance of experiencing rejection, and then what? Try again, and again, and risk seeming pushy? Or leave the ball in the other person’s court, where it may then go untouched for the next few months, because (in the most positive scenario) they were waiting for you to initiate at a better time for them?
The person who does not initiate, and/but does not want sex at that time, gets the special prize of either making their partner feel unwanted, insecure, and perhaps unloved, or else grudgingly consenting to sex that’s going to be no fun while your heart’s not in it, and thus create the same end result plus you had an extra bad experience?
So, that sucks all around:
- Initiating touch (sex or cuddling) can feel like a test of being wanted, whereupon a lack of initiation or response may be misinterpreted as a lack of love or appreciation.
- Meanwhile, non-reciprocation might stem from exhaustion or unrelated issues. For many, it’s a physiological lottery.
10almonds note: not discussed in this video, but for many couples, problems can also arise because one partner or another just isn’t showing up with the expected physical signs of physiological arousal, so even if they say (and mean!) an enthusiastic “yes”, their body’s signs get misread as a “not really, though”, resulting in one partner feeling rejected, and both feeling inadequate—on account of something that was completely unrelated to how the person actually felt about the prospect of sex*.
*Sometimes, physiological arousal will simply not accompany psychological arousal, no matter how sincere the latter. And on the flipside, sometimes the signs of physiological arousal will just show up without psychological arousal. The human body is just like that sometimes. We all must listen to our partners’ words, not their genitals!
The solution to this problem is thus the same as the solution to the rest of the problem that is discussed in the video, and it’s: good communication.
That can be easier said than done, of course—not everyone is at their most eloquent in such situations! Which is why it can be important to have those conversations first outside of the bedroom when the stakes are low/non-existent.
Even with the best communication, a more general, overarching non-reciprocity (real or perceived) of sexual desire can cause bitterness, resentment, and can ultimately be relationship-ending if a resolution that’s acceptable to everyone involved is not found.
Ultimately, the work as a couple must begin from within as individuals—addressing self-worth issues to better navigate love and intimacy.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Relationships: When To Stick It Out & When To Call It Quits
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Reduce Your Skin Tag Risk
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝As I get older, I seem to be increasingly prone to skin tags, which appear, seemingly out of nowhere, on my face, chest and back. My dermatologist happily burns them off – but is there anything I can do to prevent them?!❞
Not a lot! But, potentially something.
The main risk factor for skin tags is genetic, and you can’t change that in any easy way.
The other main risk factors are connected to each other:
Skin folds, and chafing
Skin tags mostly appear where chafing happens. This can be, for example:
- Inside joint articulations (especially groin and armpits)
- Between fat rolls (if you have them)
So, if you have fat rolls, then losing weight will also reduce the risk of skin tags.
Additionally, obesity and some often-related problems such as diabetes, hypertension, and an atherogenic lipid profile also increase the risk of skin tags (amongst other more serious things):
See: Association of Skin Tag with Metabolic Syndrome and its Components
As for the chafing, this can be reduced in various ways, including:
- losing weight if (and only if) you are carrying excess weight
- dressing against chafing (consider your underwear choices, for example)
- keeping hair in the armpits and groin (it’s part of what it’s there for)
See also: Simply The Pits: These Underarm Myths!
Take care!
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