Train For The Event Of Your Life!

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Mobility As A Sporting Pursuit

As we get older, it becomes increasingly important to treat life like a sporting event. By this we mean:

As an “athlete of life”, there are always events coming up for which we need to train. Many of these events will be surprise tests!

Such events/tests might include:

  • Not slipping in the shower and breaking a hip (or worse)
  • Reaching an item from a high shelf without tearing a ligament
  • Getting out of the car at an awkward angle without popping a vertebra
  • Climbing stairs without passing out light-headed at the top
  • Descending stairs without making it a sled-ride-without-a-sled

…and many more.

Train for these athletic events now

Not necessarily this very second; we appreciate you finishing reading first. But, now generally in your life, not after the first time you fail such a test; it can (and if we’re not attentive: will) indeed happen to us all.

With regard to falling, you might like to revisit our…

Fall Special

…which covers how to not fall, and to not injure yourself if you do.

You’ll also want to be able to keep control of your legs (without them buckling) all the way between standing and being on the ground.

Slav squats or sitting squats (same exercise, different names, amongst others) are great for building and maintaining this kind of strength and suppleness:

(Click here for a refresher if you haven’t recently seen Zuzka’s excellent video explaining how to do this, especially if it’s initially difficult for you, “The Most Anti-Aging Exercise”)

this exercise is, by the way, great for pretty much everything below the waist!

You will also want to do resistance exercises to keep your body robust:

Resistance Is Useful! (Especially As We Get Older)

And as for those shoulders? If it is convenient for you to go swimming, then backstroke is awesome for increasing and maintaining shoulder mobility (and strength).

If swimming isn’t a viable option for you, then doing the same motion with your arms, while standing, will build the same flexibility. If you do it while holding a small weight (even just 1kg is fine, but feel free to increase if you so wish and safely can) in each hand will build the necessary strength as you go too.

As for why even just 1kg is fine: read on

About that “and strength”, by the way…

Stretching is not everything. Stretching is great, but mobility without strength (in that joint!) is just asking for dislocation.

You don’t have to be built like the Terminator, but you do need to have the structural integrity to move your body and then a little bit more weight than that (or else any extra physical work could be enough to tip you to breaking point) without incurring damage from the strain. So, it needs to not be a strain! See again, the aforementioned resistance exercises.

That said, even very gentle exercise helps too; see for example the impact of walking on osteoporosis:

Living near green spaces linked to higher bone density and lower osteoporosis risk

and…

Walking vs Osteoporosis

So you don’t have to run marathons—although you can if you want:

Marathons in Mid- and Later-Life

…to keep your hips and more in good order.

Want to test yourself now?

Check out:

Building & Maintaining Mobility

Take care!

Don’t Forget…

Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

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  • Cashew Nuts vs Macadamia Nuts – Which is Healthier?

    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.

    Our Verdict

    When comparing cashews to macadamias, we picked the cashews.

    Why?

    In terms of macros, cashews have more than 2x the protein, while macadamias have nearly 2x the fat. The fats are mostly monounsaturated, so it’s still healthy in moderation, but still, we’re going to prize the protein over it and call this category a nominal win for cashews.

    When it comes to vitamins, things are fairly even; cashews have more of vitamins B5, B6, B9, and E, while macadamias have more of vitamins B1, B2, B3, and C.

    In the category of minerals, cashews take the clear lead; cashews have more copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while macadamias have more calcium and manganese.

    In short, enjoy both (as macadamias have their benefits too), but cashews win in total nutrient density.

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

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  • Why 7 Hours Sleep Is Not Enough

    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.

    How Sleep-Deprived Are You, Really?

    This is Dr. Matthew Walker. He’s a neuroscientist and sleep specialist, and is the Director of the Center for Human Sleep Science at UC Berkeley’s Department of Psychology. He’s also the author of the international bestseller “Why We Sleep”.

    What does he want us to know?

    Sleep deprivation is more serious than many people think it is. After about 16 hours without sleep, the brain begins to fail, and needs more than 7 hours of sleep to “reset” cognitive performance.

    Note: note “seven or more”, but “more than seven”.

    After ten days with only 7 hours sleep (per day), Dr. Walker points out, the brain is as dysfunctional as it would be after going without sleep for 24 hours.

    Here’s the study that sparked a lot of Dr. Walker’s work:

    The Cumulative Cost of Additional Wakefulness: Dose-Response Effects on Neurobehavioral Functions and Sleep Physiology From Chronic Sleep Restriction and Total Sleep Deprivation

    Importantly, in Dr. Walker’s own words:

    Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping❞

    ~ Dr. Matthew Walker

    See also: Why You Probably Need More Sleep

    Furthermore: the sleep-deprived mind is unaware of how sleep-deprived it is.

    You know how a drunk person thinks they can drive safely? It’s like that.

    You do not know how sleep-deprived you are, when you are sleep-deprived!

    For example:

    ❝(60.7%) did not signal sleepiness before a sleep fragment occurred in at least one of the four MWT trials❞

    Source: Sleepiness is not always perceived before falling asleep in healthy, sleep-deprived subjects

    Sleep efficiency matters

    With regard to the 7–9 hours band for optimal health, Dr. Walker points out that the sleep we’re getting is not always the sleep we think we’re getting:

    ❝Assuming you have a healthy sleep efficiency (85%), to sleep 9 hours in terms of duration (i.e. to be a long-sleeper), you would need to be consistently in bed for 10 hours and 36 minutes a night. ❞

    ~ Dr. Matthew Walker

    At the bottom end of that, by the way, doing the same math: to get only the insufficient 7 hours sleep discussed earlier, a with a healthy 85% sleep efficiency, you’d need to be in bed for 8 hours and 14 minutes per night.

    The unfortunate implication of this: if you are consistently in bed for 8 hours and 14 minutes (or under) per night, you are not getting enough sleep.

    “But what if my sleep efficiency is higher than 85%?”

    It shouldn’t be.If your sleep efficiency is higher than 85%, you are sleep-deprived and your body is having to enforce things.

    Want to know what your sleep efficiency is?

    We recommend knowing this, by the way, so you might want to check out:

    Head-To-Head Comparison of Google and Apple’s Top Sleep-Monitoring Apps

    (they will monitor your sleep and tell you your sleep efficiency, amongst other things)

    Want to know more?

    You might like his book:

    Why We Sleep: Unlocking the Power of Sleep and Dreams

    …and/or his podcast:

    The Matt Walker Podcast

    …and for those who like videos, here’s his (very informative) TED talk:

    !

    Prefer text? Click here to read the transcript

    Want to watch it, but not right now? Bookmark it for later

    Enjoy!

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  • How they did it: STAT reporters expose how ailing seniors suffer when Medicare Advantage plans use algorithms to deny care

    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.

    In a call with a long-time source, what stood out most to STAT reporters Bob Herman and Casey Ross was just how viscerally frustrated and angry the source was about an algorithm used by insurance companies to decide how long patients should stay in a nursing home or rehab facility before being sent home.­

    The STAT stories had a far-reaching impact:

    • The U.S. Senate Committee on Homeland Security and Government Affairs took a rare step of launching a formal investigation into the use of algorithms by the country’s three largest Medicare Advantage insurers.
    • Thirty-two House members urged the Centers for Medicare and Medicaid Services to increase the oversight of algorithms that health insurers use to make coverage decisions.
    • In a rare step, CMS launched its own investigation into UnitedHealth. It also stiffened its regulations on the use of proprietary algorithms and introduced plans to audit denials across Medicare Advantage plans in 2024.
    • Based on STAT’s reporting, Medicare Advantage beneficiaries filed two class-action lawsuits against UnitedHealth and its NaviHealth subsidiary, the maker of the algorithm, and against Humana, another major health insurance company that was also using the algorithm. 
    • Amid scrutiny, UnitedHealth renamed NaviHealth.

    The companies never allowed an on-the-record interview with their executives, but they acknowledged that STAT’s reporting was true, according to the news organization.

    Ross and Herman spoke with The Journalist’s Resource about their project and shared the following eight tips.

    1. Search public comments on proposed federal rules to find sources.

    Herman and Ross knew that the Centers for Medicare and Medicaid Services had put out a request for public comments, asking stakeholders within the Medicare Advantage industry how the system could improve.

    There are two main ways to get Medicare coverage: original Medicare, which is a fee-for-service health plan, and Medicare Advantage, which is a type of Medicare health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans have increasingly become popular in recent years.

    Under the Social Security Act, the public has the opportunity to submit comments on Medicare’s proposed national coverage determinations. CMS uses public comments to inform its proposed and final decisions. It responds in detail to all public comments when issuing a final decision.

    The reporters began combing through hundreds of public comments attached to a proposed Medicare Advantage rule that was undergoing federal review. NaviHealth, the UnitedHealth subsidiary and the maker of the algorithm, came up in many of the comments, which include the submitters’ information.

    “These are screaming all-caps comments to federal regulators about YOU NEED TO SOMETHING ABOUT THIS BECAUSE IT’S DISGUSTING,” Ross says.

    “The federal government is proposing rules and regulations all the time,” adds Herman, STAT’s business of health care reporter. “If someone’s going to take the time and effort to comment on them, they must have at least some knowledge of what’s going on. It’s just a great tool for any journalist to use to figure out more and who to contact.”

    The reporters also found several attorneys who had complained in the comments. They began reaching out to them, eventually gaining access to confidential documents and intermediaries who put them in touch with patients to show the human impact of the algorithm.

    2. Harness the power of the reader submission box.

    At the suggestion of an editor, the reporters added a reader submission box at the bottom of their first story, asking them to share their own experiences with Medicare Advantage denials.

    The floodgates opened. Hundreds of submissions arrived.

    By the end of their first story, Herman and Ross had confidential records and some patients, but they had no internal sources in the companies they were investigating, including Navihealth. The submission box led them to their first internal source.

    (Screenshot of STAT’s submission box.)

    The journalists also combed through LinkedIn and reached out to former and current employees, but the response rate was much lower than what they received via the submission box.

    The submission box “is just right there,” Herman says. “People who would want to reach out to us can do it right then and there after they read the story and it’s fresh in their minds.”

    3. Mine podcasts relevant to your story.

    The reporters weren’t sure if they could get interviews with some of the key figures in the story, including Tom Scully, the former head of the Centers for Medicare and Medicaid Services who drew up the initial plans for NaviHealth years before UnitedHealth acquired it.

    But Herman and another colleague had written previously about Scully’s private equity firm and they had found a podcast where he talked about his work. So Herman went back to the podcast — where he discovered Scully had also discussed NaviHealth.

    The reporters also used the podcast to get Scully on the phone for an interview.

    “So we knew we had a good jumping off point there to be like, ‘OK, you’ve talked about NaviHealth on a podcast, let’s talk about this,’” Herman says. “I think that helped make him more willing to speak with us.”

    4. When covering AI initiatives, proceed with caution.

    “A source of mine once said to me, ‘AI is not magic,’” Ross says. “People need to just ask questions about it because AI has this aura about it that it’s objective, that it’s accurate, that it’s unquestionable, that it never fails. And that is not true.”

    AI is not a neutral, objective machine, Ross says. “It’s based on data that’s fed into it and people need to ask questions about that data.”

    He suggests several questions to ask about the data behind AI tools:

    • Where does the data come from?
    • Who does it represent?
    • How is this tool being applied?
    • Do the people to whom the tool is being applied match the data on which it was trained? “If racial groups or genders or age of economic situations are not adequately represented in the training set, then there can be an awful lot of bias in the output of the tool and how it’s applied,” Ross says.
    • How is the tool applied within the institution? Are people being forced to forsake their judgment and their own ability to do their jobs to follow the algorithm?

    5. Localize the story.

    More than half of all Medicare beneficiaries have Medicare Advantage and there’s a high likelihood that there are multiple Medicare Advantage plans in every county across the nation.

    “So it’s worth looking to see how Medicare Advantage plans are growing in your area,” Herman says.

    Finding out about AI use will most likely rely on shoe-leather reporting of speaking with providers, nursing homes and rehab facilities, attorneys and patients in your community, he says. Another source is home health agencies, which may be caring for patients who were kicked out of nursing homes and rehab facilities too soon because of a decision by an algorithm.

    The anecdote that opens their first story involves a small regional health insurer in Wisconsin, which was using NaviHealth and a contractor to manage post-acute care services, Ross says.

    “It’s happening to people in small communities who have no idea that this insurer they’ve signed up with is using this tool made by this other company that operates nationally,” Ross says.

    There are also plenty of other companies like NaviHealth that are being used by Medicare Advantage plans, Herman says. “So it’s understanding which Medicare Advantage plans are being sold in your area and then which post-acute management companies they’re using,” he adds.

    Some regional insurers have online documents that show which contractors they use to evaluate post-acute care services.

    6. Get familiar with Medicare’s appeals databases

    Medicare beneficiaries can contest Medicare Advantage denials through a five-stage process, which can last months to years. The appeals can be filed via the Office of Medicare Hearings and Appeals.

    “Between 2020 and 2022, the number of appeals filed to contest Medicare Advantage denials shot up 58%, with nearly 150,000 requests to review a denial filed in 2022, according to a federal database,” Ross and Herman write in their first story. “Federal records show most denials for skilled nursing care are eventually overturned, either by the plan itself or an independent body that adjudicates Medicare appeals.”

    There are several sources to find appeals data. Be mindful that the cases themselves are not public to protect patient privacy, but you can find the number of appeals filed and the rationale for decisions.

    CMS has two quality improvement organizations, or QIOs, Livanta and Kepro, which are required to file free, publicly-available annual reports, about the cases they handle, Ross says.

    Another company, Maximus, a Quality Improvement Contractor, also files reports on prior authorization cases it adjudicates for Medicare. The free annual reports include data on raw numbers of cases and basic information about the percentage denials either overturned or upheld on appeal, Ross explains.

    CMS also maintains its own database on appeals for Medicare Part C (Medicare Advantage plans) and Part D, which covers prescription drugs, although the data is not complete, Ross explains.

    7. Give your editor regular updates.

    “Sprinkle the breadcrumbs in front of your editors,” Ross says.

    “If you wrap your editors in the process, you’re more likely to be able to get to the end of [the story] before they say, ‘That’s it! Give me your copy,’” Ross says.

    8. Get that first story out.

    “You don’t have to know everything before you write that first story,” Ross says. “Because with that first story, if it has credibility and it resonates with people, sources will come forward and sources will continue to come forward.”

    Read the stories

    Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need

    How UnitedHealth’s acquisition of a popular Medicare Advantage algorithm sparked internal dissent over denied care

    UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care

    UnitedHealth used secret rules to restrict rehab care for seriously ill Medicare Advantage patients

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Asparagus vs Eggplant – Which is Healthier?

    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.

    Our Verdict

    When comparing asparagus to eggplant, we picked the asparagus.

    Why?

    In terms of macros, they’re very similar. Technically asparagus has twice the protein, but it’s at 2.2g/100g compared to eggplant’s 0.98g/100g, so it’s not too meaningful. They’re both mostly water, low in carbs, with a little fiber, and negligible fat (though eggplant technically has more fat, but again, these numbers are miniscule). For practical purposes, the two vegetables are even in this category, or if you really want decisive answers, a tiny margin of a win for asparagus.

    In the category of vitamins, asparagus is much higher in vitamins A, B1, B2, B3, B5, B6, B9, E, & K, as well as choline. Eggplant is not higher in any vitamins. A clear win for asparagus.

    When it comes to minerals, asparagus is much higher in calcium, copper, iron, phosphorus, selenium, and zinc, while eggplant is a little higher in manganese. Another easy win for asparagus.

    Lastly, asparagus wins on polyphenols too, with its high quercetin content. Eggplant does contain some polyphenols, but in such tiny amounts that even added up they’re less than 7% of what asparagus has to offer in quercetin alone.

    Obviously, enjoy both, though! Diversity is healthy.

    Want to learn more?

    You might like to read:

    Fight Inflammation & Protect Your Brain, With Quercetin

    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

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  • Life Is in the Transitions – by Bruce Feiler

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    Change happens. Sometimes, because we choose it. More often, we don’t get a choice.

    Our bodies change; with time, with illness, with accident or incident, or even, sometimes, with effort. People in our lives change; they come, they go, they get sick, they die. Our working lives change; we get a job, we lose a job, we change jobs, our jobs change, we retire.

    Whether we’re undergoing cancer treatment or a religious conversion, whether our families are growing or down to the last few standing, change is inescapable.

    Our author makes the case that on average, we each undergo at least 5 major “lifequakes”; changes that shake our lives to the core. Sometimes one will come along when we’ve barely got back on our feet from the previous—if we have at all.

    What, then, to do about this? We can’t stop change from occurring, and some changes aren’t easy to “roll with”. Feiler isn’t prescriptive about this, but rather, descriptive:

    By looking at the stories of hundreds of people he interviewed for this book, he looks at how people pivoted on the spot (or picked up the pieces!) and made the best of their situation—or didn’t.

    Bottom line: zooming out like this, looking at many people’s lives, can remind us that while we don’t get to choose what winds we get swept by, we at least get to choose how we set the sails. The examples of others, as this book gives, can help us make better decisions.

    Click here to check out Life Is In The Transitions, and get conscious about how you handle yours!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Breaking The Age Code – by Dr. Becca Levy

    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 author, a social psychologist, sets out to not only bust ageist expectations, but also boost life expectancy by 7.5 years.

    How? By examining the extent to which how we think about our age affects our actual aging. Lest this sound wishy-washy, there are 52 pages of scientific references at the back.

    We’ve written about this before at 10almonds, for example about the famous “Counterclockwise” study that saw reversals in biological markers of aging after a one-week intervention that consisted only of a (albeit rather intensive) mental reframe with regard to their age.

    This book goes into such ideas much more than we can in a single article here, and in more ways, both on the personal level and the societal level.

    The style is (despite its heavy leanings on hundreds of scientific studies) quite conversational in tone, with many personal anecdotes padding the pages a little, but it does get the message across and helps to illustrate things.

    Bottom line: if you’d like a fresh take on aging, to make a big difference to yours, this book tackles that.

    Click here to check out Breaking The Age Code, and break the age code!

    Don’t Forget…

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    Learn to Age Gracefully

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