Reduce Your Stroke Risk

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❝Each year in the U.S., over half a million people have a first stroke; however, up to 80% of strokes may be preventable.❞

~ American Stroke Association

Source: New guideline: Preventing a first stroke may be possible with screening, lifestyle changes

So, what should we do?

Some of the risk factors are unavoidable or not usefully avoidable, like genetic predispositions and old age, respectively (i.e. it is possible to avoid old age—by dying young, which is not a good approach).

Some of the risk factors are avoidable. Let’s look at the most obvious first:

You cannot drink to your good health

While overall, the World Health Organization has declared that “the only safe amount of alcohol is zero”, when it comes to stroke risk specifically, it seems that low consumption is not associated with stroke, while moderate to high consumption is associated with a commensurately increased risk of stroke:

Alcohol Intake as a Risk Factor for Acute Stroke

Note: there are some studies out there that say that a low to moderate consumption may decrease the risk compared to zero consumption. However, any such study that this writer has seen has had the methodological flaw of not addressing why those who do not drink alcohol, do not drink it. In many cases, someone who drinks no alcohol at all does so because either a) it would cause problems with some medication(s) they are taking, or b) they used to drink heavily, and quit. In either case, their reasons for not drinking alcohol may themselves be reasons for an increased stroke risk—not the lack of alcohol itself.

Smoke now = stroke later

This one is straightforward; smoking is bad for pretty much everything, and that includes stroke risk, as it’s bad for your heart and brain both, increasing stroke risk by 200–400%:

Smoking and stroke: the more you smoke the more you stroke

So, the advice here of course is: don’t smoke

Diet matters

The American Stroke Association’s guidelines recommend, just for a change, the Mediterranean Diet. This does not mean just whatever is eaten in the Mediterranean region though, and there are specifically foods that are included and excluded, and the ratios matter, so here’s a run-down of what the Mediterranean Diet does and doesn’t include:

The Mediterranean Diet: What Is It Good For? ← what isn’t it good for?!

You can outrun stroke

Or out-walk it; that’s fine too. Most important here is frequency of exercise, more than intensity. So basically, getting those 150 minutes moderate exercise per week as a minimum.

See also: The Doctor Who Wants Us To Exercise Less & Move More

Which is good, because it means we can get a lot of exercise in that doesn’t feel like “having to do” exercise, for example:

Do You Love To Go To The Gym? No? Enjoy These “No-Exercise Exercises”!

Your brain needs downtime too

Your brain (and your heart) both need you to get good regular sleep:

Sleep Disorders in Stroke: An Update on Management

We sometimes say that “what’s good for your heart is good for your brain” (because the heart feeds the brain, and also ultimately clears away detritus), and that’s true here too, so we might also want to prioritize sleep regularity over other factors, even over duration:

How Regularity Of Sleep Can Be Even More Important Than Duration ← this is about adverse cardiovascular events, including ischemic stroke

Keep on top of your blood pressure

High blood pressure is a very modifiable risk factor for stroke. Taking care of the above things will generally take care of this, especially the DASH variation of the Mediterranean diet:

Hypertension: Factors Far More Relevant Than Salt

However, it’s still important to actually check your blood pressure regularly, because sometimes an unexpected extra factor can pop up for no obvious reason. As a bonus, you can do this improved version of the usual blood pressure test, still using just a blood pressure cuff:

Try This At Home: ABI Test For Clogged Arteries

Consider GLP-1 receptor agonists (or…)

GLP-1 receptor agonists (like Ozempic et al.) seem to have cardioprotective and neuroprotective (thus: anti-stroke) activity independent of their weight loss benefits:

Neuroprotective Mechanisms of Glucagon-Like Peptide-1-Based Therapies in Ischemic Stroke: An Update Based on Preclinical Research

Of course, GLP-1 RAs aren’t everyone’s cup of tea, and they do have their downsides (including availability, cost, and the fact benefits reverse themselves if you stop taking them), so if you want a similar effect from a natural approach, there are some foods that work on the body’s incretin responses in the same way as GLP-1 RAs do:

5 Foods That Naturally Mimic The “Ozempic Effect”

Better to know sooner rather than too late

Rather than waiting until one half of our face is drooping to know that there was a stroke risk, here are things to watch out for to know about it before it’s too late:

6 Signs Of Stroke (One Month In Advance)

Take care!

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  • The Kitchen Prescription – by Saliha Mahmood Ahmed

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    One of the biggest challenges facing anyone learning to cook more healthily, is keeping it tasty. What to cook when your biggest comfort foods all contain things you “should” avoid?

    Happily for us, Dr. Ahmed is here with a focus on comfort food that’s good for your gut health. It’s incidentally equally good for the heart and good against diabetes… but Dr. Ahmed is a gastroenterologist, so that’s where she’s coming from with these.

    There’s a wide range of 101 recipes here, including many tagged vegetarian, vegan, and/or gluten-free, as appropriate.

    While this is not a vegetarian cookbook, Dr. Ahmed does consider the key components of a good diet to be, in order of quantity that should be consumed:

    1. Fruits and vegetables
    2. Whole grains
    3. Legumes
    4. Pulses
    5. Nuts and seeds

    …and as such, the recipes are mostly plant-based.

    The recipes are from all around the world, and/but the ingredients are mostly things that are almost universal. In the event that something might be hard-to-get, she suggests an appropriate substitution.

    The recipes are straightforward and clear, as well as being beautifully illustrated.

    All in all, a fine addition to anyone’s kitchen!

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  • Fixing Fascia

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    Fascia: Why (And How) You Should Take Care Of Yours

    Fascia is the web-like layer of connective tissue that divides your muscles and organs from each other. It simultaneously holds some stuff in place, and allows other parts to glide over each other with minimal friction.

    At least, that’s what it’s supposed to do.

    Like any body part, it can go wrong. More on this later. But first…

    A quick note on terms

    It may seem like sometimes people say “myofascial” because it sounds fancier, but it does actually have a specific meaning too:

    • Fascia” is what we just described above
    • Myofascial” means “of or relating to muscles and fascia

    For example, “myofascial release” means “stopping the fascia from sticking to the muscle where it shouldn’t” and “myofascial pain” means “pain that has to do with the muscles and fascia”. See also:

    Myofascial vs Fascia: When To Use Each One? What To Consider

    Why fascia is so ignored

    For millennia, it was mostly disregarded as a “neither this nor that” tissue that just happens to be in the body. We didn’t pay attention to it, just like we mostly don’t pay attention to the air around us.

    But, much like the air around us, we sure pay attention when something goes wrong with it!

    However, even in more recent years, we’ve been held back until quite new developments like musculoskeletal ultrasound that could show us problems with the fascia.

    What can go wrong

    It’s supposed to be strong, thin, supple, and slippery. It holds on in the necessary places like a spiderweb, but for the most part, it is evolved for minimum friction.

    Some things can cause it to thicken and become sticky in the wrong places. Things such as:

    • Physical trauma, e.g. an injury or surgery—but we repeat ourselves, because a surgery is an injury! It’s a (usually) necessary injury, but an injury nonetheless.
    • Compensation for pain. If a body part hurts for some reason, and your posture changes to accommodate that, doing so can mess up your fascia, and cause you different problems somewhere else entirely.
      • This is not witchcraft; think of how, when using a corded vacuum cleaner, sometimes the cord can get snagged on something in the next room and we nearly break something because we expected it to just come with us and it didn’t? It’s like that.
    • Repetitive movements (repetitive strain injury is partly a myofascial issue)
    • Not enough movement: when it comes to range of motion, it’s “use it or lose it”.
      • The human body tries its best to be as efficient as possible for us! So eventually it will go “Hey, I notice you never move more than 30º in this direction, so I’m going to stop making fascia that allows you to go past that point, and I’ll just dump the materials here instead”

    “I’ll just dump the materials here instead” is also part of the problem—it creates what we colloquially call “knots”, which are not so much part of the muscle as the fascia that covers it. That’s an actual physical sticky lumpy bit.

    What to do about it

    Firstly, avoid the above things! But, if for whatever reason something has gone wrong and you now have sticky lumpy fascia that doesn’t let you move the way you’d like (if you have any mobility/flexibility issues that aren’t for another known reason, then this is usually it), there are things can be done:

    • Heat—is definitely not a cure-all, but it’s a good first step before doing the other things. A heating pad or a warm bath are great.
    • Massage—ideally, by someone else who knows what they are doing. Self-massage is possible, as is teaching oneself (there are plenty of video tutorials available), but skilled professional therapeutic myofascial release massage is the gold standard.
      • Foam rollers are a great no-skill way to get going with self-massage, whether because that’s what’s available to you, or because you just want something you can do between sessions. Here’s an example of the kind we mean.
    • Acupuncture—triggering localized muscular relaxation, an important part of myofascial release, is something acupuncture is good at.
      • See also: Pinpointing The Usefulness Of Acupuncture ← noteworthily, the strongest criticism of acupuncture for pain relief is that it performs only slightly better than sham acupuncture, but taken in practical terms, all that really means is “sticking little needles in does work, even if not necessarily by the mechanism acupuncturists believe”
    • Calisthenics—Pilates, yoga, and other forms of body movement training can help gradually get one’s fascia to where and how it’s supposed to be.
    • This is that “use it or lose it” bodily efficiency we talked about!

    Remember, the body is always rebuilding itself. It never stops, until you die. So on any given day, you get to choose whether it rebuilds itself a little bit worse or a little bit better.

    Take care!

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  • How Healthy People Regulate Their Emotions

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    Some people seem quite unflappable, while others are consistently on the edge of a breakdown or outburst. So, how does a person regulate emotions, without suppressing them?

    Eight things mentally healthy people do

    Doing these things is hardest when one is actually in a disrupted emotional state, so they are all good things to get in the habit of doing at all times:

    1. Recognize and label emotions: identify specific emotions like anxiety, excitement, frustration, and so forth. You can track them for better emotional management, but it suffices even to recognize in the moment such things as “ok, I’m feeling anxious” etc.
    2. Embrace self-awareness: acknowledge emotions without judgment, using mindfulness and meditation to enhance emotional awareness and reduce reactivity—view your emotions neutrally, with a detached curiosity.
    3. Reframe negative thoughts: use cognitive reappraisal to change your perspective on situations, viewing setbacks as opportunities for growth.
    4. Express emotions constructively: use outlets like writing, or talking to someone to process emotions, preventing emotional build-up. Creating expressive art can also help many.
    5. Seek social support: cultivate strong relationships that provide emotional support and perspective, helping to manage stress and emotions.
    6. Maintain physical health: exercise, sleep, and a balanced diet support emotional resilience by improving overall well-being and brain function. It’s harder to be in the best mental health if your body is collapsing from exhaustion.
    7. Use stress management techniques: practice deep breathing, meditation, or other (non-chemical) relaxation methods to reduce stress and calm the mind and body.
    8. Seek professional help when needed: when emotions become overwhelming, consider therapy to develop personalized coping mechanisms and emotional regulation strategies.

    For more details on all of these, enjoy:

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    Want to learn more?

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    Take care!

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  • Women’s Strength Training Anatomy – by Frédéric Delavier

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    Fitness guides for women tend to differ from fitness guides for men, in the wrong ways:

    “Do some squats and jumping jacks, and here’s a exercise for your abs; you too can look like our model here”

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  • The Toe-Tapping Tip For Better Balance

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    Balance is critical for health especially in older age, since it’s amazing how much else can go dramatically and suddenly wrong after a fall. So, here’s an exercise to give great balance and stability:

    How to do it

    You will need:

    • Something to hold onto, such as a countertop
    • A target on the floor, such as a mark or a coin

    The steps:

    • Lift one leg up, bring your foot forward, and tap the object in front of you.
    • Then, bring that foot back to where it started.
    • Next, switch to the other leg and tap.
    • Alternate between your right and left legs, shifting back and forth.
    • Your goal is to do this for 10 repetitions on each leg without holding on.

    How it works:

    Whenever you tap, you have to lift one leg up and reach it out in front of you. Doing this requires you to stand on one leg while moving a weight (namely: your other leg), which is something many people, especially upon getting older, are hesitant to do. If you’re unable to stand on one leg, let alone move your center of gravity (per the counterbalance of the other leg) while doing so, you may end up shuffling and walking with your feet sliding across the ground—something you really want to avoid.

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    Want to learn more?

    You might also like to read:

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    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • An Accessible New Development Against Alzheimer’s

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    Dopamine vs Alzheimer’s

    One of the key hallmarks of Alzheimer’s disease is the formation of hardened beta-amyloid plaques around neurons. The beta-amyloid peptides themselves are supposed to be in the brain, but the hardened pieces of them that form the plaques are not.

    While the full nature of the relationship between those plaques and Alzheimer’s disease is not known for sure (there are likely other factors involved, and “the amyloid hypothesis” is at this stage nominally just that, a hypothesis), one thing that has been observed is that increasing or reducing the plaques increases or reduces (respectively) Alzheimer’s symptoms such as memory loss.

    Neprilysin

    There is an enzyme, neprilysin, that can break down those plaques.

    Neprilysin is made naturally in the brain, and/but we cannot take it as a supplement or medication, because it’s too big to pass through the blood-brain barrier.

    A team of researchers led by Dr. Takaomi Saido genetically manipulated mice to produce more neprilysin, and those mice resultantly experienced fewer beta-amyloid plaques and better memory in their old age.

    However wonderful for the mice (and a great proof of principle) the above approach is not useful as a treatment for humans whose genomes weren’t modified at our conception in a lab.

    Since (as mentioned before) we also can’t take it as a medication/supplement, that leaves one remaining option: find a way to make our already-existing brains produce more of it.

    The team’s previous research allowed them to narrow this down to “there is probably a hormone made in the hypothalamus that modulates this”, so they began experimenting with making the mice produce more hormones there.

    The DREADD switch

    DREADDs, or Designer Receptors Exclusively Activated by Designer Drugs, were the next tool in the toolbox. The scientists attached these designer receptors to dopamine-producing neurons in the mice, so that they could be activated by the appropriate designer drugs—basically, allowing for a “make more dopamine” button, without having to literally wire up the brains with electrodes. The “button” gets triggered instead by a chemical trigger, the designer drug. You can read more about them here:

    DREADDs for Neuroscientists: A Primer

    The result was positive; when the mice made more dopamine, the result was that they also made more neprilysin. So far, the hypothesis is that the presence of dopamine upregulates the production of neprilysin. In other words, the increased neprilysin levels were caused by the increased dopamine levels (the alternatives would have been: they were both caused by the same thing—in this case that’d be the DREADD activation—or the increase was caused by something else entirely that hadn’t been controlled for).

    As to how the causal relationship was determined…

    “But I don’t have (or want) a DREADD switch in my head”

    Happily for us (and probably happily for the mice too, because dopamine causes feelings of happiness), the experiments continued.

    This time, instead of using the DREADD system, they tried simply supplementing the mouse food with l-dopa, a dopamine precursor. L-dopa is often used in the treatment of Parkinson’s disease, because the molecules are small enough to pass through the blood-brain barrier, and can be converted to full dopamine inside the brain itself. So, taking l-dopa normally raises dopamine levels.

    The results? The mice who were given l-dopa enjoyed:

    • higher dopamine levels
    • higher neprilysin levels
    • lower beta-amyloid plaque levels
    • better memory in tests

    The next step for the researchers is to investigate how exactly dopamine regulates neprilysin in the brain, but for now, the relationship between l-dopa consumption and the reduction of Alzheimer’s symptoms seems clear.

    You can read about the study here:

    The dopaminergic system promotes neprilysin-mediated degradation of amyloid-β in the brain

    Is there a catch?

    L-dopa has common side effects that are not pleasant; the list begins with nausea and vomiting, and continues with things that one might expect from having “too much of a good thing” when it comes to dopamine, such as dyskinesia (extra movements) and hallucinations.

    You can read about it more here at the Parkinson’s Foundation:

    Parkinson’s Foundation | Levodopa

    However! All is not lost. Rather than reaching for the heavy guns by taking l-dopa unnecessarily, there are other dopamine precursors that don’t have those side effects (and are consequently less restricted, to the point they can be purchased as supplements, or indeed, enjoyed where they occur naturally in some foods).

    Top of the list of such safe* and readily-available dopamine precursors is…

    N-Acetyl L-Tyrosine (NALT): The Dopamine Precursor & More

    If you’d like to try that, here’s an example product on Amazon… Or you could eat fish, white beans, tofu, natto, or pumpkin seeds 😉

    *Quick note on safety: “safe” is a relative term and may vary from person to person. Please speak with your own doctor to be sure, check with your pharmacist in case of any meds interactions, and be especially careful taking anything that increases dopamine levels if you have bipolar disorder or are otherwise prone to psychosis of any kind. For most people, this shouldn’t be an issue as our brains have a built-in mechanism for scrubbing excess dopamine and ensuring we don’t end up with too much, but for some people whose dopamine regulation is not so good in that regard, it can cause problems. So again, speak with your doctor to be sure, because we are not doctors, let alone your doctor.

    Lastly…

    If you’d like an entirely drug-free approach, that’s skipping even the “nutraceuticals”, you might enjoy:

    Short On Dopamine? Science Has The Answer

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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