Menopause, & When Not To Let Your Guard Down
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This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.
She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?
Untreated menopause is more serious than most people think
Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:
What Menopause Does To The Heart
…and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:
Alzheimer’s Sex Differences May Not Be What They Appear
Treated menopause is safer than many people think
The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.
The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).
It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.
In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).
However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.
You can read more about HRT and breast cancer risk (increases and decreases) here:
…and about the same with regard to HMT, here:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Lifestyle matters, and continues to matter
Menopause often receives the following attention from people:
- Perimenopause: “Is this menopause?”
- Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
- Postmenopause: “Yay, that’s behind me now, back to the new normal”
The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.
This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.
So, you can’t let your guard down!
Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.
Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.
See also: Resistance Is Useful! (Especially As We Get Older)
And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!
Want to know more from Dr. Shepherd?
You might like this book of hers that we reviewed not long back:
Generation M – by Dr. Jessica Shepherd
Take care!
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When Did You Last Have a Cognitive Health Check-Up?
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When Did You Last Have a Cognitive Health Check-Up?
Regular health check-ups are an important part of a good health regime, especially as we get older. But after you’ve been prodded, probed, sampled and so forth… When did you last have a cognitive health check-up?
Keeping on top of things
In our recent Monday Research Review main feature about citicoline, we noted that it has beneficial effects for a lot of measures of cognitive health.
And that brought us to realize: just how on top of this are we?
Your writer here today could tell you what her sleep was like on any night in the past year, what her heart rate was like, her weight, and all that. Moods too! There’s an app for that. But cognitive health? My last IQ test was in 2001, and I forget when my last memory test was.
It’s important to know how we’re doing, or else how to we know if there has been some decline? We’ve talked previously about the benefits of brain-training of various kinds to improve cognition, so in some parts we’ll draw on the same resources today, but this time the focus is on getting quick measurements that we can retest regularly (mark the calendar!)
Some quick-fire tests
These tests are all free, quick, and accessible. Some of them will try to upsell you on other (i.e. paid) services; we leave that to your own discretion, but the things we’ll be using today are free.
Test your verbal memory
This one’s a random word list generator. It defaults to 12 words, but you can change that if you like. Memorize the words, and then test yourself by seeing how many you can write down from memory. If it gets too easy, crank up the numbers.
Test your visual memory
This one’s a series of images; the test is to click to say whether you’ve seen this exact image previously in the series or not.
Test your IQ
This one’s intended to be general purpose intelligence; in reality, IQ tests have their flaws too, but it’s not a bad metric to keep track of. Just don’t get too hung up on the outcome, and remember, your only competition is yourself!
Test your attention / focus
This writer opened this and this three other attention tests (to get you the best one) before getting distracted, noting the irony, and finally taking the test. Hopefully you can do better!
Test your creativity
This one’s a random object generator. Give yourself a set period of time (per your preference, but make a note of the time you allow yourself, so that you can use the same time period when you retest yourself at a later date) in which to list as many different possible uses for the item.
Test your musical sense
This one’s a pitch recognition test. So, with the caveat that it is partially testing your hearing as well as your cognition, it’s a good one to take and regularly retest in any case.
How often should you retest?
There’s not really any “should” here, but to offer some advice:
- If you take them too often, you might find you get bored of doing so and stop, essentially burning out.
- If you don’t take them regularly, you may forget, lose this list of tests, etc.
- Likely a good “sweet spot” is quarterly or six-monthly, but there’s nothing wrong with testing annually either.
It’s all about the big picture, after all.
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Luxurious Longevity Risotto
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Pearl barley is not only tasty and fiber-rich, but also, it contains propionic acid, which lowers cholesterol. The fiber content also lowers cholesterol too, of course, by the usual mechanism. The dish’s health benefits don’t end there, though; check out the science section at the end of the recipe!
You will need
- 2 cups pearl barley
- 3 cups sliced chestnut mushrooms
- 2 onions, finely chopped
- 6 large leaves collard greens, shredded
- ½ bulb garlic, finely chopped
- 8 spring onions, sliced
- 1½ quarts low-sodium vegetable stock
- 2 tbsp nutritional yeast
- 1 tbsp chia seeds
- 1 tbsp black pepper, coarse ground
- 1 tsp MSG or 2 tsp low-sodium salt
- 1 tsp rosemary
- 1 tsp thyme
- Extra virgin olive oil, for cooking
- Optional garnish: fresh basil leaves
Method
(we suggest you read everything at least once before doing anything)
1) Heat a little oil in a large sauté pan; add the onions and garlic and cook for 5 minutes; add the mushrooms and cook for another 5 minutes.
2) Add the pearl barley and a cup of the vegetable stock. Cook, stirring, until the liquid is nearly all absorbed, and add more stock every few minutes, as per any other risotto. You may or may not use all the stock you had ready. Pearl barley takes longer to cook than rice, so be patient—it’ll be worth the wait!
Alternative: an alternative is to use a slow cooker, adding a quart of the stock at once and coming back about 4 hours later—thus, it’ll take a lot longer, but will require minimal/no supervision.
3) When the pearl barley has softened, become pearl-like, and the dish is taking on a creamy texture, stir in the rest of the ingredients. Once the greens have softened, the dish is done, and it’s time to serve. Add the garnish if using one:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- The Many Health Benefits Of Garlic
- Chia: The Tiniest Seeds With The Most Value
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?
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Hay fever (also called allergic rhinitis) affects 24% of Australians. Symptoms include sneezing, a runny nose (which may feel blocked or stuffy) and itchy eyes. People can also experience an itchy nose, throat or ears.
But COVID is still spreading, and other viruses can cause cold-like symptoms. So how do you know which one you’ve got?
Lysenko Andrii/Shutterstock Remind me, how does hay fever cause symptoms?
Hay fever happens when a person has become “sensitised” to an allergen trigger. This means a person’s body is always primed to react to this trigger.
Triggers can include allergens in the air (such as pollen from trees, grasses and flowers), mould spores, animals or house dust mites which mostly live in people’s mattresses and bedding, and feed on shed skin.
When the body is exposed to the trigger, it produces IgE (immunoglobulin E) antibodies. These cause the release of many of the body’s own chemicals, including histamine, which result in hay fever symptoms.
People who have asthma may find their asthma symptoms (cough, wheeze, tight chest or trouble breathing) worsen when exposed to airborne allergens. Spring and sometimes into summer can be the worst time for people with grass, tree or flower allergies.
However, animal and house dust mite symptoms usually happen year-round.
Ryegrass pollen is a common culprit. bangku ceria/Shutterstock What else might be causing my symptoms?
Hay fever does not cause a fever, sore throat, muscle aches and pains, weakness, loss of taste or smell, nor does it cause you to cough up mucus.
These symptoms are likely to be caused by a virus, such as COVID, influenza, respiratory syncytial virus (RSV) or a “cold” (often caused by rhinoviruses). These conditions can occur all year round, with some overlap of symptoms:
Natasha Yates/The Conversation COVID still surrounds us. RSV and influenza rates appear higher than before the COVID pandemic, but it may be due to more testing.
So if you have a fever, sore throat, muscle aches/pains, weakness, fatigue, or are coughing up mucus, stay home and avoid mixing with others to limit transmission.
People with COVID symptoms can take a rapid antigen test (RAT), ideally when symptoms start, then isolate until symptoms disappear. One negative RAT alone can’t rule out COVID if symptoms are still present, so test again 24–48 hours after your initial test if symptoms persist.
You can now test yourself for COVID, RSV and influenza in a combined RAT. But again, a negative test doesn’t rule out the virus. If your symptoms continue, test again 24–48 hours after the previous test.
If it’s hay fever, how do I treat it?
Treatment involves blocking the body’s histamine release, by taking antihistamine medication which helps reduce the symptoms.
Doctors, nurse practitioners and pharmacists can develop a hay fever care plan. This may include using a nasal spray containing a topical corticosteroid to help reduce the swelling inside the nose, which causes stuffiness or blockage.
Nasal sprays need to delivered using correct technique and used over several weeks to work properly. Often these sprays can also help lessen the itchy eyes of hay fever.
Drying bed linen and pyjamas inside during spring can lessen symptoms, as can putting a smear of Vaseline in the nostrils when going outside. Pollen sticks to the Vaseline, and gently blowing your nose later removes it.
People with asthma should also have an asthma plan, created by their doctor or nurse practitioner, explaining how to adjust their asthma reliever and preventer medications in hay fever seasons or on allergen exposure.
People with asthma also need to be alert for thunderstorms, where pollens can burst into tinier particles, be inhaled deeper in the lungs and cause a severe asthma attack, and even death.
What if it’s COVID, RSV or the flu?
Australians aged 70 and over and others with underlying health conditions who test positive for COVID are eligible for antivirals to reduce their chance of severe illness.
Most other people with COVID, RSV and influenza will recover at home with rest, fluids and paracetamol to relieve symptoms. However some groups are at greater risk of serious illness and may require additional treatment or hospitalisation.
For RSV, this includes premature infants, babies 12 months and younger, children under two who have other medical conditions, adults over 75, people with heart and lung conditions, or health conditions that lessens the immune system response.
For influenza, people at higher risk of severe illness are pregnant women, Aboriginal people, people under five or over 65 years, or people with long-term medical conditions, such as kidney, heart, lung or liver disease, diabetes and decreased immunity.
If you’re concerned about severe symptoms of COVID, RSV or influenza, consult your doctor or call 000 in an emergency.
If your symptoms are mild but persist, and you’re not sure what’s causing them, book an appointment with your doctor or nurse practitioner. Although hay fever season is here, we need to avoid spreading other serious infectious.
For more information, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria); use the online Symptom Checker; or visit healthdirect.gov.au or the Australian Society of Clinical Immunology and Allergy.
Deryn Thompson, Eczema and Allergy Nurse; Lecturer, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Matcha is having a moment. What are the health benefits of this green tea drink?
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Matcha has experienced a surge in popularity in recent months, leading to reports of global shortages and price increases.
If you haven’t been caught up in the craze, matcha is a powdered version of green tea. On a cafe menu you might see a hot or iced matcha latte, or even a matcha-flavoured cake or pastry. A quick google brings up countless recipes incorporating matcha, both sweet and savoury.
Retailers and cafe owners have suggested the main reasons for matcha’s popularity include its “instagrammable” looks and its purported health benefits.
But what are the health benefits of matcha? Here’s what the evidence says.
Rawpixel.com/Shutterstock First, what is matcha?
Matcha is a finely ground powder of green tea leaves, which come from the plant Camellia sinensis. This is the same plant used to make green and black tea. However, the production process differentiates matcha from green and black tea.
For matcha, the tea plant is grown in shade. Once the leaves are harvested, they’re steamed and dried and the stems are removed. Then the leaves are carefully ground at controlled temperatures to form the powder.
The production process for green tea is simpler. The leaves are picked from the unshaded plants, heated and then dried. We then steep the dried leaves in hot water to get tea (whereas with matcha the whole leaf is consumed).
With black tea, after the leaves are picked they’re exposed to air, which leads to oxidation. This makes the leaves black and gives the tea a different flavour.
In countries such as Japan, matcha is traditionally whisked with water and served in a stone bowl. Charlotte May/Pexels A source of phytonutrients
Phytonutrients are chemical compounds found in plants which have a range of benefits for human health. Matcha contains several.
Chlorophyll gives plants such as Camellia sinensis their green colour. There’s some evidence chlorophyll may have health benefits – including anti-inflammatory, anti-cancer and anti-obesity effects – due to its antioxidant properties. Antioxidants neutralise free radicals, which are unstable molecules that harm our cells.
Theanine has been shown to improve sleep and reduce stress and anxiety. The only other known dietary source of theanine is mushrooms.
Caffeine is a phytonutrient we know well. Aside from increasing alertness, caffeine has also demonstrated antioxidant effects and some protection against a range of chronic and neurodegenerative diseases. However, too much caffeine can have negative side effects.
Interestingly, shading the plants while growing appears to change the nutritional composition of the leaf and may lead to higher levels of these phytonutrients in matcha compared to green tea.
Another compound worth mentioning is called catechins, of which there are several different types. Matcha powder similarly has more catechins than green tea. They are strong antioxidants, which have been shown to have protective effects against bacteria, viruses, allergies, inflammation and cancer. Catechins are also found in apples, blueberries and strawberries.
What are the actual health benefits?
So we know matcha contains a variety of phytonutrients, but does this translate to noticeable health benefits?
A review published in 2023 identified only five experimental studies that have given matcha to people. These studies gave participants about 2–4g of matcha per day (equivalent to 1–2 teaspoons of matcha powder), compared to a placebo, as either a capsule, in tea or in foods. Matcha decreased stress and anxiety, and improved memory and cognitive function. There was no effect on mood.
A more recent study showed 2g of matcha in older people aged 60 to 85 improved sleep quality. However, in younger people aged 27 to 64 in another study, matcha had little effect on sleep.
A study in people with obesity found no difference in the weight loss observed between the matcha group and the control group. This study did not randomise participants, and people knew which group they had been placed in.
It could be hypothesised that given you consume all of the leaf, and given levels of some phytonutrients may be higher due to the growing conditions, matcha may have more nutritional benefits than green tea. But to my knowledge there has been no direct comparison of health outcomes from green tea compared to matcha.
Matcha has grown in popularity – but evidence for its health benefits is still limited. Usanee/Shutterstock There’s lots of evidence for green tea
While to date a limited number of studies have looked at matcha, and none compared matcha and green tea, there’s quite a bit of research on the health benefits of drinking green tea.
A systematic review of 21 studies on green tea has shown similar benefits to matcha for improvements in memory, plus evidence for mood improvement.
There’s also evidence green tea provides other health benefits. Systematic reviews have shown green tea leads to weight loss in people with obesity, lower levels of certain types of cholesterol, and reduced blood pressure. Green tea may also lower the risk of certain types of cancer.
So, if you can’t get your hands on matcha at the moment, drinking green tea may be a good way to get your caffeine hit.
Although the evidence on green tea provides us with some hints about the health benefits of matcha, we can’t be certain they would be the same. Nonetheless, if your local coffee shop has a good supply of matcha, there’s nothing to suggest you shouldn’t keep enjoying matcha drinks.
However, it may be best to leave the matcha croissant or cronut for special occasions. When matcha is added to foods with high levels of added sugar, salt and saturated fat, any health benefits that could be attributed to the matcha may be negated.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Diabetes Code – by Dr. Jason Fung
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Cure this serious disease with diet!” is often a bold-claim that overreaches scientific rigor, but in this case, it’s well-established as scientifically valid.
Caveat up-front: the only known circumstance in which this won’t work is if you have comorbidities that prevent you from following the advice.
You may be wondering: is this just the Mediterranean diet again? The answer is that the Mediterreanean diet (or similar) is part of it. But there’s a lot more to this book than that.
Dr. Fung explains to us a lot of the physiology of type 2 diabetes; how insulin resistance occurs, how it becomes a vicious cycle that we get locked into, and how to escape it.
- We learn about the role of fructose, and why fruit is very healthful whereas high-fructose corn syrup and similars are very much not.
- We learn about the role of the liver in glycogen metabolism, and how to un-fatty a fatty liver. Good news: the liver has famously strong self-regenerative abilities, if we give it a break to allow it to do so!
- We learn why portion control doesn’t work, and why intermittent fasting does (here be science).
Dr. Fung’s very readable explanations are free from needless jargon while not dumbing down. The writing style is clear and direct: “this happens this way”, “do this, not that”, etc.
Bottom line: if you have type 2 diabetes and would like to not have that (or if you are pre-diabetic and would like to avoid diabetes) this is a book for you. If you are in great metabolic health and would like to stay that way as you get older, then this is a book for you too.
Click here to check out The Diabetes Code, and get/keep your metabolic health in order!
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Spiced Fruit & Nut Chutney
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‘Tis the season to make the chutney that will then be aged chutney when you want it later! And unlike supermarket varieties with their ingredients list that goes “Sugar, spirit vinegar, inverted glucose-fructose syrup,” this one has an array of health-giving fruits and nuts (just omit the nuts if you or someone you may want to give this to has an allergy), and really nothing bad in here at all. And of course, tasty healthful spices!
You will need
- 2 red onions, chopped
- 1½ cups dried apricots, chopped
- 1½ cups dried figs, chopped
- 1 cup raisins
- ½ cup apple cider vinegar
- ½ cup slivered almonds
- ½ lime, chopped and deseeded
- ¼ bulb garlic, chopped
- 1 hot pepper, chopped (your choice what kind; omit if you don’t like heat at all; multiply if you want more heat)
- 2 tablespoons honey or maple syrup (omit for a less sweet chutney; there is sweetness in the dried fruits already, after all)
- 1 tbsp freshly grated ginger
- 2 tsp sweet cinnamon
- 1 tsp nutmeg
- 1 tsp black pepper
- ½ teaspoon allspice
- ½ MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a heavy-based pan that will be large enough for all ingredients to go into eventually. Fry the onions on a gentle heat for around 15 minutes. We don’t need to caramelize them yet (this will happen with time), but we do want them soft and sweet already.
2) Add the ginger, garlic, and chili, and stir in well.
3) When the onions start to brown, add the fruit and stir well to mix thoroughly.
4) Add the honey or maple syrup (if using), and the vinegar; add the remaining spices/seasonings, so everything is in there now except the almonds.
5) Cook gently for another 30 minutes while stirring. At some point it’ll become thick and sticky; add a little water as necessary. You don’t want to drown it, but you do want it to stay moist. It’ll probably take only a few tablespoons of added water in total, but add them one at a time and stir in before judging whether more is needed. By the end of the 30 minutes, it should be more solid, to the point it can stand up by itself.
6) Add the almonds, stir to combine, and leave to cool. Put it in jars until you need it (or perhaps give it as gifts).
Alternative method: if you don’t want to be standing at a stove stirring for about an hour in total, you can use a slow cooker / crock pot instead. Put the same ingredients in the same order, but don’t stir them, just leave them in layers (this is because of the pattern of heat distribution; it’ll be hotter at the bottom, so the things that need to be more cooked should be there, and the design means they won’t burn) for about two hours, then stir well to mix thoroughly, and leave it for another hour or two, before turning it off to let it cool. Put it in jars until you need it (or perhaps give it as gifts).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Top 8 Fruits That Prevent & Kill Cancer ← figs and apricots appear here
- Apricots vs Peaches – Which is Healthier? ← have a guess
- Almonds vs Walnuts – Which is Healthier? ← almonds won, but walnuts were close and would also work in this recipe
- Pistachios vs Almonds – Which is Healthier? ← almonds won, but pistachios were close and would also work in this recipe
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we scored 4/5 today!
Take care!
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