Practical Optimism – by Dr. Sue Varma
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We’ve written before about how to get your brain onto a more positive track (without toxic positivity), but there’s a lot more to be said than we can fit into an article, so here’s a whole book packed full with usable advice.
The subtitle claims “the art, science, and practice of…”, but mostly it’s the science of. If there’s art to be found here, then this reviewer missed it, and as for the practice of, well, that’s down to the reader, of course.
However, it is easy to use the contents of this book to translate science into practice without difficulty.
If you’re a fan of acronyms, initialisms, and other mnemonics (such as the rhyming “Name, Claim, Tame, and Reframe”), then you’ll love this book as they come thick and fast throughout, and they contribute to the overall ease of application of the ideas within.
The writing style is conversational but with enough clinical content that one never forgets who is speaking—not in the egotistical way that some authors do, but rather, just, she has a lot of professional experience to share and it shows.
Bottom line: if you’d like to be more optimistic without delving into the delusional, this book can really help a lot with that (in measurable ways, no less!).
Click here to check out Practical Optimism, and brighten up your life!
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How Aging Changes At 44 And Again At 60 (And What To Do About It)
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As it turns out, aging is not linear. Or rather: chronological aging may be, but biological aging isn’t, and there are parts of our life where it kicks into a different gear. This study looked at 108 people (65 of whom women) between the ages of 25 and 75, as part of a longitudinal cohort study, tracked for around 2–8 years (imprecise as not all follow-up durations were the same). They took frequent blood and urine samples, and tested them for thousands of different molecules and analyzing changes in gene expression, proteomic, blood biomarkers, and more. All things that are indicators of various kinds of health/disease, and which might seem more simple but it isn’t: aging.
Here’s what they found:
Landmark waypoints
At 44, significant changes occur in the metabolism, including notably the metabolism of carbs, caffeine, and alcohol. A large portion of this may be hormone related, as that’s a time of change not just for those undergoing the menopause, but also the andropause (not entirely analogous to the menopause, but it does usually entail a significant reduction in sex hormone production; in this case, testosterone).
However, the study authors also hypothesize that lifestyle factors may be relevant, as one’s 40s are often a stressful time, and an increase in alcohol consumption often occurs around the same time as one’s ability to metabolize it drops, resulting in further dysfunctional alcohol metabolism.
At 60, carb metabolism slows again, with big changes in glucose metabolism specifically, as well as an increased risk of cardiovascular disease, and a decline in kidney function. In case that wasn’t enough: also an increase free radical pathology, meaning a greatly increased risk of cancer. Immune function drops too.
What to do about this: the recommendation is of course to be proactive, and look after various aspects of your health before it becomes readily apparent that you need to. For example, good advice for anyone approaching 44 might be to quit alcohol, go easy on caffeine, and eat a diet that is conducive to good glucose metabolism. Similarly, good advice for anyone approaching 60 might be to do the same, and also pay close attention to keeping your kidneys healthy. Getting regular tests done is also key, including optional extras that your doctor might not suggest but you should ask for, such as blood urea nitrogen levels (biomarkers of kidney function). The more we look after each part of our body, the more they can look after us in turn, and the fewer/smaller problems we’ll have down the line.
If you, dear reader, are approaching the age 44 or 60… Be neither despondent nor complacent. We must avoid falling into the dual traps of “Well, that’s it, bad health is around the corner, nothing I can do about it; that’s nature”, vs “I’ll be fine, statistics are for other people, and don’t apply to me”.
Those are averages, and we do not have to be average. Every population has statistical outliers. But it would be hubris to think none of this will apply to us and we can just carry on regardless. So, for those of us who are approaching one of those two ages… It’s time to saddle up, knuckle down, and do our best!
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Also, if you’d like to read the actual paper by Dr. Xiaotao Shen et al., here it is:
Nonlinear dynamics of multi-omics profiles during human aging ← honestly, it’s a lot clearer and more informative than the video, and also obviously discusses things in a lot more detail than we have room to here
Take care!
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10,000 Steps, 30 Days, 4 Changes
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Ariel wasn’t the most active person, and took on a “30 day challenge” to do the commonly-prescribed 10,000 steps per day—without adjusting her diet or doing any other exercise. How much of a difference does it make, really?
Stepping onwards
The 4 main things that she found changed for her weren’t all what she expected:
- Weight loss yes, but only marginally: she lost 3 lbs in a month, which did nevertheless make a visible difference. We might hypothesize that part of the reason for the small weight loss and yet visible difference is that she gained a little muscle, and the weight loss was specifically shifting away from a cortisol-based fat distribution, to a more healthy fat distribution.
- Different eating habits: she felt less hungry and craved less sugar. This likely has less to do with calorie consumption, and more to do with better insulin signalling.
- Increased energy and improved mood: these are going together in one item, because she said “4 things”, but really they are two related things. So, consider one of them a bonus item! In any case, she felt more energized and productive, and less reliant on caffeine.
- Improved sleep: or rather, at first, disrupted sleep, and then slept better and stayed better. A good reminder that changes for the better don’t always feel better in the first instance!
To hear about it in her own words, and see the before and after pictures, enjoy:
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You might also like to read:
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Codependency Isn’t What Most People Think It Is
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Codependency isn’t what most people think it is
In popular parlance, people are often described as “codependent” when they rely on each other to function normally. That’s interdependent mutualism, and while it too can become a problem if a person is deprived of their “other half” and has no idea how to do laundry and does not remember to take their meds, it’s not codependency.
Codependency finds its origins in the treatment and management of alcoholism, and has been expanded to encompass other forms of relationships with dependence on substances and/or self-destructive behaviors—which can be many things, including the non-physical, for example a pattern of irresponsible impulse-spending, or sabotaging one’s own relationship(s).
We’ll use the simplest example, though:
- Person A is (for example) an alcoholic. They have a dependency.
- Person B, married to A, is not an alcoholic. However, their spouse’s dependency affects them greatly, and they do what they can to manage that, and experience tension between wanting to “save” their spouse, and wanting their spouse to be ok, which latter, superficially, often means them having their alcohol.
Person B is thus said to be “codependent”.
The problem with codependency
The problems of codependency are mainly twofold:
- The dependent partner’s dependency is enabled and thus perpetuated by the codependent partner—they might actually have to address their dependency, if it weren’t for their partner keeping them from too great a harm (be it financially, socially, psychologically, medically, whatever)
- The codependent partner is not having a good time of it either. They have the stress of two lives with the resources (e.g. time) of one. They are stressing about something they cannot control, understandably worrying about their loved one, and, worse: every action they might take to “save” their loved one by reducing the substance use, is an action that makes their partner unhappy, and causes conflict too.
Note: codependency is often a thing in romantic relationships, but it can appear in other relationships too, e.g. parent-child, or even between friends.
See also: Development and validation of a revised measure of codependency
How to deal with this
If you find yourself in a codependent position, or are advising someone who is, there are some key things that can help:
- Be a nurturer, not a rescuer. It is natural to want to “rescue” someone we care about, but there are some things we cannot do for them. Instead, we must look for ways to build their strength so that they can take the steps that only they can take to fix the problem.
- Establish boundaries. Practise saying “no”, and also be clear over what things you can and cannot control—and let go of the latter. Communicate this, though. An “I’m not the boss of you” angle can prompt a lot of people to take more personal responsibility.
- Schedule time for yourself. You might take some ideas from our previous tangentially-related article:
How To Avoid Carer Burnout (Without Dropping Care)
Want to read more?
That’s all we have space for today, but here’s a very useful page with a lot of great resources (including questionnaires and checklist and things, in case you’re thinking “is it, or…?”)
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The BAT-pause!
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When Cold Weather & The Menopause Battle It Out
You may know that (moderate, safe) exposure to the cold allows our body to convert our white and yellow fat into the much healthier brown fat—also called brown adipose tissue, or “BAT” to its friends.
If you didn’t already know that, then well, neither did scientists until about 15 years ago:
The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
You can read more about it here:
Cool Temperature Alters Human Fat and Metabolism
This is important, especially because the white fat that gets converted is the kind that makes up most visceral fat—the kind most associated with all-cause mortality:
Visceral Belly Fat & How To Lose It ← this is not the same as your subcutaneous fat, the kind that sits directly under your skin and keeps you warm; this is the fat that goes between your organs and of which we should only have a small amount!
The BAT-pause
It’s been known (since before the above discovery) that BAT production slows considerably as we get older. Not too shocking—after all, many metabolic functions slow as we get older, so why should fat regulation be any different?
But! Rodent studies found that this was tied less to age, but to ovarian function: rats who underwent ovariectomies suffered reduced BAT production, regardless of their age.
Naturally, it’s been difficult to recreate such studies in humans, because it’s difficult to find a large sample of young adults willing to have their ovaries whipped out (or even suppressed chemically) to see how badly their metabolism suffers as a result.
Nor can an observational study (for example, of people who incidentally have ovaries removed due to ovarian cancer) usefully be undertaken, because then the cancer itself and any additional cancer treatments would be confounding factors.
Perimenopausal study to the rescue!
A recent (published last month, at time of writing!) study looked at women around the age of menopause, but specifically in cohorts before and after, measuring BAT metabolism.
By dividing the participants into groups based on age and menopausal status, and dividing the post-menopausal group into “takes HRT” and “no HRT” groups, and dividing the pre-menopausal group into “normal ovarian function” and “ovarian production of estrogen suppressed to mimic slightly early menopause” groups (there’s a drug for that), and then having groups exposed to warm and cold temperatures, and measuring BAT metabolism in all cases, they were able to find…
It is about estrogen, not age!
You can read more about the study here:
“Good” fat metabolism changes tied to estrogen loss, not necessarily to aging, shows study
…and the study itself, here:
Brown adipose tissue metabolism in women is dependent on ovarian status
What does this mean for men?
This means nothing directly for (cis) men, sorry.
But to satisfy your likely curiosity: yes, testosterone does at least moderately suppress BAT metabolism—based on rodent studies, anyway, because again it’s difficult to find enough human volunteers willing to have their testicles removed for science (without there being other confounding variables in play, anyway):
Testosterone reduces metabolic brown fat activity in male mice
So, that’s bad per se, but there isn’t much to be done about it, since the rest of your (addressing our male readers here) metabolism runs on testosterone, as do many of your bodily functions, and you would suffer many unwanted effects without it.
However, as men do typically have notably less body fat in general than women (this is regulated by hormones), the effects of changes in BAT metabolism are rather less pronounced in men (per testosterone level changes) than in women (per estrogen level changes), because there’s less overall fat to convert.
In summary…
While menopausal HRT is not necessarily a silver bullet to all metabolic problems, its BAT-maintaining ability is certainly one more thing in its favor.
See also:
Dr. Jen Gunter | What You Should Have Been Told About The Menopause Beforehand
Take care!
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Kate Middleton is having ‘preventive chemotherapy’ for cancer. What does this mean?
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Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”
“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.
No further details have been released about the Princess of Wales’ treatment.
But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.
It’s not the same as preventing cancer
To prevent cancer developing, lifestyle changes such as diet, exercise and sun protection are recommended.
Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at high risk of breast cancer.
Aspirin can also be used for those at high risk of bowel and other cancers.
How can chemotherapy be used as preventive therapy?
In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.
If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.
If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate around the body .
The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer coming back. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.
With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.
If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.
How effective is preventive therapy?
The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.
Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The first chemotherapy tested improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.
Preventive chemotherapy is usually given for three to six months.
How does chemotherapy work?
Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.
Chemotherapy is not selective for cancer cells. It kills any dividing cells.
But cancers consist of a higher proportion of dividing cells than the normal body cells. A greater proportion of the cancer is killed with each course of chemotherapy.
Normal cells can recover between courses, which are usually given three to four weeks apart.
What are the side effects?
The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.
The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.
Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.
Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.
There are also generalised symptoms such as fatigue.
Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.
Ian Olver, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Sun, Sea, And Sudden Killers To Avoid
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Stay Safe From Heat Exhaustion & Heatstroke!
For most of us, summer is upon us now. Which can be lovely… and also bring new, different health risks. Today we’re going to talk about heat exhaustion and heatstroke.
What’s the difference?
Heat exhaustion is a milder form of heatstroke, but the former can turn into the latter very quickly if left untreated.
Symptoms of heat exhaustion include:
- Headache
- Nausea
- Cold sweats
- Light-headedness
Symptoms of heatstroke include the above and also:
- Red/flushed-looking skin
- High body temperature (104ºF / 40ºC)
- Disorientation/confusion
- Accelerated heart rate
Click here for a handy downloadable infographic you can keep on your phone
What should we do about it?
In the case of heatstroke, call 911 or the equivalent emergency number for the country where you are.
Hopefully we can avoid it getting that far, though:
Prevention first
Here are some top tips to avoid heat exhaustion and thus also avoid heatstroke. Many are common sense, but it’s easy to forget things—especially in the moment, on a hot sunny day!
- Hydrate, hydrate, hydrate
- (Non-sugary) iced teas, fruit infusions, that sort of thing are more hydrating than water alone
- Avoid alcohol
- If you really want to imbibe, rehydrate between each alcoholic drink
- Time your exercise with the heat in mind
- In other words, make any exercise session early or late in the day, not during the hottest period
- Use sunscreen
- This isn’t just for skin health (though it is important for that); it will also help keep you cooler, as it blocks the UV rays that literally cook your cells
- Keep your environment cool
- Shade is good, air conditioning / cooling fans can help.
- A wide-brimmed hat is portable shade just for you
- Wear loose, breathable clothing
- We write about health, not fashion, but: light breathable clothes that cover more of your body are generally better healthwise in this context, than minimal clothes that don’t, if you’re in the sun.
- Be aware of any medications you’re taking that will increase your sensitivity to heat.
- This includes medications that are dehydrating, and includes most anti-depressants, many anti-nausea medications, some anti-allergy medications, and more.
- Check your labels/leaflets, look up your meds online, or ask your pharmacist.
Treatment
If prevention fails, treatment is next. Again, in the case of heatstroke, it’s time for an ambulance.
If symptoms are “only” of heat exhaustion and are more mild, then:
- Move to a cooler location
- Rehydrate again
- Remove clothing that’s confining or too thick
- What does confining mean? Clothing that’s tight and may interfere with the body’s ability to lose heat.
- For example, you might want to lose your sports bra, but there is no need to lose a bikini, for instance.
- What does confining mean? Clothing that’s tight and may interfere with the body’s ability to lose heat.
- Use ice packs or towels soaked in cold water, applied to your body, especially wear circulation is easiest to affect, e.g. forehead, wrists, back of neck, under the arms, or groin.
- A cool bath or shower, or a dip in the pool may help cool you down, but only do this if there’s someone else around and you’re not too dizzy.
- This isn’t a good moment to go in the sea, no matter how refreshing it would be. You do not want to avoid heatstroke by drowning instead.
If full recovery doesn’t occur within a couple of hours, seek medical help.
Stay safe and have fun!
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