Shedding Some Obesity Myths
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.
Let’s shed some obesity myths!
There are a lot of myths and misconceptions surrounding obesity… And then there are also reactive opposite myths and misconceptions, which can sometimes be just as harmful!
To tackle them all would take a book, but in classic 10almonds style, we’re going to put a spotlight on some of the ones that might make the biggest difference:
True or False: Obesity is genetically pre-determined
False… With caveats.
Some interesting results have been found from twin studies and adoption studies, showing that genes definitely play some role, but lifestyle is—for most people—the biggest factor:
- The body-mass index of twins who have been reared apart
- An adoption study of human obesity
- Using a sibling-adoption design to parse genetic and environmental influences on children’s body mass index
In short: genes predispose; they don’t predetermine. But that predisposition alone can make quite a big difference, if it in turn leads to different lifestyle factors.
But upon seeing those papers centering BMI, let’s consider…
True or False: BMI is a good, accurate measure of health in the context of bodyweight
False… Unless you’re a very large group of thin white men of moderate height, which was the demographic the system was built around.
Bonus information: it was never intended to be used to measure the weight-related health of any individual (not even an individual thin white man of moderate height), but rather, as a tool to look at large-scale demographic trends.
Basically, as a system, it’s being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
To do a deep-dive into all the flaws of the BMI system, which are many, we’d need to devote a whole main feature just to that.
Update: we have now done so!
Here it is: When BMI Doesn’t Measure Up
True or False: Obesity does not meaningfully impact more general health
False… In more ways than one (but there are caveats)
Obesity is highly correlated with increased risk of all-cause mortality, and weight loss, correspondingly, correlates with a reduced risk. See for example:
So what are the caveats?
Let’s put it this way: owning a horse is highly correlated with increased healthy longevity. And while owning a horse may come with some exercise and relaxation (both of which are good for the health), it’s probably mostly not the horse itself that conveys the health benefits… it’s that someone who has the resources to look after a horse, probably has the resources to look after their own health too.
So sometimes there can be a reason for a correlation (it’s not a coincidence!) but the causative factor is partially (or in some cases, entirely) something else.
So how could this play out with obesity?
There’s a lot of discrimination in healthcare settings, unfortunately! In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
True or False: to reduce obesity, just eat less and move more!
False… Mostly.
Moving more is almost always good for most people. When it comes to diet, quality is much more important than quantity. But these factors alone are only part of the picture!
But beyond diet and exercise, there are many other implicated factors in weight gain, weight maintenance, and weight loss, including but not limited to:
- Disrupted sleep
- Chronic stress
- Chronic pain
- Hormonal imbalances
- Physical disabilities that preclude a lot of exercise
- Mental health issues that add (and compound) extra levels of challenge
- Medications that throw all kinds of spanners into the works with their side effects
…and even just those first two things, diet and exercise, are not always so correlated to weight as one might think—studies have found that the difference for exercise especially is often marginal:
Read: Widespread misconceptions about obesity ← academic article in the Journal of the College of Family Physicians of Canada
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
A Correction, And A New, Natural Way To Boost Daily Energy Levels
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
First: a correction and expansion!
After yesterday’s issue of 10almonds covering breast cancer risks and checks, a subscriber wrote to say, with regard to our opening statement, which was:
“Anyone (who has not had a double mastectomy, anyway) can get breast cancer”
❝I have been enjoying your newsletter. This statement is misleading and should have a disclaimer that says even someone who has had a double mastectomy can get breast cancer, again. It is true and nothing…nothing is 100% including a mastectomy. I am a 12 year “thriver” (I don’t like to use the term survivor) who has had a double mastectomy. I work with a local hospital to help newly diagnosed patients deal with their cancer diagnosis and the many decisions that follow. A double mastectomy can help keep recurrence from happening but there are no guarantees. I tried to just delete this and let it go but it doesn’t feel right. Thank you!❞
Thank you for writing in about this! We wouldn’t want to mislead, and we’re always glad to hear from people who have been living with conditions for a long time, as (assuming they are a person inclined to learning) they will generally know topics far more deeply than someone who has researched it for a short period of time.
Regards a double mastectomy (we’re sure you know this already, but noting here for greater awareness, prompted by your message), a lot of circumstances can vary. For example, how far did a given cancer spread, and especially, did it spread to the lymph nodes at the armpits? And what tissue was (and wasn’t) removed?
Sometimes a bilateral prophylactic mastectomy will leave the lymph nodes partially or entirely intact, and a cancer could indeed come back, if not every last cancerous cell was removed.
A total double mastectomy, by definition, should have removed all tissue that could qualify as breast tissue for a breast cancer, including those lymph nodes. However, if the cancer spread unnoticed somewhere else in the body, then again, you’re quite correct, it could come back.
Some people have a double mastectomy without having got cancer first. Either because of a fear of cancer due to a genetic risk (like Angelina Jolie), or for other reasons (like Elliot Page).
This makes a difference, because doing it for reasons of cancer risk may mean surgeons remove the lymph nodes too, while if that wasn’t a factor, surgeons will tend to leave them in place.
In principle, if there is no breast tissue, including lymph nodes, and there was no cancer to spread, then it can be argued that the risk of breast cancer should now be the same “zero” as the risk of getting prostate cancer when one does not have a prostate.
But… Surgeries are not perfect, and everyone’s anatomy and physiology can differ enough from “textbook standard” that surprises can happen, and there’s almost always a non-zero chance of certain health outcomes.
For any unfamiliar, here’s a good starting point for learning about the many types of mastectomy, that we didn’t go into in yesterday’s edition. It’s from the UK’s National Health Service:
NHS: Mastectomy | Types of Mastectomy
And for the more sciency-inclined, here’s a paper about the recurrence rate of cancer after a prophylactic double mastectomy, after a young cancer was found in one breast.
The short version is that the measured incidence rate of breast cancer after prophylactic bilateral mastectomy was zero, but the discussion (including notes about the limitations of the study) is well worth reading:
Breast Cancer after Prophylactic Bilateral Mastectomy in Women with a BRCA1 or BRCA2 Mutation
❝[Can you write about] the availability of geriatric doctors Sometimes I feel my primary isn’t really up on my 70 year old health issues. I would love to find a doctor that understands my issues and is able to explain them to me. Ie; my worsening arthritis in regards to food I eat; in regards to meds vs homeopathic solutions.! Thanks!❞
That’s a great topic, worthy of a main feature! Because in many cases, it’s not just about specialization of skills, but also about empathy, and the gap between studying a condition and living with a condition.
About arthritis, we’re going to do a main feature specifically on that quite soon, but meanwhile, you might like our previous article:
Keep Inflammation At Bay (arthritis being an inflammatory condition)
As for homeopathy, your question prompts our poll today!
(and then we’ll write about that tomorrow)
Share This Post
Who Screens The Sunscreens?
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.
We Screen The Sunscreens!
Yesterday, we asked you what your sunscreen policy was, and got a spread of answers. Apparently this one was quite polarizing!
One subscriber who voted for “Sunscreen is essential to protect us against skin aging and cancer” wrote:
❝My mom died of complications from melanoma, so we are vigilant about sun and sunscreen. We are a family of campers and hikers and gardeners—outdoors in all seasons—and we never burn❞
Our condolences with regard to your mom! Life is so precious, and when something like that happens, it tends to stick with us. We’re glad you and your family are taking care of yourselves.
Of the subscribers who voted for “I put some on if I think I might otherwise get sunburned”, about half wrote to express uncertainties:
- uncertainty about how safe it is, and
- uncertainty about how helpful it is
…so we’re going to tackle those questions in a moment. But what of those who voted for “Sunscreen is full of harmful chemicals that can cause cancer”?
Of those, only one wrote a message, which was to say one has to be very careful of what is in the formula.
Let’s take a look, then…
Sunscreen is full of harmful chemicals that can cause cancer: True or False?
False—according to current best science. Research is ongoing!
There are four main chemicals (found in most sunscreens) that people tend to worry about:
- Abobenzone
- Oxybenzone
- Octocrylene
- Ecamsule
Now, these two sound like four brands of rocket fuel, but then, dihydrogen monoxide (DHMO), which is also found in most sunscreens, sounds like a deadly toxin too. That’s water, by the way.
But what of these four chemicals? Well, as we say, research is ongoing, but we found a study that measured all four, to see how much got into the blood, and what adverse effects, if any, this caused.
We’ll skip to their conclusion:
❝In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.❞
Now, “exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens” sounds alarming, so why did they close with the words “These results do not indicate that individuals should refrain from the use of sunscreen”?
Let’s skip back up to a line from the results:
❝The most common adverse event was rash, which developed in 1 participant with each sunscreen.❞
This was most probably due to the oxybenzone, which can cause allergic skin reactions in some people.
Let us take a moment to remember the most common adverse event that occurs from not wearing sunscreen: sunburn!
You can read the full study here:
None of those ingredients have been found to be carcinogenic, even at the maximal blood plasma concentrations studied, from applications 4x/day to 75% of the body.
UVA rays, on the other hand, are absolutely very much known to cause cancer, and the effect is cumulative.
Sunscreen is essential to protect us against skin aging and cancer: True or False?
True, unequivocally, unless we live indoors and/or otherwise never go about under sunlight.
“But our ancestors—” lived under the same sun we do, and either used sunscreen or got advanced skin aging and cancer.
Sunscreen of times past ranged from mud to mineral lotions, but it’s pretty much always existed. Even non-human animals that have skin and don’t have fur or feathers, tend to take mud-baths in sunny parts of the world.
If you’d like to avoid oxybenzone and other chemicals, though, you might have your reasons. Maybe you’re allergic, or maybe you read that it’s a potential endocrine disruptor with estrogen-like and anti-androgenic properties that you don’t want.
There are other options, to include physical blockers containing zinc and titanium dioxide, which are generally recognized as safe and effective ingredients.
If you’re interested, you can even make your own sunscreen that blocks both UVA and UVB rays (UVA is what causes skin cancer; UVB is “milder” and is what causes sunburn):
Share This Post
Safe Effective Sleep Aids For Seniors
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.
Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
Share This Post
Related Posts
Afterwork – by Joel Malick and Alex Lippert
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.
Regular 10almonds readers may remember that one of the key unifying factors of Blue Zones supercentenarians is the importance of having purpose, sometimes called ikigai (borrowing the Japanese term, as a nod to the Okinawan Blue Zone).
The authors are financial advisors by profession, but don’t let that fool you; this book is not about retirement financial planning, but rather, simply addressing a problem that was often presented to them while helping people plan their retirements:
A lot of people find themselves adrift without purpose at several points in life. Often, these are: 1) early twenties, 2) some point in the midlife, and/or 3) retirement. This book addresses the third of those life points.
The authors advise cultivating 10 key disciplines; we’ll not keep them a mystery; they are:
- Purpose
- Calendar
- Movement
- Journaling
- Faith
- Connection
- Learning
- Awareness
- Generosity
- Awe
…which each get a chapter in this book.
A note on the chapter about faith: the authors are Christians, and that does influence their perspective here, but if Christianity’s not your thing, then don’t worry: the rest also stands on its own feet without that.
The general “flavor” of the book overall is in essence, embracing a new period of enjoying what is in effect the strongest, most potentially impactful version of you you’ve ever been, as well as avoiding the traps of retirement “sugar rush” and “retirement drift”, to define, well, a more purposeful life—with what’s most meaningful to you.
The style of the book is self-help in layout, with occasional diagrams, flowcharts, and the like; sometimes we see well-sourced stats, but there’s no hard science here. In short, a simple and practical book.
Bottom line: if your retirement isn’t looking like what you imagined it to be, and/or you think it could be more fulfilling, then this book can help you find, claim, and live your ikigai.
Click here to check out Afterwork, and indeed live a future that’s worthy of dreams!
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
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
Dodging Dengue In The US
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.
Dengue On The Rise
We wrote recently about dengue outbreaks in the Americas, with Puerto Rico declaring an epidemic. Cases are now being reported in Florida too, and are likely to spread, so it’s good to be prepared, if your climate is of the “warm and humid” kind.
If you want to catch up on the news first, here you go:
- UN health agency cites tenfold increase in reported cases of dengue over the last generation
- Puerto Rico has declared an epidemic following a spike in dengue cases
- Dengue fever confirmed in Florida Keys as US on watch for rise in mosquito illness
Note: dengue is far from unheard of in Florida, but the rising average temperatures in each year mean that each year stands a good chance of seeing more cases than the previous. It’s been climbing since at least 2017, took a dip during the time of COVID restrictions keeping people at home more, and then for the more recent years has been climbing again since.
What actually is it?
Dengue is a viral, mosquito-borne disease, characterized by fever, vomiting, muscle pain, and a rash, in about 1 in 4 cases.
Which can sound like “you’ll know if you have it”, but in fact it’s usually asymptomatic for a week or more after infection, so, watch out!
What next, if those symptoms appear?
The good news is: the fever will usually last less than a week
The bad news is: a day or so after that the fever subsided, the more serious symptoms are likely to start—if they’re going to.
If you’re unlucky enough to be one of the 1 in 20 who get the serious symptoms, then you can expect abdominal cramps, repeat vomiting, bleeding from various orifices (you may not get them all, but all are possible), and (hardly surprising, given the previous items) “extreme fatigue and restlessness”.
If you get those symptoms, then definitely get to an ER as soon as possible, as dengue can become life-threatening within hours of such.
Read more: CDC | Symptoms of Dengue and Testing
While there is not a treatment for dengue per se, the Emergency Room will be better able to manage your symptoms and thus keep you alive long enough for them to pass.
If you’d like much more detail (on symptoms, seriousness, at-risk demographics, and prognosis) than what the CDC offers, then…
Read more: BMJ | Dengue Fever
Ok, so how do we dodge the dengue?
It sounds flippant to say “don’t get bitten”, but that’s it. However, there are tips are not getting bitten:
- Use mosquito-repellent, but it has to contain >20% DEET, so check labels
- Use mosquito nets where possible (doors, windows, etc, and the classic bed-tent net is not a bad idea either)
- Wear clothing that covers your skin, especially during the day—it can be light clothing; it doesn’t need to be a HazMat suit! But it does need to reduce the area of attack to reduce the risk of bites.
- Limit standing water around your home—anything that can hold even a small amount of standing water is a potential mosquito-breeding ground. Yes, even if it’s a crack in your driveway or a potted bromeliad.
Further reading
You might also like to check out:
Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
…and in case dengue wasn’t bad enough:
Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
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
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
How To Regrow Receding Gums
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.
One of the problems with the human form is that our teeth evolved to last us for the whole of our life, with plenty of room to spare before our eventual death at the ripe old age of about 35 on average. Dr. Ellie Phillips advises those of us who might be a bit older than that, on how we can avoid becoming “too long in the tooth”—in other words, how to keep our gums, and thus our teeth, in place and healthy.
Getting to the root of the problem
The single biggest cause of gum recession is an acidic environment in the mouth, which harms teeth and gums alike. This acidic environment is produced not merely by consuming acid foods or drinks, but also (and much more often, and more problematically) by sugary foods and drinks, which are not necessarily themselves acidic, but they feed bacteria that release acids as a by-product of their metabolism. If we consume an acidic food or drink, it’s there for a moment, but if we then salivate and/or take a drink of water, it’s pretty much gone in a few seconds. But those bacteria when we feed them sugar? They are there to stay unless we do something more about them than just drink some water.
Other contributing factors to gum recession include teeth grinding, and (ironically) certain oral care products, especially many artificial teeth whiteners.
In case you were wondering: no, brushing will not* generally cause or even worsen gum recession, but flossing can exacerbate it if it’s already underway.
*unless, of course, you are using one of the whiteners we mentioned above
What to do about it: Dr. Phillips recommends:
- use a moderately firm toothbrush to massage gums and promote blood flow
- avoid acidic oral products and homemade remedies even if they’re not acidic but can be caustic, such as baking soda
- rebuild your gums’ and teeth’s protective biofilm (yes, there are “good bacteria” that are supposed to be there) with proper brushing
- avoid cleanings that are more intensive than brushing—skip flossing until your gums have recovered, too
- adjust your diet to avoid acids and (especially) sugars
10almonds note: she also recommends the use of xylitol to promote a healthy oral environment; we don’t recommend that, as while it may be great for the teeth, studies have found it to be bad for the heart.
For more on all of her advices and a bit more of the science of it, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Toothpastes & Mouthwashes: Which Help And Which Harm?
- Flossing Without Flossing?
- Less Common Oral Hygiene Options ← including the miswak “chewing stick”, which even outperformed toothbrushes in clinical trials, by biochemically altering the composition of the saliva while gently cleaning like a toothbrush.
- Fluoride Toothpaste vs Non-Fluoride Toothpaste – Which is Healthier?
- Non-Alcohol Mouthwash vs Alcohol Mouthwash – Which is Healthier?
- Xylitol vs Erythritol – Which is Healthier?
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
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
