Radical Longevity – by Dr. Ann Gittleman
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Dr. Gittleman takes a comprehensive approach, advising us about avoiding AGEs, freeing up fascia, stimulating cellular rejuvenation, the mind-gut connection, keeping the immune system healthy, and more.
The “plan” promised by the subtitle involves identifying the key factors of nutrition and lifestyle most impactful to you, and adjusting them accordingly, in a multistep, author-walks-the-reader-by-the-hand process.
There’s also, for those who prefer it, a large section (seven chapters) on a body part/system by body part/system approach, e.g. brain health, heart health, revitalizing skin, reversing hair loss, repairing bones, muscles, joints, etc.
The writing style is quite casual,butalso with a mind to education, with its call-out boxes, bullet-point summaries, and so forth. There is a “select references” section, but if one wants to find studies, it’s often necessary to go looking, as there aren’t inline citations.
Bottom line: we’d love to see better referencing, but otherwise this is a top-tier anti-aging book, and a lot more accessible than most, without skimping on depth and breadth.
Click here to check out Radical Longevity, and get rejuvenating radically!
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The Sweet Truth About Glycine
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Make Your Collagen Work Better
This is Dr. James Nicolantonio. He’s a doctor of pharmacy, and a research scientist. He has a passion for evidence-based nutrition, and has written numerous books on the subject.
Controversy! Dr. DiNicolatonio’s work has included cardiovascular research, in which field he has made the case for increasing (rather than decreasing) the recommended amount of salt in our diet. This, of course, goes very much against the popular status quo.
We haven’t reviewed that research so we won’t comment on it here, but we thought it worth a mention as a point of interest. We’ll investigate his claims in that regard another time, though!
Today, however, we’ll be looking at his incisive, yet not controversial, work pertaining to collagen and glycine.
A quick recap on collagen
We’ve written about collagen before, and its importance for maintaining… Well, pretty much most of our body, really, buta deficiency in collagen can particularly weaken bones and joints.
On a more surface level, collagen’s also important for healthy elastic skin, and many people take it for that reason alone,
Since collagen is found only in animals, even collagen supplements are animal-based (often marine collagen or bovine collagen). However, if we don’t want to consume those, we can (like most animals) synthesize it ourselves from the relevant amino acids, which we can get from plants (and also laboratories, in some cases).
You can read our previous article about this, here:
We Are Such Stuff As Fish Are Made Of
What does he want us to know about collagen?
We’ll save time and space here: first, he’d like us to know the same as what we said in our article above
However, there is also more:
Let’s assume that your body has collagen to process. You either consumed it, or your body has synthesized it. We’ll skip describing the many steps of collagen synthesis, fascinating as that is, and get to the point:
When our body weaves together collagen fibrils out of the (triple-helical) collagen molecules…
- the cross-linking of the collagen requires lysyl oxidase
- the lysyl oxidase (which we make inside us) deanimates some other amino acids yielding aldehydes that allow the stable cross-links important for the high tensile strength of collagen, but to do that, it requires copper
- in order to use the copper it needs to be in its reduced cuprous form and that requires vitamin C
- but moving it around the body requires vitamin A
So in other words: if you are taking (or synthesizing) collagen, you also need copper and vitamins A and C.
However! Just to make things harder, if you take copper and vitamin C together, it’ll reduce the copper too soon in the wrong place.
Dr. DiNicolantonio therefore advises taking vitamin C after copper, with a 75 minutes gap between them.
What does he want us to know about glycine?
Glycine is one of the amino acids that makes up collagen. Specifically, it makes up every third amino acid in collagen, and even more specifically, it’s also the rate-limiting factor in the formation of glutathione, which is a potent endogenous (i.e., we make it inside us) antioxidant that works hard to fight inflammation inside the body.
What this means: if your joints are prone to inflammation, being glycine-deficient means a double-whammy of woe.
As well as being one of the amino acids most key to collagen production, glycine has another collagen-related role:
First, the problem: as we age, glycated collagen accumulates in the skin and cartilage (that’s bad; there is supposed to be collagen there, but not glycated).
More on glycation and what it is and why it is so bad:
Are You Eating Advanced Glycation End-Products? The Trouble Of The AGEs
Now, the solution: glycine suppresses advanced glycation end products, including the glycation of collagen.
See for example:
With these three important functions of glycine in mind…
Dr. DiNicolantonio therefore advises getting glycine at a dose of 100mg/kg/day. So, if you’re the same size as this rather medium-sized writer, that means 7.2g/day.
Where can I get it?
Glycine is found in many foods, including gelatin for those who eat that, eggs for the vegetarians, and spinach for vegans.
However, if you’d like to simply take it as a supplement, here’s an example product on Amazon
(the above product is not clear whether it’s animal-derived or not, so if that’s important to you, shop around. This writer got some locally that is certified vegan, but is in Europe rather than N. America, which won’t help most of our subscribers)
Note: pure glycine is a white crystalline powder that has the same sweetness as glucose. Indeed, that is how it got its name, from the Greek “γλυκύς”, pronounced /ɡly.kýs/, meaning “sweet”. Yes, same etymology as glucose.
So don’t worry that you’ve been conned if you order it and think “this is sugar!”; it just looks and tastes the same.
That does mean you should buy from a reputable source though, as a con would be very easy!
this does also mean that if you like a little sugar/sweetener in your tea or coffee, glycine can be used as a healthy substitute.
If you don’t like sweet tastes, then, condolences. This writer pours two espresso coffees (love this decaffeinated coffee that actually tastes good), puts the glycine in the first, and then uses the second to get rid of the sweet taste of the first. So that’s one way to do it.
Enjoy (if you can!)
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5 Ways To Avoid Hearing Loss
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Hear Ye, Hear Ye
Hearing loss is often associated with getting older—but it can strike at any age. In the US, for example…
- Around 13% of adults have hearing difficulties
- Nearly 27% of those over 65 have hearing difficulties
Complete or near-complete hearing loss is less common. From the same source…
- A little under 2% of adults in general had a total or near-total inability to hear
- A little over 4% of those over 65 had a total or near-total inability to hear
Source: CDC | Hearing Difficulties Among Adults: United States, 2019
So, what to do if we want to keep our hearing as it is?
Avoid loud environments
An obvious one, but it bears stating for the sake of being methodical. Loud environments damage our ears, but how loud is too loud?
You can check how loud an environment is by using a free smartphone app, such as:
Decibel Pro: dB Sound Level Meter (iOS / Android)
An 82 dB environment is considered safe for 16 hours. That’s the equivalent of, for example moderate traffic.
Every 3 dB added to that halves the safe exposure time, for example:
- An 85 dB environment is considered safe for 8 hours. That’s the equivalent of heavier traffic, or a vacuum cleaner.
- A 94 dB environment is considered safe for 1 hour. That might be a chainsaw, a motorcycle, or a large sporting event.
Many nightclubs or concert venues often have environments of 110 dB and more. So the safe exposure time would be under two minutes.
Source: NIOSH | Noise and Hearing Loss
With differences like that per 3 dB increase, then you may want to wear hearing protection if you’re going to be in a noisy environment.
Discreet options include things like these -20 dB silicone ear plugs that live in a little case on one’s keyring.
Stop sticking things in your ears
It’s said “nothing smaller than your elbow should go in your ear canal”. We’ve written about this before:
What’s Good (And What’s Not) Against Earwax
Look after the rest of your health
Our ears are not islands unaffected by the rest of our health, and indeed, they’re larger and more complex organs than we think about most of the time, since we only tend to think about the (least important!) external part.
Common causes of hearing loss that aren’t the percussive injuries we discussed above include:
- Diabetes
- High blood pressure
- Smoking
- Infections
- Medications
Lest that last one sound a little vague, it’s because there are hundreds of medications that have hearing loss as a potential side-effect. Here’s a list so you can check if you’re taking any of them:
List of Ototoxic Medications That May Cause Tinnitus or Hearing Loss
Get your hearing tested regularly.
There are online tests, but we recommend an in-person test at a local clinic, as it won’t be subject to the limitations and quirks of the device(s) you’re using. Pretty much anywhere that sells hearing aids will probably offer you a free test, so take advantage of it!
And, more generally, if you suddenly notice you lost some or all of your hearing in one or more ears, then get thee to a doctor, and quickly.
Treat it as an emergency, because there are many things that can be treated if and only if they are caught early, before the damage becomes permanent.
Use it or lose it
This one’s important. As we get older, it’s easy to become more reclusive, but the whole “neurons that fire together, wire together” neuroplasticity thing goes for our hearing too.
Our brain is, effectively, our innermost hearing organ, insofar as it processes the information it receives about sounds that were heard.
There are neurological hearing problems that can show up without external physical hearing damage (auditory processing disorders being high on the list), but usually these things are comorbid with each other.
So if we want to maintain our ability to process the sounds our ears detect, then we need to practice that ability.
Important implication:
That means that if you might benefit from a hearing aid, you should get it now, not later.
It’s counterintuitive, we know, but because of the neurological consequences, hearing aids help people retain their hearing, whereas soldiering on without can hasten hearing loss.
On the topic of hearing difficulty comorbidities…
Tinnitus (ringing in the ears) is, paradoxically, associated with both hearing loss, and with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).
Learn more about managing that, here:
Tinnitus: Quieting The Unwanted Orchestra In Your Ears
Take care!
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When Doctors Make House Calls, Modern-Style!
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In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:
- About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
- About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
- And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”
*We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.
So, what does the science say?
A quick note first
Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.
Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.
Nevertheless, we’ll do what we can with the science we have!
Telehealth is more accessible than in-person consultations: True or False?
True, for most people. For example…
❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.
Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.
Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞
whereas…
❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞
~ Ibid.
Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review
Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.
The quality of care provided via telehealth is as good as in-person: True or False?
True, ostensibly, with caveats. The caveats are:
- We’re going offreported patient satisfaction, not objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
- We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.
*we did find some, but it wasn’t very helpful yet. For example:
An electronic trigger to detect telemedicine-related diagnostic errors
this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.
While most oft-considered demographic groups reported comparable patient satisfaction (per race, gender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).
However!
Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:
❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞
Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology
There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?
True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:
❝The doctor uses his five senses to assess. This cannot be attained over the phone❞
~ 10almonds subscriber
A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!
Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).
However, nowadays indeed a doctor will use sight, sound, touch, and sometimes even smell.
In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.
With this in mind, it really comes down to what you need from your doctor in that consultation.
- If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
- If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
- If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.
If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.
Take care!
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Eat All You Want (But Wisely)
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Some Surprising Truths About Hunger And Satiety
This is Dr. Barbara Rolls. She’s Professor and Guthrie Chair in Nutritional Sciences, and Director of the Laboratory for the Study of Human Ingestive Behavior at Pennsylvania State University, after graduating herself from Oxford and Cambridge (yes, both). Her “awards and honors” take up four A4 pages, so we won’t list them all here.
Most importantly, she’s an expert on hunger, satiety, and eating behavior in general.
What does she want us to know?
First and foremost: you cannot starve yourself thin, unless you literally starve yourself to death.
What this is about: any weight lost due to malnutrition (“not eating enough” is malnutrition) will always go back on once food becomes available. So unless you die first (not a great health plan), merely restricting good will always result in “yo-yo dieting”.
So, to avoid putting the weight back on and feeling miserable every day along the way… You need to eat as much as you feel you need.
But, there’s a trick here (it’s about making you genuinely feel you need less)!
Your body is an instrument—so play it
Your body is the tool you use to accomplish pretty much anything you do. It is, in large part, at your command. Then there are other parts you can’t control directly.
Dr. Rolls advises taking advantage of the fact that much of your body is a mindless machine that will simply follow instructions given.
That includes instructions like “feel hungry” or “feel full”. But how to choose those?
Volume matters
An important part of our satiety signalling is based on a physical sensation of fullness. This, by the way, is why bariatric surgery (making a stomach a small fraction of the size it was before) works. It’s not that people can’t eat more (the stomach is stretchy and can also be filled repeatedly), it’s that they don’t want to eat more because the pressure sensors around the stomach feel full, and signal the hormone leptin to tell the brain we’re full now.
Now consider:
- On the one hand, 20 grapes, fresh and bursting with flavor
- On the other hand, 20 raisins (so, dried grapes), containing the same calories
Which do you think will get the leptin flowing sooner? Of course, the fresh grapes, because of the volume.
So if you’ve ever seen those photos that show two foods side by side with the same number of calories but one is much larger (say, a small slice of pizza or a big salad), it’s not quite the cheap trick that it might have appeared.
Or rather… It is a cheap trick; it’s just a cheap trick that works because your stomach is quite a simple organ.
So, Dr. Rolls’ advice: generally speaking, go for voluminous food. Fruit is great from this, because there’s so much water. Air-popped popcorn also works great. Vegetables, too.
Water matters, but differently than you might think
A well-known trick is to drink water before and with a meal. That’s good, it’s good to be hydrated. However, it can be better. Dr. Rolls did an experiment:
The design:
❝Subjects received 1 of 3 isoenergetic (1128 kJ) preloads 17 min before lunch on 3 d and no preload on 1 d.
The preloads consisted of 1) chicken rice casserole, 2) chicken rice casserole served with a glass of water (356 g), and 3) chicken rice soup.
The soup contained the same ingredients (type and amount) as the casserole that was served with water.❞
The results:
❝Decreasing the energy density of and increasing the volume of the preload by adding water to it significantly increased fullness and reduced hunger and subsequent energy intake at lunch.
The equivalent amount of water served as a beverage with a food did not affect satiety.❞
The conclusion:
❝Consuming foods with a high water content more effectively reduced subsequent energy intake than did drinking water with food.❞
You can read the study in full (it’s a worthwhile read!) here:
Water incorporated into a food but not served with a food decreases energy intake in lean women
Protein matters
With all those fruits and vegetables and water, you may be wondering Dr. Rolls’ stance on proteins. It’s simple: protein is an appetite suppressant.
However, it takes about 20 minutes to signal the brain about that, so having some protein in a starter (if like this writer, you’re the cook of the household, a great option is to enjoy a small portion of nuts while cooking!) gets that clock ticking, to signal satiety sooner.
It may also help in other ways:
Clinical Evidence and Mechanisms of High-Protein Diet-Induced Weight Loss
As for other foods that can suppress appetite, by the way, you might like;
25 Foods That Act As Natural Appetite Suppressants
Variety matters, and in ways other than you might think
A wide variety of foods (especially: a wide variety of plants) in one’s diet is well recognized as a key to a good balanced diet.
However…
A wide variety of dishes at the table, meanwhile, promotes greater consumption of food.
Dr. Rolls did a study on this too, a while ago now (you’ll see how old it is) but the science seems robust:
Variety in a Meal Enhances Food Intake in Man
Notwithstanding the title, it wasnot about a man (that was just how scientists wrote in ye ancient times of 1981). The test subjects were, in order: rats, cats, a mixed group of men and women, the same group again, and then a different group of all women.
So, Dr. Rolls’ advice is: it’s better to have one 20-ingredient dish, than 10 dishes with 20 ingredients between them.
Sorry! We love tapas and buffets too, but that’s the science!
So, “one-pot” meals are king in this regard; even if you serve it with one side (reasonable), that’s still only two dishes, which is pretty good going.
Note that the most delicious many-ingredient stir-fries and similar dishes from around the world also fall into this category!
Want to know more?
If you have the time (it’s an hour), you can enjoy a class of hers for free:
Want to watch it, but not right now? Bookmark it for later
Enjoy!
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Yes, you do need to clean your tongue. Here’s how and why
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Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health.
The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity.
But there’s no need to wait for a trip to the doctor. Cleaning your tongue twice a day can help you check how your tongue looks and feels – and improve your breath.
luisrsphoto/Shutterstock What does a healthy tongue look like?
Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move.
The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface.
These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0
A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light pink.
A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or other issues.
How should I clean my tongue?
Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine.
Build-up can occur if you stop brushing or scraping your tongue even for a few days. Anthony Shkraba/Pexels You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface.
Or you can use a special tongue scraper. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush.
Your co-workers will thank you as well – cleaning your tongue can help combat stinky breath. Tongue scrapers are particularly effective at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface.
What’s that stuff on my tongue?
So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP.
Here’s what your tongue might be telling you.
White coating
Developing a white coating on the tongue’s surface is one of the most common changes in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days.
In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause serious illnesses.
Scrubbing or scraping your tongue only takes around ten seconds and can be done while brushing your teeth. Ketut Subiyanto/Pexels Yellow coating
This may indicate oral thrush, a fungal infection that leaves a raw surface when scrubbed.
Oral thrush is common in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary suppression of the immune system or antibiotic use.
If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month.
Black coating
Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a black hairy tongue. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene.
Smoking can add to poor oral hygiene and make the tongue look black. Sophon Nawit/Shutterstock Pink patches
Pink patches surrounded by a white border can make your tongue look like a map – this is called “geographic tongue”. It’s not known what causes this condition, which usually doesn’t require treatment.
Pain and inflammation
A red, sore tongue can indicate a range of issues, including:
- nutritional deficiencies such as folic acid or vitamin B12
- diseases including pernicious anaemia, Kawasaki disease and scarlet fever
- inflammation known as glossitis
- injury from hot beverages or food
- ulcers, including cold sores and canker sores
- burning mouth syndrome.
Dryness
Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt.
What about cancer?
White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a higher risk of turning into cancer, compared to other parts of the mouth.
Oral cancers have low survival rates due to delayed detection – and they are on the rise. So checking your tongue for changes in colour, texture, sore spots or ulcers is critical.
Dileep Sharma, Professor and Head of Discipline – Oral Health, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Fall Asleep In 2 Minutes (Doctor Explains)
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Beyond “sleep hygiene”, Dr. Siobhan Deshauer has insights to share:
Rest for your body and mind
First, do still do the basics. That means dimming/filtering lights for an hour before bed, lowering the room temperature a little, ensuring you have nice fresh sheets, not having alcohol or caffeine before bed, and getting out of bed if you’re not asleep within half an hour, to avoid associating being in bed with wakefulness.
Next, the extra tips:
- Progressive relaxation: tense and relax each muscle group from toes to head
- Box breathing: inhale, hold, exhale, and hold for 4 seconds each; helps calm the nervous system (it’s called “box breathing” because of the 4:4:4:4 setup)
- Diaphragmatic breathing: focus on belly breathing, with longer exhalation to activate the parasympathetic nervous system (note that this can, and even ideally should, be done at the same time as the previous)
- Cognitive shuffling: think of words starting with each letter of a chosen word while visualizing them (this is like “counting sheep”, but does the job better—the job in question being preventing your brain from moving to anything more strenuous or stressful)
For more on all of these plus some extra side-along advice, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Non-Sleep Deep Rest: A Neurobiologist’s Take ← a way to get many of the benefits of sleep, while awake
Take care!
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