Qigong: A Breath Of Fresh Air?
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Qigong: Breathing Is Good (Magic Remains Unverified)
In Tuesday’s newsletter, we asked you for your opinions of qigong, and got the above-depicted, below-described, set of responses:
- About 55% said “Qigong is just breathing, but breathing exercises are good for the health”
- About 41% said “Qigong helps regulate our qi and thus imbue us with healthy vitality”
- One (1) person said “Qigong is a mystical waste of time and any benefits are just placebo”
The sample size was a little low for this one, but the results were quite clearly favorable, one way or another.
So what does the science say?
Qigong is just breathing: True or False?
True or False, depending on how we want to define it—because qigong ranges in its presentation from indeed “just breathing exercises”, to “breathing exercises with visualization” to “special breathing exercises with visualization that have to be exactly this way, with these hand and sometimes body movements also, which also must be just right”, to far more complex definitions that involve qi by various mystical definitions, and/or an appeal to a scientific analog of qi; often some kind of bioelectrical field or such.
There is, it must be said, no good quality evidence for the existence of qi.
Writer’s note, lest 41% of you want my head now: I’ve been practicing qigong and related arts for about 30 years and find such to be of great merit. This personal experience and understanding does not, however, change the state of affairs when it comes to the availability (or rather, the lack) of high quality clinical evidence to point to.
Which is not to say there is no clinical evidence, for example:
Acute Physiological and Psychological Effects of Qigong Exercise in Older Practitioners
…found that qigong indeed increased meridian electrical conductance!
Except… Electrical conductance is measured with galvanic skin responses, which increase with sweat. But don’t worry, to control for that, they asked participants to dry themselves with a towel. Unfortunately, this overlooks the fact that a) more sweat can come where that came from, because the body will continue until it is satisfied of adequate homeostasis, and b) drying oneself with a towel will remove the moisture better than it’ll remove the salts from the skin—bearing in mind that it’s mostly the salts, rather than the moisture itself, that improve the conductivity (pure distilled water does conduct electricity, but not very well).
In other words, this was shoddy methodology. How did it pass peer review? Well, here’s an insight into that journal’s peer review process…
❝The peer-review system of EBCAM is farcical: potential authors who send their submissions to EBCAM are invited to suggest their preferred reviewers who subsequently are almost invariably appointed to do the job. It goes without saying that such a system is prone to all sorts of serious failures; in fact, this is not peer-review at all, in my opinion, it is an unethical sham.❞
~ Dr. Edzard Ernst, a founding editor of EBCAM (he since left, and decries what has happened to it since)
One of the other key problems is: how does one test qigong against placebo?
Scientists have looked into this question, and their answers have thus far been unsatisfying, and generally to the tune of the true-but-unhelpful statement that “future research needs to be better”:
Problems of scientific methodology related to placebo control in Qigong studies: A systematic review
Most studies into qigong are interventional studies, that is to say, they measure people’s metrics (for example, blood pressure, heart rate, maybe immune function biomarkers, sleep quality metrics of various kinds, subjective reports of stress levels, physical biomarkers of stress levels, things like that), then do a course of qigong (perhaps 6 weeks, for example), then measure them again, and see if the course of qigong improved things.
This almost always results in an improvement when looking at the before-and-after, but it says nothing for whether the benefits were purely placebo.
We did find one study that claimed to be placebo-controlled:
…but upon reading the paper itself carefully, it turned out that while the experimental group did qigong, the control group did a reading exercise. Which is… Saying how well qigong performs vs reading (qigong did outperform reading, for the record), but nothing for how well it performs vs placebo, because reading isn’t a remotely credible placebo.
See also: Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago ← this one explains a lot about how placebo effect does work
Qigong is a mystical waste of time: True or False?
False! This one we can answer easily. Interventional studies invariably find it does help, and the fact remains that even if placebo is its primary mechanism of action, it is of benefit and therefore not a waste of time.
Which is not to say that placebo is its only, or even necessarily primary, mechanism of action.
Even from a purely empirical evidence-based medicine point of view, qigong is at the very least breathing exercises plus (usually) some low-impact body movement. Those are already two things that can be looked at, mechanistic processes pointed to, and declarations confidently made of “this is an activity that’s beneficial for health”.
See for example:
- Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial
- Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults
- Impact of Medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial
…and those are all from respectable journals with meaningful peer review processes.
None of them are placebo-controlled, because there is no real option of “and group B will only be tricked into believing they are doing deep breathing exercises with low-impact movements”; that’s impossible.
But! They each show how doing qigong reliably outperforms not doing qigong for various measurable metrics of health.
And, we chose examples with physical symptoms and where possible empirically measurable outcomes (such as COVID-19 infection levels, or inflammatory responses); there are reams of studies showings qigong improves purely subjective wellbeing—but the latter could probably be claimed for any enjoyable activity, whereas changes in inflammatory biomarkers, not such much.
In short: for most people, it indeed reliably helps with many things. And importantly, it has no particular risks associated with it, and it’s almost universally framed as a complementary therapy rather than an alternative therapy.
This is critical, because it means that whereas someone may hold off on taking evidence-based medicines while trying out (for example) homeopathy, few people are likely to hold off on other treatments while trying out qigong—since it’s being viewed as a helper rather than a Hail-Mary.
Want to read more about qigong?
Here’s the NIH’s National Center for Complementary and Integrative Health has to say. It cites a lot of poor quality science, but it does mention when the science it’s citing is of poor quality, and over all gives quite a rounded view:
Enjoy!
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The Beautiful Cure – by Dr. Daniel Davis
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This one is not just a book about the history of immunology and a primer on how the immune system works. It is those things too, but it’s more:
Dr. Daniel Davis, a professor of immunology and celebrated researcher in his own right, bids us look at not just what we can do, but also what else we might.
This is not to say that the book is speculative; Dr. Davis deals in data rather than imaginings. He also cautions us against falling prey to sensationalization of the “beautiful cures” that the field of immunology is working towards. What, then, are these “beautiful cures”?
Just like our immune systems (in the plural; by Dr. Davis’ count, primarily talking about our innate and adaptive immune systems) can in principle deal with any biological threat, but in practice don’t always get it right, the same goes for our medicine.
He argues that in principle, we categorically can cure any immune-related disease (including autoimmune diseases, and tangentially, cancer). The theoretical existence of such cures is a mathematically known truth. The practical, contingent existence of them? That’s what takes the actual work.
The style of the book is accessible pop science, with a hard science backbone from start to finish.
Bottom line: if you’d like to know more about immunology, and be inspired with hope and wonder without getting carried away, this is the book for you.
Click here to check out The Beautiful Cure, and learn about these medical marvels!
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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link
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The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was originally developed to help people with type 2 diabetes manage their blood sugar levels.
However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for weight loss, and hundreds of thousands of people around the world are using it for this purpose.
Evidence has also shown the drug can help manage heart failure and chronic kidney disease in people with obesity and type 2 diabetes.
Now, a study published in the New England Journal of Medicine has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?
Pormezz/Shutterstock Osteoarthritis and obesity
Osteoarthritis is a common joint disease, affecting 2.1 million Australians. Most people with osteoarthritis have pain and find it difficult to perform common daily activities such as walking. The knee is the joint most commonly affected by osteoarthritis.
Being overweight or obese is a major risk factor for osteoarthritis in the knee. The link between the two conditions is complex. It involves a combination of increased load on the knee, metabolic factors such as high cholesterol and high blood sugar, and inflammation.
For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the development of osteoarthritis.
Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. International and Australian guidelines suggest losing as little as 5% of body weight can help.
But losing weight with just diet and exercise can be difficult for many people. One study from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.
Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.
Semaglutide for osteoarthritis?
The rationale for the recent study was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.
They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.
As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.
Osteoarthritis of the knee is the most common type of osteoarthritis. SKT Studio/Shutterstock The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.
This is much greater than the pain reduction in another recent study among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.
The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as anti-inflammatories, opioids and antidepressants.
Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.
How could semaglutide reduce knee pain?
It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.
But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have anti-inflammatory properties, and could even protect against cartilage wear and tear.
While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.
The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis are prescribed opioids. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.
It’s also important to consider semaglutide can have a range of side effects, including gastrointestinal symptoms and fatigue.
There are some concerns that semaglutide could reduce muscle mass and bone density, though we’re still learning more about this.
Further, it can be difficult to access.
I have knee osteoarthritis, what should I do?
Osteoarthritis is a disease caused by multiple factors, and it’s important to take a multifaceted approach to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of self-management. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.
Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney and Christina Abdel Shaheed, Associate Professor, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Seven-Day Sleep Prescription – by Dr. Aric Prather
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You probably already know about sleep hygiene. So, what does this book have to offer?
Dr. Aric Prather offers seven days’ worth of adjustments, practices to take up, from when you get up in the morning to when you lay your head down at night.
Some you’ll surely be familiar with, like avoiding blue light and social media at night.
Others, you might not be familiar with, like scheduling 15 minutes for worrying in the daytime. The rationale for this one is that when you find yourself inclined to worry at a time that will keep you awake, you’ll know that you can put off such thoughts to your scheduled “worrying time”. That they’ll be addressed then, and that you can thus sleep soundly meanwhile.
Where the book really comes into its own is in such things as discussing how to not just manage sleep debt, but how to actually use it in your favour.
Nor does Dr. Prather shy away from the truths of our world… That the world these days is not built for us to sleep well. That there are so many other priorities; to get our work done, to succeed and achieve, to pay bills, to support our kids and partners. That so many of these things make plenty of sense in the moment, but catch up with us eventually.
Bottom line: what this book aims to give is a genuinely sustainable approach to sleeping—controlling what we can, and working with what we can’t. If you’d like to have a better relationship with sleep, this book is an excellent choice.
Click here to check out the Seven-Day Sleep Prescription, and improve yours!
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The Brain As A Work-In-Progress
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And The Brain Goes Marching On!
In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:
- About 64% of people said “Never”
- About 16% of people said “25 years”
- About 9% of people said “65 years”
- About 5% of people said “13 years”
- About 3% of people said “18 years”
- About 3% of people said “45 years”
Some thoughts, before we get into the science:
An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:
- “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
- When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages
Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!
Why we picked those ages
We picked those ages as poll options for reasons people might be drawn to them:
- 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
- 18 years: age of legal majority in N. America and many other places
- 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
- 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
- 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research
Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!
Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.
So, what does the science say?
Our brains are never finished developing: True or False?
True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.
Glossary:
- Neurogenesis: the process of creating new brain cells
- Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs
We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.
For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:
How To Grow New Brain Cells (At Any Age)
Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.
Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:
Our brains are still developing up to the age of 25: True or False?
True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.
A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:
❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞
Source: Structural Magnetic Resonance Imaging of the Adolescent Brain
There are several things to note here:
- The above statement is talking about the physical size of the brain growing
- Nowhere does he say “and stops developing at 25”
However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.
This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.
The study didn’t misrepresent this, by the way, but the popular press did!
Another 2012 study looked at various metrics of brain development, and found:
- Synapse overproduction into the teens
- Cortex pruning into the late 20s
- Prefrontal pruning into middle age at least (they stopped looking)
- Myelination beyond middle age (they stopped looking)
Source: Experience and the developing prefrontal cortex ← check out figure 1, and make sure you’re looking at the human data not the rat data
So how’s the most recent research looking?
Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:
Brain charts for the human lifespan ← check out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!
Want to know how not to get caught out by science being misrepresented by the popular press? Check out:
How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)
Take care!
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7 Signs of Undiagnosed Autism in Adults
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When it comes to adults and autism, there are two kinds of person in the popular view: those who resemble the Rain Man, and those who are making it up. But, it’s not so, as Paul Micallef explains:
The signs
We’ll not keep them a mystery; they are:
- Social interaction difficulties: such a person may struggle with understanding social cues, leading to awkwardness, isolation, or appearing eccentric.
- Need for structure and routine: either highly structured or disorganized, both of which stem from executive function challenges. The former, of course, is a coping mechanism, while the latter is the absence of same.
- Sensory sensitivities: can include sensitivities or insensitivities to light, sound, temperature, smells, tastes, and so forth.
- Spiky skillset: extreme strengths in certain areas, coupled with significant difficulties in others, leading to uneven abilities. May be able to dismantle and rebuild a PC, while not knowing how to arrange an Über.
- Emotional regulation issues: experiences of meltdowns, shutdowns, or withdrawal as coping mechanisms when overwhelmed. Not that this is “or”, not necessarily “and”. The latter goes especially unnoticed as an emotional regulation issue, because for everyone else, it’s something that’s not there to see.
- Unusual associations: making mental connections or associations that seem random or uncommon compared to others. The mind went to 17 places quickly and while everyone else got from idea A to idea B, this person is already at idea Q.
- Being “just different”: a general sense of being the odd one out, standing out in subtle or distinct ways. This is rather a catch-all, but if there’s someone who fits this, there’s a good chance, the other things apply too.
For more on all of these, whether pertaining to yourself or a loved one (or both!), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- 16 Overlooked Autistic Traits In Women
- What is AuDHD? 5 important things to know when someone has both autism and ADHD
Take care!
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Cherries vs Grapes – Which is Healthier?
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Our Verdict
When comparing cherries to grapes, we picked the cherries.
Why?
First, let’s mention: we are looking at sour cherries and Californian grapes. Even those will of course vary in quality, but the nutritional values here are quite reliable averages.
In terms of macros you might have guessed this one: cherries have nearly 2x the fiber and grapes have about 50% more carbs. So, while neither fruit is bad and they are both low glycemic index foods, cherry is the winner in this category.
When it comes to vitamins, cherries have more of vitamins A, B3, B5, B9, C, and choline, while grapes have more of vitamins B1, B2, B6, E, and K. That’s a 6:5 win for cherries, and the respective margins of difference bear that out too.
In the category of minerals, cherries have more calcium, copper, iron, magnesium, phosphorus, and zinc, while grapes have more manganese and potassium. An easy 6:2 win for cherries.
You might be wondering about polyphenols: both are very abundant in very many polyphenols; so much and so many, in fact, that we couldn’t possibly try to adjudicate between them without doing some complex statistical modeling (especially given how much this can vary from one sample to another, much more so than the micro-and macronutrient values discussed above), so we’ll call it a tie on these.
Adding up the section makes for a clear win for cherries, but of course, enjoy either or both!
Want to learn more?
You might like to read:
Cherries’ Very Healthy Wealth Of Benefits!
Resveratrol & Healthy AgingTake care!
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