Policosanol: A Rival To Statins, Without The Side Effects?

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Policosanol (which can be extracted from various sources, but is mostly made from sugar cane extract) is marketed as lipid-lowering agent for improving cholesterol levels, but its research history has not been without controversy:

2001: it works!

After a lot of research in the 1990s, it came out of the gate strong in 2001, with:

❝Policosanol (5 and 10 mg/day) significantly decreased LDL-cholesterol (17.3% and 26.7%, respectively), total cholesterol (12.9% and 19.5%), as well as the ratios of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (17.2% and 26.5%) and total cholesterol to HDL-cholesterol (16.3% and 21.0%) compared with baseline and placebo❞

This, by the way, is comparable in efficacy to the most powerful statins, but without the adverse side effects.

Source: Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women

Furthermore, its effects were not limited to postmenopausal women, and additionally, it was found that 20mg/day was sufficient for optimal effects; 40mg worked exactly the same as 20mg:

Read: Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind study

2006–2010: we do not trust the Cubans!

After it had been marketed and used in much of the world for some years, extra scrutiny was brought upon it, because the initial studies had been performed by the same lab in Cuba, a commercial lab that had tested them for a private interest (i.e., a company selling the supplement):

Heart Beat: Policosanol: A sweet nothing for high cholesterol

And furthermore, US-based labs were unable to replicate the results:

Policosanols as Nutraceuticals: Fact or Fiction

The Cuban researchers countered that the composition of policosanol as produced in their lab was different than the composition of the policosanol as produced in the US labs, because of the purity of the ingredients used in the Cuban lab.

Which, on the face of it, could be true or could just be the claim of a commercial lab with an association with a company selling a product.

Of course, importing Cuban ingredients to test them in the US was not a reasonably accessible option for the US-based labs, because of the US’s embargo of Cuba. In principle it could be done, but unless there is already a huge clear profit incentive, research scientists are usually on their hands and knees begging for grants already, so getting extra funding for specially-important Cuban ingredients was not going to be likely.

2012: never mind, it does work after all!

An American meta-analysis of 4596 patients from 52 eligible studies (from around the world, so many of them not affected by the US’s embargo; some were from within the US using non-Cuban ingredients, though), found:

❝policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy❞

Those last words there, to be clear, mean “yes, the original claim of being on a par with statins is at least more or less true”.

Source: Meta-Analysis of Natural Therapies for Hyperlipidemia: Plant Sterols and Stanols versus Policosanol

2018: also yes, the Cuban kind does get those extra-effective results, even when tested outside of Cuba

A Korean research team verified this; it’s quite straightforward so for brevity we’ll just drop links:

Mystery resolved!

Want to try some?

We don’t sell it, but here for your convenience is an example product on Amazon—it’s not the Cuban kind, because the US’s trade embargo makes it difficult for the US to import even things that are theoretically now exempt from the embargo such as food and medicines. In principle they can now be imported, but in practice, the extra regulations added to Cuban imports make it nearly impossible, especially for small sellers.

Still, it’s 40mg/tablet policosanol from sugar cane extract, and 3rd party lab tested, so it’s the next best thing 😎

Enjoy!

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  • Alzheimer’s Sex Differences May Not Be What They Appear

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    Alzheimer’s Sex Differences May Not Be What They Appear

    Women get Alzheimer’s at nearly twice the rate than men do, and deteriorate more rapidly after onset, too.

    So… Why?

    There are many potential things to look at, but four stand out for quick analysis:

    • Chromosomes: women usually have XX chromosomes, to men’s usual XY. There are outliers to both groups, people with non-standard combinations of chromosomes, but not commonly enough to throw out the stats.
    • Hormones: women usually have high estrogen and low testosterone, compared to men. Again there are outliers and this is a huge oversimplification that doesn’t even look at other sex hormones, but broadly speaking (which sounds vague, but is actually what is represented in epidemiological studies), it will be so.
    • Anatomy: humans have some obvious sexual dimorphism (again, there are outliers, but again, not enough to throw out the stats); this seems least likely to be relevant (Alzheimer’s is probably not stored in the breasts, for examples), though average body composition (per muscle:fat ratio) could admittedly be a factor.
    • Social/lifestyle: once again, #NotAllWomen etc, but broadly speaking, women and men often tend towards different social roles in some ways, and as we know, of course lifestyle can play a part in disease pathogenesis.

    As a quick aside before we continue, if you’re curious about those outliers, then a wiki-walk into the fascinating world of intersex conditions, for example, could start here. But by and large, this won’t affect most people.

    So… Which parts matter?

    Back in 2018, Dr. Maria Teresa Ferretti et al. kicked up some rocks in this regard, looking not just at genes (as much research has focussed on) or amyloid-β (again, well-studied) but also at phenotypes and metabolic and social factors—bearing in mind that all three of those are heavily influenced by hormones. Noting, for example, that (we’ll quote directly here):

    • Men and women with Alzheimer disease (AD) exhibit different cognitive and psychiatric symptoms, and women show faster cognitive decline after diagnosis of mild cognitive impairment (MCI) or AD dementia.
    • Brain atrophy rates and patterns differ along the AD continuum between the sexes; in MCI, brain atrophy is faster in women than in men.
    • The prevalence and effects of cerebrovascular, metabolic and socio-economic risk factors for AD are different between men and women.

    See: Sex differences in Alzheimer disease—the gateway to precision medicine

    So, have scientists controlled for each of those factors?

    Mostly not! But they have found clues, anyway, while noting the limitations of the previous way of conducting studies. For example:

    ❝Women are more likely to develop Alzheimer’s disease and experience faster cognitive decline compared to their male counterparts. These sex differences should be accounted for when designing medications and conducting clinical trials❞

    ~ Dr. Feixiong Cheng

    Read: Research finds sex differences in immune response and metabolism drive Alzheimer’s disease

    Did you spot the clue?

    It was “differences in immune response and metabolism”. These things are both influenced by (not outright regulated by, but strongly influenced by) sex hormones.

    ❝As [hormonal] sex influences both the immune system and metabolic process, our study aimed to identify how all of these individual factors influence one another to contribute to Alzheimer’s disease❞

    ~ Dr. Justin Lathia

    Ignoring for a moment progesterone’s role in metabolism, estrogen is an immunostimulant and testosterone is an immunosuppressant. These thus both also have an effect in inflammation, which yes, includes neuroinflammation.

    But wait a minute, shouldn’t that mean that women are more protected, not less?

    It should! Except… Alzheimer’s is an age-related disease, and in the age-bracket that generally gets Alzheimer’s (again, there are outliers), menopause has been done and dusted for quite a while.

    Which means, and this is critical: post-menopausal women not on HRT are essentially left without the immune boost usually directed by estrogen, while men of the same age will be ticking over with their physiology that (unlike that of the aforementioned women) was already adapted to function with negligible estrogen.

    Specifically:

    ❝The metabolic consequences of estrogen decline during menopause accelerate neuropathology in women❞

    ~ Dr. Rasha Saleh

    Source: Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women

    Critical idea to take away from all this:

    Alzheimer’s research is going to be misleading if it doesn’t take into account sex differences, and not just that, but also specifically age-relevant sex differences—because that can flip the narrative. If we don’t take age into account, we could be left thinking estrogen is to blame, when in fact, it appears to be the opposite.

    In the meantime, if you’re a woman of a certain age, you might talk with a doctor about whether HRT could be beneficial for you, if you haven’t already:

    ❝Women at genetic risk for AD (carrying at least one APOE e4 allele) seem to be particularly benefiting from MHT❞

    (MHT = Menopausal Hormone Therapy; also commonly called HRT, which is the umbrella term for Hormone Replacement Therapies in general)

    ~ Dr. Herman Depypere

    Source study: Menopause hormone therapy significantly alters pathophysiological biomarkers of Alzheimer’s disease

    Pop-sci press release version: HRT could ward off Alzheimer’s among at-risk women

    Take care!

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  • Indistractable – by Nir Eyal

    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.

    Have you ever felt that you could accomplish anything you wanted/needed, if only you didn’t get distracted?

    This book lays out a series of psychological interventions for precisely that aim, and it goes a lot beyond the usual “download/delete these apps to help you stop checking social media every 47 seconds”.

    Some you’ll have heard of before, some you won’t have, and if even one method works for you, it’ll have been well worth your while reading this book. This reviewer, for example, enjoyed the call to identity-based strength, e.g. adopting an “I am indistractable*” perspective going into tasks. This is akin to the strength of, for example, “I don’t drink” over “I am a recovering alcoholic”.

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    Nor is the book just about maximizing productivity to the detriment of everything else; this is not about having a 25 hours per day “grindset”. Rather, it even makes sure to cover such things as focusing on one’s loved ones, for instance.

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    Click here to check out Indistractible, and become indeed indistractable!

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  • Power Vegan Meals – by Maya Sozer

    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.

    This book has inspired some of the recipes we’ve shared recently—we’ve invariably tweaked and in our opinion improved them, but the recipes are great as written too.

    The recipes, of which there are 75, are all vegan, gluten-free, high protein, and high fiber. Some reviewers on Amazon have complained that the recipes are high-calorie, and they often are, but those calories are mostly from healthy fats, so we don’t think it’s a bad thing. Still, if you’re doing a strict calorie-controlled diet, this is probably not the one for you.

    Another thing the recipes are is tasty without being unduly complicated, as well as being mostly free from obscure ingredients. This latter is a good thing not because obscure ingredients are inherently bad, but rather that it can be frustrating to read a recipe and find its star ingredient is a cup of perambulatory periannath that must be harvested from the west-facing slopes of Ithilien during a full moon, no substitutions.

    The style and format is simple and clear with minimal overture, one recipe per double-page; picture on one side, recipe on the other; perfect for a kitchen reading-stand.

    Bottom line: these recipes are for the most part very consistent with what we share here, and we recommend them, unless you’re looking for low-calorie options.

    Click here to check out Power Vegan Meals, and power-up your vegan meals!

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  • The Intelligence Trap – by David Robson

    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’re including this one under the umbrella of “general wellness”, because it happens that a lot of very intelligent people make stunningly unfortunate choices sometimes, for reasons that may baffle others.

    The author outlines for us the various reasons that this happens, and how. From the famous trope of “specialized intelligence in one area”, to the tendency of people who are better at acquiring knowledge and understanding to also be better at acquiring biases along the way, to the hubris of “I am intelligent and therefore right as a matter of principle” thinking, and many other reasons.

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    Click here to check out The Intelligence Trap, and be more wary!

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  • ‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters

    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.

    Pratik Raul, University of Canberra; Jeroen van Boxtel, University of Canberra, and Jovana Acevska, University of Canberra

    Autism is a neurodevelopmental difference associated with specific experiences and characteristics.

    For decades, autism research has focused on behavioural, cognitive, social and communication difficulties. These studies highlighted how autistic people face issues with everyday tasks that allistic (meaning non-autistic) people do not. Some difficulties may include recognising emotions or social cues.

    But some research, including our own study, has explored specific advantages in autism. Studies have shown that in some cognitive tasks, autistic people perform better than allistic people. Autistic people may have greater success in identifying a simple shape embedded within a more complex design, arranging blocks of different shapes and colours, or spotting an object within a cluttered visual environment (similar to Where’s Wally?). Such enhanced performance has been recorded in babies as young as nine months who show emerging signs of autism.

    How and why do autistic individuals do so well on these tasks? The answer may be surprising: more “neural noise”.

    What is neural noise?

    Generally, when you think of noise, you probably think of auditory noise, the ups and downs in the amplitude of sound frequencies we hear.

    A similar thing happens in the brain with random fluctuations in neural activity. This is called neural noise.

    This noise is always present, and comes on top of any brain activity caused by things we see, hear, smell and touch. This means that in the brain, an identical stimulus that is presented multiple times won’t cause exactly the same activity. Sometimes the brain is more active, sometimes less. In fact, even the response to a single stimulus or event will fluctuate continuously.

    Neural noise in autism

    There are many sources of neural noise in the brain. These include how the neurons become excited and calm again, changes in attention and arousal levels, and biochemical processes at the cellular level, among others. An allistic brain has mechanisms to manage and use this noise. For instance, cells in the hippocampus (the brain’s memory system) can make use of neural noise to enhance memory encoding and recall.

    Evidence for high neural noise in autism can be seen in electroencephalography (EEG) recordings, where increased levels of neural fluctuations were observed in autistic children. This means their neural activity is less predictable, showing a wider range of activity (higher ups and downs) in response to the same stimulus.

    In simple terms, if we imagine the EEG responses like a sound wave, we would expect to see small ups and downs (amplitude) in allistic brains each time they encounter a stimulus. But autistic brains seem to show bigger ups and downs, demonstrating greater amplitude of neural noise.

    Many studies have linked this noisy autistic brain with cognitive, social and behavioural difficulties.

    But could noise be a bonus?

    The diagnosis of autism has a long clinical history. A shift from the medical to a more social model has also seen advocacy for it to be reframed as a difference, rather than a disorder or deficit. This change has also entered autism research. Neuroaffirming research can examine the uniqueness and strengths of neurodivergence.

    Psychology and perception researcher David Simmons and colleagues at the University of Glasgow were the first to suggest that while high neural noise is generally a disadvantage in autism, it can sometimes provide benefits due to a phenomenon called stochastic resonance. This is where optimal amounts of noise can enhance performance. In line with this theory, high neural noise in the autistic brain might enhance performance for some cognitive tasks.

    Our 2023 research explores this idea. We recruited participants from the general population and investigated their performance on letter-detection tasks. At the same time, we measured their level of autistic traits.

    We performed two letter-detection experiments (one in a lab and one online) where participants had to identify a letter when displayed among background visual static of various intensities.

    By using the static, we added additional visual noise to the neural noise already present in our participants’ brains. We hypothesised the visual noise would push participants with low internal brain noise (or low autistic traits) to perform better (as suggested by previous research on stochastic resonance). The more interesting prediction was that noise would not help individuals who already had a lot of brain noise (that is, those with high autistic traits), because their own neural noise already ensured optimal performance.

    Indeed, one of our experiments showed people with high neural noise (high autistic traits) did not benefit from additional noise. Moreover, they showed superior performance (greater accuracy) relative to people with low neural noise when the added visual static was low. This suggests their own neural noise already caused a natural stochastic resonance effect, resulting in better performance.

    It is important to note we did not include clinically diagnosed autistic participants, but overall, we showed the theory of enhanced performance due to stochastic resonance in autism has merits.

    Why this is important?

    Autistic people face ignorance, prejudice and discrimination that can harm wellbeing. Poor mental and physical health, reduced social connections and increased “camouflaging” of autistic traits are some of the negative impacts that autistic people face.

    So, research underlining and investigating the strengths inherent in autism can help reduce stigma, allow autistic people to be themselves and acknowledge autistic people do not require “fixing”.

    The autistic brain is different. It comes with limitations, but it also has its strengths.

    Pratik Raul, PhD candidiate, University of Canberra; Jeroen van Boxtel, Associate professor, University of Canberra, and Jovana Acevska, Honours Graduate Student, University of Canberra

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

    The Conversation

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  • The Galveston Diet – by Dr. Mary Claire Haver

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    We’ve previously reviewed “It’s Not You, It’s Your Hormones” by nutritionist Nikki Williams, and noted at the time that it was very similar to the bestselling “The Galveston Diet”, not just in its content but all the way down its formatting. Some Amazon reviewers have even gone so far as to suggest that “It’s Not You, It’s Your Hormones” (2017) brazenly plagiarized “The Galveston Diet” (2023). However, after carefully examining the publication dates, we feel quite confident that the the earlier book did not plagiarize the later one.

    Of course, we would not go so far as to make a counter-accusation of plagiarism the other way around; it was surely just a case of Dr. Haver having the same good ideas 6 years later.

    Still, while the original book by Nikki Williams did not get too much international acclaim, the later one by Dr. Mary Claire Haver has had very good marketing and thus received a lot more attention, so let’s review it:

    Dr. Haver’s basic principle is (again) that we can manage our hormonal fluctuations, by managing our diet. Specifically, in the same three main ways:

    • Intermittent fasting
    • Anti-inflammatory diet
    • Eating more protein and healthy fats

    Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.

    Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.

    The style is once again very accessible and just as clear, and Dr. Haver also walks us just as skilfully through the changes we may want to make, to avoid the changes we don’t want. The recipes are also very similar, so if you loved the recipes in the other book, you certainly won’t dislike this book’s menu.

    In the category of criticism, there is (as with the other book by the other author) some extra support that’s paywalled, in the sense that she wants the reader to buy her personally-branded online plan, and it can feel a bit like she’s holding back in order to upsell to that.

    Bottom line: this book is (again) aimed at peri-menopausal and post-menopausal women. It could also (again) definitely help a lot of people with PCOS too, and, when it comes down to it, pretty much anyone with an endocrine system. It’s (still) a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.

    Click here to check out The Galveston Diet, and enjoy its well-told, well-formatted advice!

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