New Evidence: HRT Doesn’t Increase Cancer Risk Even If You Have The Genes For It

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…and other items from this week’s health news:

Good news for those with the unfortunate mutation in the BRCA1 and BRCA2 genes

After the deeply-flawed, since-refuted, and popularly-misrepresented Women’s Health Initiative study that tanked the reputation of hormone replacement therapy (HRT), many people worry about the possibility of menopausal HRT (MHT) increasing the risk of cancer. And while some cancers in some people can be affected by estrogen levels, the latest research shows that not only does estrogen convey no additional risk to carriers of the cancer-risk-increasing mutations in the BRCA1 and BRCA2 genes, but also, some formulations can even reduce the risk.

Dr. Joanne Kotsopoulos and her team set up 676 matched pairs of post-menopausal BRCA carriers—one MHT user, one non-user—matched by mutation type, birth year, and age at menopause, and looked at the effect of their use of estrogen alone, progesterone alone, combined estrogen–progesterone, tibolone, or old-fashioned conjugated equine estrogen with bazedoxifene, and found that over a mean 5.6-year follow-up, MHT users had 87 breast cancer cases versus 128 in non-users (remember, these had been matched 1:1, so this isn’t a case of “there were more non-users”, because there were 676 users and 676 non-users).

Most formulations showed no increase or decrease in risk; however, the use of estrogen-only MHT was associated with a 63% lower breast cancer risk compared with non-users!

Read in full: Menopausal hormone therapy shows no added breast cancer risk for BRCA carriers

Related: The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

NAD⁺ vs Long COVID & brain fog

Researchers looked at whether raising NAD⁺ with high-dose nicotinamide riboside (NR) could ease long COVID symptoms such as fatigue, sleep problems, and brain fog.

The short answer: among all participants who took NR for at least 10 weeks, researchers observed improvements from baseline in fatigue, sleep, depressive symptoms, and performance on an executive-function task.

Also, NR reliably increased circulating NAD⁺ levels in participants who took the supplement, which is important, as taking NAD⁺ directly often doesn’t increase the levels so well.

Read in full: NAD+ supplement shows early promise for long COVID fatigue and brain fog

Related: NAD⁺ vs Long COVID!

“Disabled” is other people… Right?

A recent survey of 3,881 Americans aged 50–95 (of whom, 1,353 from Michigan) found that many older Americans avoid the disability label even though far more report significant functional limits (there’s a medical word for those, and the word is “disability”).

Some notes about numbers:

  • Disability incidence: about ⅓ of people aged 65–74 and more than 44% of those over 75 had difficulties with hearing, seeing, walking, climbing stairs, dressing, bathing, concentrating, remembering, working, or leaving the home
  • ADA-related conditions: when asked about conditions such as speech or breathing difficulties that would qualify for accommodations under disability law, half of adults aged 65 to 74 and about ⅔ of older respondents reported disability-level needs
  • The accommodations gap: fewer than 1 in 5 older adults had ever received a healthcare accommodation and only 1 in 4 had asked for one

And yet, studies show that people who do identify as disabled have higher self-esteem, less depression and anxiety, and stronger self-efficacy, and it has been noted that the disability community often works together to solve problems that others ignore:

Read in full: Many older Americans don’t see themselves as disabled, survey finds

Related: This Chair Rocks: A Manifesto Against Ageism – by Ashton Applewhite

Take care!

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  • What are heart rate zones, and how can you incorporate them into your exercise routine?

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    If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates.

    Heart rate zones reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute.

    But what are the different heart rate zones, and how can you use these zones to optimise your workout?

    The three-zone model

    While there are several models used to describe heart rate zones, the most common model in the scientific literature is the three-zone model, where the zones may be categorised as follows:

    • zone 1: 55%–82% of maximum heart rate
    • zone 2: 82%–87% of maximum heart rate
    • zone 3: 87%–97% of maximum heart rate.

    If you’re not sure what your maximum heart rate is, it can be calculated using this equation: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute.

    There are also other models used to describe heart rate zones, such as the five-zone model (as its name implies, this one has five distinct zones). These models largely describe the same thing and can mostly be used interchangeably.

    What do the different zones involve?

    The three zones are based around a person’s lactate threshold, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic.

    Aerobic exercise uses oxygen to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time.

    On average your lactate threshold tends to sit around 85% of your maximum heart rate, although this varies from person to person, and can be higher in athletes.

    A woman with an activity tracker on her wrist looking at a smartphone.
    Wearable technology has taken off in recent years. Ketut Subiyanto/Pexels

    In the three-zone model, each zone loosely describes one of three types of training.

    Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace.

    Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences.

    Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3.

    Striking a balance

    To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout.

    While zone 3 is thought to produce the largest improvements in maximal oxygen uptake – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much.

    Training in different heart rate zones improves slightly different physiological qualities, and so by spending time in each zone, you ensure a variety of benefits for performance and health.

    So how much time should you spend in each zone?

    Most elite endurance athletes, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3.

    Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate more than 250 kilometres per week, which would be impossible to recover from if it was all performed in zone 2 or 3.

    Of course, most people are not professional athletes. The World Health Organization recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week.

    If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines.

    What if I don’t have a heart rate monitor?

    If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training.

    The three heart rate zones discussed in this article can also be prescribed based on feel using a simple 10-point scale, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce.

    With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10.

    Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.

    Hunter Bennett, Lecturer in Exercise Science, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Can you ‘boost’ your immune system?

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    As flu season and a likely winter COVID-19 wave approach, you may encounter both proven and unproven methods claiming to “boost” your immune system. Before you reach for supplements, learn more about how the immune system works, how vaccines give us the best protection against many illnesses, and how some lifestyle factors can help your immune system function properly.

    What is the immune system?

    The immune system is the body’s first line of defense against invaders like viruses, bacteria, or fungi. You develop immunity—or protection from infection—when your immune system has learned how to recognize an invader and attack it before it makes you sick.

    How can you boost your immune system?

    You can teach your immune system how to fight back against dangerous invaders by staying up to date on vaccines. This season’s updated flu and COVID-19 vaccines target newer variants and are recommended for everyone 6 months and older.

    Vaccines reduce your risk of getting sick and spreading illness to others. Even if you get infected with a disease after you’ve been vaccinated against it, the vaccine will still increase protection against severe illness, hospitalization, and death.

    People who have compromised immune systems due to certain health conditions or because they need to take immunosuppressant medications may need additional vaccine doses.

    Find out which vaccines you and your children need by using the CDC’s Adult Vaccine Assessment Tool and Child and Adolescent Vaccine Assessment Tool. Talk to your health care provider about the best vaccines for your family. 

    Find pharmacies offering updated flu and COVID-19 vaccines by visiting Vaccines.gov.

    Can supplements boost your immune system?

    Many vitamin, mineral, and herbal supplements that are marketed as “immune boosting” have little to no effect on your immune system. Research is split on whether some of these supplements—like vitamin C, vitamin D, and zinc—are capable of helping your body fight infections.

    Plus, the Food and Drug Administration typically does not review supplements until after they have reached store shelves, and companies can sell supplements without notifying the FDA. This means that supplements may not be accurately labeled.

    Eating a diverse diet rich in fruits and vegetables is the best way for most people to absorb nutrients that support optimal immune system function. People with certain health conditions and deficiencies may need specific supplements prescribed by a health care provider. For example, people with anemia may need iron supplements in order to maintain appropriate iron levels.

    Before you begin taking a new supplement, talk to your health care provider, as some supplements may interact with medications you are taking or worsen certain health conditions.

    Can lifestyle factors strengthen your immune system?

    Based on current evidence, there is no direct link between lifestyle changes and enhanced immunity to infections. However, maintaining a healthy lifestyle through the following practices can help ensure that your immune system functions as it should:

    Taking steps to avoid contact with germs also reduces your risk of getting sick. Safer sex barriers like condoms protect against HIV, while wearing a high-quality, well-fitting mask—especially in high-risk environments—protects against COVID-19. Both of these illnesses can reduce your production of white blood cells, which protect against infection. 

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Hazelnuts vs Cashews – Which is Healthier?

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    Our Verdict

    When comparing hazelnuts to cashews, we picked the hazelnuts.

    Why?

    It’s close! This one’s interesting…

    In terms of macros, hazelnuts have more fiber and fats, while cashews have more protein and carbs. All in all, all good stuff all around; maybe a win for one or the other depending on your priorities. We’d pick hazelnuts here, but your preference may vary.

    When it comes to vitamins, hazelnuts have more of vitamins A, B1, B2, B3, B5, B6, B9, C, and E, while cashews have more vitamin K. An easy win for hazelnuts here, and the margins weren’t close.

    In the category of minerals, hazelnuts have more calcium, manganese, and potassium, while cashews have more copper, iron, magnesium, phosphorus, selenium, and zinc. This is a win for cashews, but it’s worth noting that cup for cup, both of these nuts provide more than the daily requirement of most of those minerals. This means that in practical terms, it doesn’t matter too much that (for example), while cashews provide 732% of the daily requirement for copper, hazelnuts “only” provide 575%. So while this category remains a victory for cashews, it’s something of a “on paper” thing for the most part.

    Adding up the sections (ambivalent + clear win for hazelnuts + nominal win for cashews) means that in total today we’re calling it in favour of hazelnuts… But as ever, enjoy both, because both are good and so is diversity!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

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  • The Best Foods For Collagen Production

    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.

    Dr. Andrea Suarez gives us the low-down on collagen synthesis and maintenance. Collagen is the most abundant protein in our body, and it can be fairly described as “the stuff that holds us together”. It’s particularly important for joints and bones too, though many people’s focus on it is for the skin. Whatever your priorities, collagen levels are something it pays to be mindful of, as they usually drop quite sharply after a certain age. What certain age? Well, that depends a lot on you, and your diet and lifestyle. But it can start to decline from the age of 30 with often noticeable drop-offs in one’s mid-40s and again in one’s mid-60s.

    Showing us what we’re made of

    There’s a lot more to having good collagen levels than just how much collagen we consume (which for vegetarians/vegans, will be “none”, unless using the “except if for medical reasons” exemption, which is probably a little tenuous in the case of collagen but nevertheless it’s a possibility; this exemption is usually one that people use for, say, a nasal spray vaccine that contains gelatine, or a medicinal tablet that contains lactose, etc).

    Rather, having good collagen levels is also a matter of what we eat that allows us to synthesize our own collagen (which includes: its ingredients, and various “helper” nutrients), as well as what dietary adjustments we make to avoid our extant collagen getting broken down, degraded, and generally lost.

    Here’s what Dr. Suarez recommends:

    Protein-rich foods (but watch out)

    • Protein is essential for collagen production.
    • Sources: fish, soy, lean meats (but not red meats, which—counterintuitively—degrade collagen), eggs, lentils.
    • Egg whites are high in lysine, vital for collagen synthesis.
    • Bone broth is a natural source of collagen.

    Omega-3 fatty acids

    • Omega-3s are anti-inflammatory and protect skin collagen.
    • Sources: walnuts, chia seeds, flax seeds, fatty fish (e.g. mackerel, sardines).

    Leafy greens

    • Leafy dark green vegetables (e.g. kale, spinach) are rich in vitamins C and B9.
    • Vitamin C is crucial for collagen synthesis and acts as an antioxidant.
    • Vitamin B9 supports skin cell division and DNA repair.

    Red fruits & vegetables

    • Red fruits/vegetables (e.g. tomatoes, red bell peppers) contain lycopene, an antioxidant that protects collagen from UV damage (so, that aspect is mostly relevant for skin, but antioxidants are good things to have in all of the body in any case).

    Orange-colored vegetables

    • Carrots and sweet potatoes are rich in vitamin A, which helps in collagen repair and synthesis.
    • Vitamin A is best from food, not supplements, to avoid potential toxicity.

    Fruits rich in vitamin C

    • Citrus fruits, kiwi, and berries are loaded with vitamin C and antioxidants, essential for collagen synthesis and skin health.

    Soy

    • Soy products (e.g. tofu, soybeans) contain isoflavones, which reduce inflammation and inhibit enzymes that degrade collagen.
    • Soy is associated with lower risks of chronic diseases.

    Garlic

    • Garlic contains sulfur, taurine, and lipoic acid, important for collagen production and repair.

    What to avoid:

    • Reduce foods high in advanced glycation end products (AGEs), which damage collagen and promote inflammation.
    • AGEs are found in fried, roasted, or grilled fatty proteinous foods (e.g. meat, including synthetic meat, and yes, including grass-fed nicely marketed meat—although processed meat such as bacon and sausages are even worse than steaks etc).
    • Switch to cooking methods like boiling or steaming to reduce AGE levels.
    • Processed foods, sugary pastries, and red meats contribute to collagen degradation.

    General diet tips:

    • Incorporate more plant-based, antioxidant-rich foods.
    • Opt for slow cooking to reduce AGEs.
    • Since sustainability is key, choose foods you enjoy for a collagen-boosting diet that you won’t seem like a chore a month later.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    We Are Such Stuff As Fish Are Made Of ← our main feature research review about collagen

    Take care!

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  • The Alzheimer’s Solution – by Dr. Dean Sherzai and Dr. Ayesha Sherzai

    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.

    After discussing the myths and misunderstandings that surround Alzheimer’s, the authors (both neurologists) explain the importance of evidence-based lifestyle medicine, which many people underestimate and thus neglect.

    There’s a risk assessment for the reader to perform, which can help inform what things will be the highest priority when it comes to, as the subtitle promises, preventing and reversing Alzheimer’s.

    How they go about this: they note the four main biological processes that drive the development of Alzheimer’s:

    • Inflammation
    • Oxidation
    • Glucose dysregulation
    • Lipid dysregulation

    …and then focus on how to prevent or reverse those four things, each of which are better-understood by current science than Alzheimer’s in its entirety.

    As for how they present that in practical terms, they offer the acronym NEURO:

    • Nutrition
    • Exercise
    • Unwind
    • Restore
    • Optimize

    You may be wondering what the distinction between “unwind” and “restore” is; the former is about stress management, while the latter is about restorative sleep.

    Within each of these five categories, each of which gets a chapter devoted to it, they give instructions for making one’s own personalized program for each part.

    The style is direct and explanatory, with no fluff or padding, no sensationalization, no detours into anecdotes of cherry-picked case studies, just science, data, explanations. In terms of legibility for those not accustomed to reading scientifically dense texts: it’s easier to read than most actual papers, though for many it may be beneficial to read the book cover-to-cover, because the authors define terms early and then will expect the reader to remember them later (although, one can also refer to the glossary, included). Speaking of scientific papers, there’s a generous bibliography here, nearly 40 pages of such.

    Bottom line: if you’re serious about preventing/reversing Alzheimer’s, and you want an evidence-based holistic approach, this book lays out the most important things currently known to science, and how to do them optimally.

    Click here to check out The Alzheimer’s Solution, and improve your odds!

    Don’t Forget…

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  • How To Get Unstuck

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    At 10almonds we sometimes say “mental health is also simply health”, and in this video, we get an examination of how one’s state of mind affects physical health and life in general—for better or for worse—and how to shift out of the wrong mental gear and into a better one:

    Inside out

    Zuzka notes that feeling stuck is often a result of fear and limited perspective, not an actual lack of options. Now, this does not mean that external circumstances don’t exist, or that we go through life without limitations. But it does mean we must start by asking ourselves the right questions, such as in this case, “Am I being resourceful right now?”

    For her, she considers that being resourceful means seeking solutions and seeing possibilities, even in difficult situations—and that it’s a skill that can be trained like a muscle.

    To that end, she champions trying things even if we think we may fail (indeed, she acknowledges that experiencing failure is inevitable and/but ultimately, however, learning from short-term failure increases chances of long-term success).

    In the case of being afraid (of failure, or more specifically, trying hard and failing anyway, which can feel worse than not trying at all), she recommends that small actions (which she calls actions of “micro-bravery”) can break the cycle and reduce fear—which is important, because otherwise, fear only grows over time if we avoid taking actions to challenge it.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    The Most Anti-Aging Exercise ← this same YouTuber’s most well-known video (and our discussion of it). She is, by the way, in her early 40s at time of writing. So, rather younger than the average 10almonds reader, but also rather older than the average fitness influencer!

    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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