Outlive – by Dr. Peter Attia
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We know, we know; this diet, that exercise, don’t smoke or drink, get decent sleep”—a lot of books don’t go beyond this level of advice!
What Dr. Attia offers is a multi-vector approach that covers the above and a lot more.
Themes of the book include:
- The above-mentioned things, of course
- Rethinking medicine for the age of chronic disease
- The pros and cons of…
- caloric restriction
- dietary restriction
- intermittent fasting
- Pre-emptive interventions for…
- specific common cause-of-death conditions
- specific common age-related degenerative conditions
- The oft-forgotten extra pillar of longevity: mental health
The last one in the list there is covered mostly in the last chapter of the book, but it’s there as a matter of importance, not as an afterthought. As Dr. Attia puts it, not only are you less likely to take care of your physical health if you are (for example) depressed, but also… “Longevity is meaningless if your life sucks!”
So, it’s important to do things that promote and maintain good physical and mental health.
Bottom line: if you’re interested in happy, healthy, longevity, this is a book for you.
Click here to check out Dr. Attia’s “Outlive” on Amazon today!
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One More Resource Against Osteoporosis!
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Your Bones Were Made For Moving Too!
We know that to look after bone health, resistance training is generally what’s indicated. Indeed, we mentioned it yesterday, and we’ve talked about it before:
Resistance Is Useful! (Especially As We Get Older)
We also know that if you have osteoporosis already, some exercises are a better or worse idea than others:
Osteoporosis & Exercises: Which To Do (And Which To Avoid)
However! New research suggests that also getting in your recommended 150 minutes per week of moderate exercise slows bone density loss.
The study by Dr. Tiina Savikangas et al. looked at 299 people in their 70s (just over half being women) and found that, over the course of a year, bone mineral density loss was inversely correlated with moderate exercise as recorded by an accelerometer (as found in most fitness-tracking wearables and smartphones).
In other words: those who got more minutes of exercise, kept more bone mineral density.
As well as monitoring bone mineral density, the study also looked at cross-sectional area, but that remained stable throughout.
As for how much is needed:
❝Even short bursts of activity can be significant for the skeleton, so we also looked at movement in terms of the number and intensity of individual impacts. For example, walking and running cause impacts of different intensities.
We found that impacts that were comparable to at least brisk walking were associated with better preservation of bone mineral density.❞
Read more: Impacts during everyday physical activity can slow bone loss ← pop-science source, interviewing the lead researcher
On which note, we’ve a small bone to pick…
As a small correction, the pop-science source says that the subjects’ ages ranged from 70 to 85 years; the paper, meanwhile, clearly shows that the age-range was 74.4±3.9 years (shown in the “Results” table), rounded to 74.4 ± 4 years, in the abstract. So, certainly no participant was older than 78 years and four months.
Why this matters: the age range itself may be critical or it might not, but what is important is that this highlights how we shouldn’t just believe figures cited in pop-science articles, and it’s always good to click through to the source!
This paper is a particularly fascinating read if you have time, because—unlike a lot of studies—they really took great care to note what exactly can and cannot be inferred from the data, and how and why.
Especially noteworthy was the diligence with which they either controlled for, or recognized that they could not control for, far more variables than most studies even bother to mention.
This kind of transparency is critical for good science, and we’d love to see more of it!
Want to apply this to your life?
Tracking minutes-of-movement is one of the things that fitness trackers are best at, so connect your favourite app (one of these days we’ll do a fitness tracker comparison article) and get moving!
And as for the other things that fitness trackers do? As it turns out, they do have their strengths and weaknesses, which are good to bear in mind:
Take care!
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Sweet Potato vs Cassava – Which is Healthier?
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Our Verdict
When comparing sweet potato to cassava, we picked the sweet potato.
Why?
For any unfamiliar with cassava, it’s also called manioc or yuca/yucca, and it’s a tuber that can be used a lot like sweet potato. It’s popular in S. America, often in recipes that aren’t the healthiest (deep-fried chunky “cassava chips” are popular in Brazil, for example, and farofa, a flour made from cassava, is less healthy even than refined white flour from wheat), but today we’re going to judge it on its own merit—since after all, almost anything can be deep-fried and many things can be turned into flour, but it doesn’t mean we have to do that.
Let’s talk macros first: sweet potato has nearly 2x the protein, while cassava has nearly 2x the carbs. As for fiber to soften those carbs’ impact on our blood sugars, well, sweet potato has about 2x the fiber. All in all for macros, a clear and easy win for sweet potato.
Important note: as for the impact that has on glycemic index: the exact glycemic index will depend on what you do with it (different cooking methods change the GI), but broadly speaking, sweet potatoes are considered a medium GI food, while cassava is a very high GI food, to the point that it’s higher than sucrose, and nearly equal to pure glucose. Which is impressive, for a tuber.
In terms of vitamins, sweet potato’s famously high vitamin A content raises the bar, but it’s not all it has to offer: sweet potato has more of vitamins A, B1, B2, B3, B5, B6, E, and K, while cassava has more of vitamins B9 and choline. Just for amusement’s sake, let’s note that the sweet potato has over 1,478x the vitamin A content. In any case, the vitamins category is another clear win for sweet potato.
When it comes to minerals, it’s again quite one-sided: sweet potato has more calcium, copper, iron, magnesium, manganese, phosphorus, and potassium, while cassava has more selenium. So, sweet potato wins yet again.
In short: definitely a case of “the less widely-available option is not necessarily the healthier”!
Want to learn more?
You might like to read:
Glycemic Index vs Glycemic Load vs Insulin Index
Take care!
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Lower Cholesterol Naturally
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Lower Cholesterol, Without Statins
We’ll start this off by saying that lowering cholesterol might not, in fact, be critical or even especially helpful for everyone, especially in the case of women. We covered this more in our article about statins:
…which was largely informed by the wealth of data in this book:
The Truth About Statins – by Dr. Barbara H. Roberts
…which in turn, may in fact put a lot of people off statins. We’re not here to tell you don’t use them—they may indeed be useful or even critical for some people, as Dr. Roberts herself also makes makes clear. But rather, we always recommend learning as much as possible about what’s going on, to be able to make the most informed choices when it comes to what often might be literally life-and-death decisions.
On which note, if anyone would like a quick refresher on cholesterol, what it actually is (in its various forms) and what it does, why we need it, the problems it can cause anyway, then here you go:
Now, with all that in mind, we’re going to assume that you, dear reader, would like to know:
- how to lower your LDL cholesterol, and/or
- how to maintain a safe LDL cholesterol level
Because, while the jury’s out on the dangers of high LDL levels for women in particular, it’s clear that for pretty much everyone, maintaining them within well-established safe zones won’t hurt.
Here’s how:
Relax
Or rather, manage your stress. This doesn’t just reduce your acute risk of a heart attack, it also improves your blood metrics along the way, and yes, that includes not just blood pressure and blood sugars, but even triglycerides! Here’s the science for that, complete with numbers:
What are the effects of psychological stress and physical work on blood lipid profiles?
With that in mind, here’s…
How To Manage Chronic Stress (Even While Chronically Stressed)
Not chemically “relaxed”, though
While relaxing is important, drinking alcohol and smoking are unequivocally bad for pretty much everything, and this includes cholesterol levels:
Can We Drink To Good Health? ← this also covers popular beliefs about red wine and heart health, and the answer is no, we cannot
As for smoking, it is good to quit as soon as possible, unless your doctor specifically advises you otherwise (there are occasional situations where something else needs to be dealt with first, but not as many some might like to believe):
Addiction Myths That Are Hard To Quit
If you’re wondering about cannabis (CBD and/or THC), then we’d love to tell you about the effect these things have on heart health in general and cholesterol levels in particular, but the science is far too young (mostly because of the historic, and in some places contemporary, illegality cramping the research), and we could only find small, dubious, mutually contradictory studies so far. So the honest answer is: science doesn’t know this one, yet.
Exercise… But don’t worry, you can still stay relaxed
When it comes to heart health, the most important thing is keeping moving, so getting in those famous 150 minutes per week of moderate exercise is critical, and getting more is ideal.
240 minutes per week is a neat 40 minutes per day, by the way and is very attainable (this writer lives a 20-minute walk away from where she does her daily grocery shopping, thus making for a daily 40-minute round trip, not counting the actual shopping).
See: The Doctor Who Wants Us To Exercise Less, And Move More
If walking is for some reason not practical for you, here’s a whole list of fun options that don’t feel like exercise but are:
Manage your hormones
This one is mostly for menopausal women, though some people with atypical hormonal situations may find it applicable too.
Estrogen protects the heart… Until it doesn’t:
See also: World Menopause Day: Menopause & Cardiovascular Disease Risk
Here’s a great introduction to sorting it out, if necessary:
Dr. Jen Gunter: What You Should Have Been Told About Menopause Beforehand
Eat a heart-healthy diet
Shocking nobody, but it has to be said, for the sake of being methodical. So, what does that look like?
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
(it’s fiber in the #1 spot, but there’s a list of most important things there, that’s worth checking out and comparing it to what you habitually eat)
You can also check out the DASH (Dietary Approaches to Stop Hypertension) edition of the Mediterranean diet, here:
Four Ways To Upgrade The Mediterranean Diet
As for saturated fat (and especially trans-fats), the basic answer is to keep them to minimal, but there is room for nuance with saturated fats at least:
Can Saturated Fats Be Healthy?
And lastly, do make sure to get enough omega 3 fatty-acids:
What Omega-3s Really Do For Us
And enjoy plant sterols and stanols! This would need a whole list of their own, so here you go:
Take These To Lower Cholesterol! (Statin Alternatives)
Take care!
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How does cancer spread to other parts of the body?
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All cancers begin in a single organ or tissue, such as the lungs or skin. When these cancers are confined in their original organ or tissue, they are generally more treatable.
But a cancer that spreads is much more dangerous, as the organs it spreads to may be vital organs. A skin cancer, for example, might spread to the brain.
This new growth makes the cancer much more challenging to treat, as it can be difficult to find all the new tumours. If a cancer can invade different organs or tissues, it can quickly become lethal.
When cancer spreads in this way, it’s called metastasis. Metastasis is responsible for the majority (67%) of cancer deaths.
Cells are supposed to stick to surrounding tissue
Our bodies are made up of trillions of tiny cells. To keep us healthy, our bodies are constantly replacing old or damaged cells.
Each cell has a specific job and a set of instructions (DNA) that tells it what to do. However, sometimes DNA can get damaged.
This damage might change the instructions. A cell might now multiply uncontrollably, or lose a property known as adherence. This refers to how sticky a cell is, and how well it can cling to other surrounding cells and stay where it’s supposed to be.
If a cancer cell loses its adherence, it can break off from the original tumour and travel through the bloodstream or lymphatic system to almost anywhere. This is how metastasis happens.
Many of these travelling cancer cells will die, but some will settle in a new location and begin to form new cancers.
Some cells settle in a new location.
Scipro/ShutterstockParticular cancers are more likely to metastasise to particular organs that help support their growth. Breast cancers commonly metastasise to the bones, liver, and lungs, while skin cancers like melanomas are more likely to end up in the brain and heart.
Unlike cancers which form in solid organs or tissues, blood cancers like leukaemia already move freely through the bloodstream, but can escape to settle in other organs like the liver or brain.
When do cancers metastasise?
The longer a cancer grows, the more likely it is to metastasise. If not caught early, a patient’s cancer may have metastasised even before it’s initially diagnosed.
Metastasis can also occur after cancer treatment. This happens when cancer cells are dormant during treatment – drugs may not “see” those cells. These invisible cells can remain hidden in the body, only to wake up and begin growing into a new cancer months or even years later.
For patients who already have cancer metastases at diagnosis, identifying the location of the original tumour – called the “primary site” – is important. A cancer that began in the breast but has spread to the liver will probably still behave like a breast cancer, and so will respond best to an anti-breast cancer therapy, and not anti-liver cancer therapy.
As metastases can sometimes grow faster than the original tumour, it’s not always easy to tell which tumour came first. These cancers are called “cancers of unknown primary” and are the 11th most commonly diagnosed cancers in Australia.
One way to improve the treatment of metastatic cancer is to improve our ways of detecting and identifying cancers, to ensure patients receive the most effective drugs for their cancer type.
What increases the chances of metastasis and how can it be prevented?
If left untreated, most cancers will eventually acquire the ability to metastasise.
While there are currently no interventions that specifically prevent metastasis, cancer patients who have their tumours surgically removed may also be given chemotherapy (or other drugs) to try and weed out any hidden cancer cells still floating around.
The best way to prevent metastasis is to diagnose and treat cancers early. Cancer screening initiatives such as Australia’s cervical, bowel, and breast cancer screening programs are excellent ways to detect cancers early and reduce the chances of metastasis.
The best way to prevent cancer spreading is to diagnose and treat them early.
Peakstock/ShutterstockNew screening programs to detect cancers early are being researched for many types of cancer. Some of these are simple: CT scans of the body to look for any potential tumours, such as in England’s new lung cancer screening program.
Using artificial intelligence (AI) to help examine patient scans is also possible, which might identify new patterns that suggest a cancer is present, and improve cancer detection from these programs.
More advanced screening methods are also in development. The United States government’s Cancer Moonshot program is currently funding research into blood tests that could detect many types of cancer at early stages.
One day there might even be a RAT-type test for cancer, like there is for COVID.
Will we be able to prevent metastasis in the future?
Understanding how metastasis occurs allows us to figure out new ways to prevent it. One idea is to target dormant cancer cells and prevent them from waking up.
Directly preventing metastasis with drugs is not yet possible. But there is hope that as research efforts continue to improve cancer therapies, they will also be more effective at treating metastatic cancers.
For now, early detection is the best way to ensure a patient can beat their cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Garlic vs Ginger – Which is Healthier?
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Our Verdict
When comparing garlic to ginger, we picked the ginger.
Why?
Both are great, and it is close!
Notwithstanding that (almost?) nobody eats garlic or ginger for the macros, let’s do a moment’s due diligence on that first: garlic has more than 3x the protein and about 2x the fiber (and slightly higher carbs). But, given the small quantities in which people usually consume these foods, these numbers aren’t too meaningful.
In the category of micronutrients, garlic has a lot more vitamins and minerals. We’ll not do a full breakdown for this though, because again, unless you’re eating it by the cupful, this won’t make a huge difference.
Which means that so far, we have two nominal wins for garlic.
Both plants have many medicinal properties. They are both cardioprotective and anticancer, and both full of antioxidants. The benefits of both are comparable in these regards.
Both have antidiabetic action also, but ginger’s effects are stronger when compared head-to head.
So that’s an actual practical win for ginger.
Each plant’s respective effects on the gastrointestinal tract sets them further apart—ginger has antiemetic effects and can be used for treating nausea and vomiting from a variety of causes. Garlic, meanwhile, can cause adverse gastrointestinal effects in some people—but it’s usually neutral for most people in this regard.
Another win for ginger in practical terms.
Want to learn more?
You might like to read:
Take care!
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In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital
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McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.
Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.
It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.
Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.
“There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.
In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.
But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.
In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.
McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.
“This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”
Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.
Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.
The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.
“I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”
The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.
In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.
While audits show few McAlester patients get financial aid, many get taken to court.
Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.
Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.
“Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”
The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.
“It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.
Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.
At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.
Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.
Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.
For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.
Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.
Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.
Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.
Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.
McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.
At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.
After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.
“All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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