How To Rebuild Your Neurons’ Myelin Sheaths
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PS: We Love You
Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.
In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).
For an overview that’s more comprehensive than we have room for here, check out:
Phosphatidylserine and the human brain
Many people take it as a supplement.
Does taking it as a supplement work?
This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:
❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞
(“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)
Why do people take it?
The health claims for phosphatidylserine fall into two main categories:
- Neuroprotection (helping your brain to avoid age-related decline in the long term)
- Cognitive enhancement (helping your brain work better in the short term)
What does the science say?
There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:
- Effects of phosphatidylserine in Alzheimer’s disease
- Double-blind cross-over study of phosphatidylserine vs. placebo in patients with early dementia of the Alzheimer type
- Effect of Phosphatidylserine on Cerebral Glucose Metabolism in Alzheimer’s Disease
- The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints
Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.
There is no established difference in the efficacy of these.
There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.
There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:
(as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)
PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.
Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.
Where can we get it?
We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.
Enjoy!
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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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Exercises for Aging-Ankles
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Can Ankles Deterioration be Stopped?
As we all know (or have experienced!), Ankle mobility deteriorates with age.
We’re here to argue that it’s not all doom and gloom!
(In fact, we’ve written about keeping our feet, and associated body parts, healthy here).
This video by “Livinleggings” (below) provides a great argument that yes, ankle deterioration can be stopped, or even reversed. It’s a must-watch for anyone from yoga enthusiasts to gym warriors who might be unknowingly crippling their ankle-health.
How We Can Prioritise Our Ankles
Poor ankle flexibility isn’t just an inconvenience – it’s a direct route to knee issues, hip hiccups, and back pain. More importantly, ankle strength is a core component of building overall mobility.
With 12 muscles in the ankle, it can be overwhelming to work out which to strengthen – and how. But fear not, we can prioritise three of the twelve: the calf duo (gastrocnemius and soleus) and the shin’s main muscle, the tibialis anterior.
The first step is to test yourself! A simple wall test reveals any hidden truths about your ankle flexibility. Go to the 1:55 point in the video to see how it’s done.
If you can’t do it, you’ve got work to be done.
If you read the book we recommended on great functional exercises for seniors, then you may already be familiar with some super ankle exercises.
Otherwise, these four ankle exercises are a great starting point:
How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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Toasted Chick’n Mango Tacos
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Tacos aren’t generally held up as the world’s healthiest food, but they can be! There’s so much going on in this dish today, healthwise, in a good way, that it’s hard to know where to start. But suffice it to say, these tacos are great for your gut, heart, blood sugars, and more.
You will need
For the chickpeas:
- 1 can chickpeas, drained
- 1 tbsp ras el-hanout*
- 1 tsp red pepper flakes
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
*You can easily make this yourself; following our recipe (linked above in the ingredients list) will be better than buying it ready-made, and if you have strong feelings about any of the ingredients, you can adjust per your preference.
For the tahini sauce:
- ⅓ cup tahini
- 2 tbsp apple cider vinegar
- 2 tbsp finely chopped fresh dill
- ¼ bulb garlic, minced
- 1 tsp red pepper flakes
- ½ tsp black pepper, coarse ground
It may seem like salt is conspicuous by its absence, but there is already enough in the chickpeas component; you do not want to overwhelm the dish. Trust us that enjoying these things together will be well-balanced and delicious as written.
For the mango relish:
- ½ mango, pitted, peeled, and cubed
- 2 tsp apple cider vinegar
- 2 tsp cilantro, finely chopped (substitute with parsley if you have the “cilantro tastes like soap” gene)
- 1 tsp red pepper flakes
For building the taco:
- Soft corn tortillas
- Handful of arugula
- 1 avocado, pitted, peeled, and sliced
- ½ red onion, sliced
Method
(we suggest you read everything at least once before doing anything)
1) Heat a sauté pan with a little olive oil in; add the chickpeas and then the rest of the ingredients from the chickpea section; cook for about 5 minutes, stirring frequently, and set aside.
2) Combine the tahini sauce ingredients in a small bowl, stirring in ¼ cup water, and set aside.
3) Combine the mango relish ingredients in a separate small bowl, and set aside. You can eat the other half of the mango if you like.
4) Lightly toast the tortillas in a dry skillet, or using a grill.
5) Assemble the tacos; we recommend the order: tortillas, arugula, avocado slices, chickpeas, mango relish, red onion slices, tahini sauce.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we hit all five today! Yay!
- An Apple (Cider Vinegar) A Day…
- Coconut vs Avocado – Which is Healthier?
- Lettuce vs Arugula – Which is Healthier?
Take care!
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Be A Plant-Based Woman Warrior – by Jane Esselstyn & Ann Esselstyn
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Notwithstanding the title, this book is not about being a woman or a warrior, but let us share what one reviewer on Amazon wrote:
❝I don’t want to become a plant based woman warrior. The sex change would be traumatic for me. However, as a man who proudly takes ballet classes and Pilates, I am old enough not to worry about stereotypes. When I see a good thing, I am going to use it❞
The authors, a mother-and-daughter team in their 80s and 50s respectively, do give a focus on things that disproportionally affect women, and rectifying those things with diet, especially in one of the opening chapters.
Most the book, however, is about preventing/reversing things that can affect everyone, such as heart disease, diabetes, inflammation and the autoimmune diseases associated with such, and cancer in general, hence the dietary advice being good for most people (unless you have an unusually restrictive diet).
We get an overview of the pantry we should cultivate and curate, as well as some basic kitchen skills that will see us well for the rest of the book, such as how to make oat flour and other similar mini-recipes, before getting into the main recipes themselves.
About the recipes: they are mostly quite simple, though often rely on having pre-prepared items from the mini-recipes we mentioned earlier. They’re all vegan, mostly but not all gluten-free, whole foods, no added sugar, and as for oil… Well, it seems to be not necessarily oil-free, but rather oil-taboo. You see, they just don’t mention it. For example, when they say to caramelize onions, they say to heat a skillet, and when it is hot, add the onions, and stir until browned. They don’t mention any oil in the ingredients or in the steps. It is a mystery. 10almonds note: we recommend olive oil, or avocado oil if you prefer a milder taste and/or need a higher smoke point.
Bottom line: the odd oil taboo aside, this is a good book of simple recipes that teaches some good plant-based kitchen skills while working with a healthy, whole food pantry.
Click here to check out Be A Plant-Based Woman Warrior, and be a plant-based woman warrior!
Or at the very least: be a plant-based cook regardless of gender, hopefully without war, and enjoy the additions to your culinary repertoire
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Staying Healthy and Active After 60
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Questions and Answers 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!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
Q: How to be your best self after 60: Self motivation / Avoiding or limiting salt, sugar & alcohol: Alternatives / Ways to sneak in more movements/exercise
…and, from a different subscriber…
Q: Inflammation & over 60 weight loss. Thanks!
Here are some of our greatest hits on those topics:
- Where Nutrition Meets Habits ← focusing on food that’s all three of: healthy + easy + cheap
- How To Keep On Keeping On ← exercise tips for when the motivation wanes
- Keep Inflammation At Bay ← science-based tips and advice
Also, while we’ve recommended a couple of books on stopping (or reducing) drinking, we’ve not done a main feature on that, so we definitely will one of these days!
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Beyond “Make Your Bed”—life lessons from experience
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Beyond “Make Your Bed”—life lessons from experience
This is Admiral William H. McRaven, a former United States Navy four-star admiral who served as the ninth commander of the United States Special Operations Command.
So, for those of us whose day-to-day lives don’t involve coordinating military operations, what does he have to offer?
Quick note: 10almonds’ mission statement is “to make health and productivity crazy simple”.
We tend to focus on the health side of this, and in the category of productivity, it’s often what most benefits our mental health.
We’re writing less for career-driven technopreneurs in the 25–35 age bracket and more for people with a more holistic view of productivity and “a good life well-lived”.
So today’s main feature is more in that vein!
Start each day with an accomplishment
McRaven famously gave a speech (and wrote a book) that began with the advice, “make your bed”. The idea here doesn’t have to be literal (if you’ll pardon the pun). Indeed, if you’re partnered, then depending on schedules and habits, it could be you can’t (sensibly) make your bed first thing because your partner is still in it. But! What you can do is start the day with an accomplishment—however small. A short exercise routine is a great example!
Success in life requires teamwork
We’re none of us an island (except in the bathtub). The point is… Nobody can do everything alone. Self-sufficiency is an illusion. You can make your own coffee, but could you have made the coffee machine, or even the cup? How about, grown the coffee? Transported it? So don’t be afraid to reach out for (and acknowledge!) help from others. Teamwork really does make the dream work.
It’s what’s inside that counts
It’s a common trap to fall into, getting caught up the outside appearance of success, rather than what actually matters the most. We need to remember this when it comes to our own choices, as well as assessing what others might bring to the table!
A setback is only permanent if you let it be
No, a positive attitude won’t reverse a lifelong degenerative illness, for example. But what we can do, is take life as comes, and press on with the reality, rather than getting caught up in the “should be”.
Use failure to your advantage
Learn. That’s all. Learn, and improve.
Be daring in life
To borrow from another military force, the SAS has the motto “Who dares, wins”. Caution has it place, but if we’ve made reasonable preparations*, sometimes being bold is the best (or only!) way forward.
*Meanwhile the Parachute Regiment, from which come 80% of all SAS soldiers, has the motto “Utrinque paratus”, “prepared on all sides”.
Keep courage close
This is about not backing down when we know what’s right and we know what we need to do. Life can be scary! But if we don’t overcome our fears, they can become self-realizing.
Writer’s note: a good example of this is an advice I sometimes gave during my much more exciting (military) life of some decades ago, and it pertains to getting into a knife-fight (top advice for civilians: don’t).
But, if you’re in one, you need to not be afraid of getting cut.
Because if you’re not afraid of getting cut, you will probably get cut.
But if you are afraid of getting cut, you will definitely get cut.
Hopefully your life doesn’t involve knives outside of the kitchen (mine doesn’t, these days, and I like it), but the lesson applies to other things too.
Sometimes the only way out is through.
Be your best at your worst
Sometimes life is really, really hard. But if we allow those moments to drive us forwards, they’re also a place we can find more strength than we ever knew we had.
Keep on swimming
It’s said that the majority in life is about showing up—and often it is. But you have to keep showing up, day after day. So make what you’re doing sustainable for you, and keep on keeping on.
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Learn to Age Gracefully
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