The Stress Prescription (Against Aging!)

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The Stress Prescription (Against Aging!)

This is Dr. Elissa Epel, whose work has for the past 20 years specialized in the effect of stress on aging. She’s led groundbreaking research on cortisol, telomeres, and telomerase, all in the context of aging, especially in women, as well as the relationship between stress and weight gain. She was elected member of the National Academy of Medicine for her work on stress pathways, and has been recognized as a key “Influencer in Aging” by the Alliance for Aging Research.

Indeed, she’s also been named in the top 0.1% of researchers globally, in terms of publication impact.

What’s that about stress and aging?

In her words,

❝Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women❞

Source: Accelerated telomere shortening in response to life stress

We say “in her words”, as she is the top-listed author on this paper—an honour reserved for the lead researcher of any given study/paper.

However, we’d be remiss not to note that the second-listed author is Nobel Prize Laureate Dr. Elizabeth Blackburn. What a team! Maybe we’ll do a spotlight feature on Dr. Blackburn’s work one of these days, but for now, back to Dr. Epel…

What does she want us to do about it?

She has the following advice for us:

Let go of what we can’t control

This one is simple enough, and can be as simple as learning how to set anxiety aside, and taking up the practice of radical acceptance of what we cannot control.

Be challenged, not afraid

This is about eustress, and being the lion, not the gazelle. Dr. Epel uses the example of how when lions are hunting gazelles, both are stressed, but both are feeling the physiological effects of that stress in terms of the augmentation to their immediate abilities, but only one of them is suffering by it.

We’ll let her explain how to leverage this:

TED ideas | Here’s how you can handle stress like a lion, not a gazelle | Dr. Elissa Epel

Build resilience through controlled discomfort

Don’t worry, you don’t have to get chased by lions. A cold shower will do it! This is about making use of hormesis, the body’s ability to build resilience to stressors by small doses of controlled cortisol release—as for example when one undergoes thermal shock, which sounds drastic, but for most people, a cold shower (or even an ice bath) is safe enough.

You can read more about this here:

A Cold Shower A Day Keeps The Doctor Away

Connect with nature

You don’t have to hug a tree, but you do have get to a natural (or at least, natural-seeming) environment once in a while. Simply put, we did not evolve to be in the urban or even suburban settings where most of us spend most of our time. Getting to be around greenery with at least some kind of regularity is hugely beneficial. It doesn’t have to be a national park; a nice garden or local park can suffice, and potted plants at home are better than nothing. Even spending time in virtual reality “nature” is an option:

Effect of Virtual Reality on Stress Reduction and Change of Physiological Parameters Including Heart Rate Variability in People With High Stress: An Open Randomized Crossover Trial

(you can see an example there, of the kind of scenery this study used)

Breathe deeply, and rest deeply

Mindful breathing, and good quality sleep, are very strongly evidence-based approaches to reduce stress, for example:

Practice gratitude to build optimism

Optimism has a huge positive impact on health outcomes, even when other factors (including socioeconomic factors, pre-existing conditions, and general reasons for one person to be more optimistic than another) are controlled for.

Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study

There are various ways to increase optimism, and practising gratitude is one of them—but that doesn’t necessarily mean abandoning realism, either:

How To Practise (Non-Toxic) Positivity

There are other ways too, though, and Dr. Epel discusses some with her friend and colleague, Dr. Elizabeth Blackburn, here:

TED ideas | Could your thoughts make you age faster? And can we reverse that? | Dr. Elizabeth Blackburn & Dr. Elissa Epel

Want to learn more from Dr. Epel?

We reviewed one of her books, The Telomere Effect, previously. It’s about what we can do to lengthen our telomeres (a key factor in health aging; effectively, being biologically younger). You also might enjoy her newer book, The Stress Prescription, as well as her blog.

Enjoy!

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  • Why 7 Hours Sleep Is Not Enough

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    How Sleep-Deprived Are You, Really?

    This is Dr. Matthew Walker. He’s a neuroscientist and sleep specialist, and is the Director of the Center for Human Sleep Science at UC Berkeley’s Department of Psychology. He’s also the author of the international bestseller “Why We Sleep”.

    What does he want us to know?

    Sleep deprivation is more serious than many people think it is. After about 16 hours without sleep, the brain begins to fail, and needs more than 7 hours of sleep to “reset” cognitive performance.

    Note: note “seven or more”, but “more than seven”.

    After ten days with only 7 hours sleep (per day), Dr. Walker points out, the brain is as dysfunctional as it would be after going without sleep for 24 hours.

    Here’s the study that sparked a lot of Dr. Walker’s work:

    The Cumulative Cost of Additional Wakefulness: Dose-Response Effects on Neurobehavioral Functions and Sleep Physiology From Chronic Sleep Restriction and Total Sleep Deprivation

    Importantly, in Dr. Walker’s own words:

    Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping❞

    ~ Dr. Matthew Walker

    See also: Why You Probably Need More Sleep

    Furthermore: the sleep-deprived mind is unaware of how sleep-deprived it is.

    You know how a drunk person thinks they can drive safely? It’s like that.

    You do not know how sleep-deprived you are, when you are sleep-deprived!

    For example:

    ❝(60.7%) did not signal sleepiness before a sleep fragment occurred in at least one of the four MWT trials❞

    Source: Sleepiness is not always perceived before falling asleep in healthy, sleep-deprived subjects

    Sleep efficiency matters

    With regard to the 7–9 hours band for optimal health, Dr. Walker points out that the sleep we’re getting is not always the sleep we think we’re getting:

    ❝Assuming you have a healthy sleep efficiency (85%), to sleep 9 hours in terms of duration (i.e. to be a long-sleeper), you would need to be consistently in bed for 10 hours and 36 minutes a night. ❞

    ~ Dr. Matthew Walker

    At the bottom end of that, by the way, doing the same math: to get only the insufficient 7 hours sleep discussed earlier, a with a healthy 85% sleep efficiency, you’d need to be in bed for 8 hours and 14 minutes per night.

    The unfortunate implication of this: if you are consistently in bed for 8 hours and 14 minutes (or under) per night, you are not getting enough sleep.

    “But what if my sleep efficiency is higher than 85%?”

    It shouldn’t be.If your sleep efficiency is higher than 85%, you are sleep-deprived and your body is having to enforce things.

    Want to know what your sleep efficiency is?

    We recommend knowing this, by the way, so you might want to check out:

    Head-To-Head Comparison of Google and Apple’s Top Sleep-Monitoring Apps

    (they will monitor your sleep and tell you your sleep efficiency, amongst other things)

    Want to know more?

    You might like his book:

    Why We Sleep: Unlocking the Power of Sleep and Dreams

    …and/or his podcast:

    The Matt Walker Podcast

    …and for those who like videos, here’s his (very informative) TED talk:

    !

    Prefer text? Click here to read the transcript

    Want to watch it, but not right now? Bookmark it for later

    Enjoy!

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  • Neuroaffirming care values the strengths and differences of autistic people, those with ADHD or other profiles. Here’s how

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We’ve come a long way in terms of understanding that everyone thinks, interacts and experiences the world differently. In the past, autistic people, people with attention deficit hyperactive disorder (ADHD) and other profiles were categorised by what they struggled with or couldn’t do.

    The concept of neurodiversity, developed by autistic activists in the 1990s, is an emerging area. It promotes the idea that different brains (“neurotypes”) are part of the natural variation of being human – just like “biodiversity” – and they are vital for our survival.

    This idea is now being applied to research and to care. At the heart of the National Autism Strategy, currently in development, is neurodiversity-affirming (neuroaffirming) care and practice. But what does this look like?

    Unsplash

    Reframing differences

    Neurodiversity challenges the traditional medical model of disability, which views neurological differences solely through a lens of deficits and disorders to be treated or cured.

    Instead, it reframes it as a different, and equally valuable, way of experiencing and navigating the world. It emphasises the need for brains that are different from what society considers “neurotypical”, based on averages and expectations. The term “neurodivergent” is applied to Autistic people, those with ADHD, dyslexia and other profiles.

    Neuroaffirming care can take many forms depending on each person’s needs and context. It involves accepting and valuing different ways of thinking, learning and experiencing the world. Rather than trying to “fix” or change neurodivergent people to fit into a narrow idea of what’s considered “normal” or “better”, neuroaffirming care takes a person-centered, strengths-based approach. It aims to empower and support unique needs and strengths.

    girl sits on couch with colourful fidget toy
    Neuroaffirming care can look different in a school or clinical setting. Shutterstock/Inna Reznik

    Adaptation and strengths

    Drawing on the social model of disability, neuroaffirming care acknowledges there is often disability associated with being different, especially in a world not designed for neurodivergent people. This shift focuses away from the person having to adapt towards improving the person-environment fit.

    This can include providing accommodations and adapting environments to make them more accessible. More importantly, it promotes “thriving” through greater participation in society and meaningful activities.

    At school, at work, in clinic

    In educational settings, this might involve using universal design for learning that benefits all learners.

    For example, using systematic synthetic phonics to teach reading and spelling for students with dyslexia can benefit all students. It also could mean incorporating augmentative and alternative communication, such as speech-generating devices, into the classroom.

    Teachers might allow extra time for tasks, or allow stimming (repetitive movements or noises) for self-regulation and breaks when needed.

    In therapy settings, neuroaffirming care may mean a therapist grows their understanding of autistic culture and learns about how positive social identity can impact self-esteem and wellbeing.

    They may make efforts to bridge the gap in communication between different neurotypes, known as the double empathy problem. For example, the therapist may avoid relying on body language or facial expressions (often different in autistic people) to interpret how a client is feeling, instead of listening carefully to what the client says.

    Affirming therapy approaches with children involve “tuning into” their preferred way of communicating, playing and engaging. This can bring meaningful connection rather than compliance to “neurotypical” ways of playing and relating.

    In workplaces, it can involve flexible working arrangements (hours, patterns and locations), allowing different modes of communication (such as written rather than phone calls) and low-sensory workspaces (for example, low-lighting, low-noise office spaces).

    In public spaces, it can look like providing a “sensory space”, such as at large concerts, where neurodivergent people can take a break and self-regulate if needed. And staff can be trained to recognise, better understand and assist with hidden disabilities.

    Combining lived experience and good practice

    Care is neuroaffirmative when it centres “lived experience” in its design and delivery, and positions people with disability as experts.

    As a result of being “different”, people in the neurodivergent community experience high rates of bullying and abuse. So neuroaffirming care should be combined with a trauma-informed approach, which acknowledges the need to understand a person’s life experiences to provide effective care.

    Culturally responsive care acknowledges limited access to support for culturally and racially marginalised Autistic people and higher rates of LGBTQIA+ identification in the neurodivergent community.

    open meeting room with people putting ideas on colourful notes on wall
    In the workplace, we can acknowledge how difference can fuel ideas. Unsplash/Jason Goodman

    Authentic selves

    The draft National Autism Strategy promotes awareness that our population is neurodiverse. It hopes to foster a more inclusive and understanding society.

    It emphasises the societal and public health responsibilities for supporting neurodivergent people via public education, training, policy and legislation. By providing spaces and places where neurodivergent people can be their authentic, unmasked selves, we are laying the foundations for feeling seen, valued, safe and, ultimately, happy and thriving.

    The author would like to acknowledge the assistance of psychologist Victoria Gottliebsen in drafting this article. Victoria is a member of the Oversight Council for the National Autism Strategy.

    Josephine Barbaro, Associate Professor, Principal Research Fellow, Psychologist, La Trobe University

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

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  • More Salt, Not Less?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I’m curious about the salt part – learning about LMNT and what they say about us needing more salt than what’s recommended by the government, would you mind looking into that? From a personal experience, I definitely noticed a massive positive difference during my 3-5 day water fasts when I added salt to my water compared to when I just drank water. So I’m curious what the actual range for salt intake is that we should be aiming for.❞

    That’s a fascinating question, and we’ll have to tackle it in several parts:

    When fasting

    3–5 days is a long time to take only water; we’re sure you know most people fast from food for much less time than that. Nevertheless, when fasting, the body needs more water than usual—because of the increase in metabolism due to freeing up bodily resources for cellular maintenance. Water is necessary when replacing cells (most of which are mostly water, by mass), and for ferrying nutrients around the body—as well as escorting unwanted substances out of the body.

    Normally, the body’s natural osmoregulatory process handles this, balancing water with salts of various kinds, to maintain homeostasis.

    However, it can only do that if it has the requisite parts (e.g. water and salts), and if you’re fasting from food, you’re not replenishing lost salts unless you supplement.

    Normally, monitoring our salt intake can be a bit of a guessing game, but when fasting for an entire day, it’s clear how much salt we consumed in our food that day: zero

    So, taking the recommended amount of sodium, which varies but is usually in the 1200–1500mg range (low end if over aged 70+; high end if aged under 50), becomes sensible.

    More detail: How Much Sodium You Need Per Day

    See also, on a related note:

    When To Take Electrolytes (And When We Shouldn’t!)

    When not fasting

    Our readers here are probably not “the average person” (since we have a very health-conscious subscriber-base), but the average person in N. America consumes about 9g of salt per day, which is several multiples of the maximum recommended safe amount.

    The WHO recommends no more than 5g per day, and the AHA recommends no more than 2.3g per day, and that we should aim for 1.5g per day (this is, you’ll note, consistent with the previous “1200–1500mg range”).

    Read more: Massive efforts needed to reduce salt intake and protect lives

    Questionable claims

    We can’t speak for LMNT (and indeed, had to look them up to discover they are an electrolytes supplement brand), but we can say that sometimes there are articles about such things as “The doctor who says we should eat more salt, not less”, and that’s usually about Dr. James DiNicolantonio, a doctor of pharmacy, who wrote a book that, because of this question today, we’ve now also reviewed:

    The Salt Fix: Why the Experts Got It All Wrong—and How Eating More Might Save Your Life – by Dr. James DiNicolantonio

    Spoiler, our review was not favorable.

    The body knows

    Our kidneys (unless they are diseased or missing) do a full-time job of getting rid of excess things from our blood, and dumping them into one’s urine.

    That includes excess sugar (which is how diabetes was originally diagnosed) and excess salt. In both cases, they can only process so much, but they do their best.

    Dr. DiNicolantino recognizes this in his book, but chalks it up to “if we do take too much salt, we’ll just pass it in urine, so no big deal”.

    Unfortunately, this assumes that our kidneys have infinite operating capacity, and they’re good, but they’re not that good. They can only filter so much per hour (it’s about 1 liter of fluids). Remember we have about 5 liters of blood, consume 2–3 liters of water per day, and depending on our diet, several more liters of water in food (easy to consume several more liters of water in food if one eats fruit, let alone soups and stews etc), and when things arrive in our body, the body gets to work on them right away, because it doesn’t know how much time it’s going to have to get it done, before the next intake comes.

    It is reasonable to believe that if we needed 8–10g of salt per day, as Dr. DiNicolantonio claims, our kidneys would not start dumping once we hit much, much lower levels in our blood (lower even than the daily recommended intake, because not all of the salt in our body is in our blood, obviously).

    See also: How Too Much Salt Can Lead To Organ Failure

    Lastly, a note about high blood pressure

    This is one where the “salt’s not the bad guy” crowd have at least something close to a point, because while salt is indeed still a bad guy (if taken above the recommended amounts, without good medical reason), when it comes to high blood pressure specifically, it’s not the worst bad guy, nor is it even in the top 5:

    Hypertension: Factors Far More Relevant Than Salt

    Thanks for writing in with such an interesting question!

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  • Fitness Freedom for Seniors – by Jackie Jacobs

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Exercise books often assume that either we are training for the Olympics, and most likely also that we are 20 years old. This one doesn’t.

    Instead, we see a well-researched, well-organized, clearly-illustrated fitness plan with age in mind. Author Jackie Jacobs offers tips and advice for all levels, and a progressive week-by-week plan of 15-minute sessions. This way, we’re neither overdoing it nor slacking off; it’s a perfect balance.

    The exercises are aimed at “all areas”, that is to say, improving cardiovascular fitness, balance, flexibility, and strength. It also gives some supplementary advice with regard to diet and suchlike, but the workouts are the real meat of the book.

    Bottom line: if you’d like a robust, science-based exercise regime that’s tailored to seniors, this is the book for you.

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  • Our blood-brain barrier stops bugs and toxins getting to our brain. Here’s how it works

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    Our brain is an extremely complex and delicate organ. Our body fiercely protects it by holding onto things that help it and keeping harmful things out, such as bugs that can cause infection and toxins.

    It does that though a protective layer called the blood-brain barrier. Here’s how it works, and what it means for drug design.

    The Conversation, Rattiya Thongdumhyu/Shutterstock, Petr Ganaj/Pexels

    First, let’s look at the circulatory system

    Adults have roughly 30 trillion cells in their body. Every cell needs a variety of nutrients and oxygen, and they produce waste, which needs to be taken away.

    Our circulatory system provides this service, delivering nutrients and removing waste.

    A fenestrated capillary
    Fenestrated capillaries let nutrients and waste pass through. Vectormine/Shutterstock

    Where the circulatory system meets your cells, it branches down to tiny tubes called capillaries. These tiny tubes, about one-tenth the width of a human hair, are also made of cells.

    But in most capillaries, there are some special features (known as fenestrations) that allow relatively free exchange of nutrients and waste between the blood and the cells of your tissues.

    It’s kind of like pizza delivery

    One way to think about the way the circulation works is like a pizza delivery person in a big city. On the really big roads (vessels) there are walls and you can’t walk up to the door of the house and pass someone the pizza.

    But once you get down to the little suburban streets (capillaries), the design of the streets means you can stop, get off your scooter and walk up to the door to deliver the pizza (nutrients).

    We often think of the brain as a spongy mass without much blood in it. In reality, the average brain has about 600 kilometres of blood vessels.

    The difference between the capillaries in most of the brain and those elsewhere is that these capillaries are made of specialised cells that are very tightly joined together and limit the free exchange of anything dissolved in your blood. These are sometimes called continuous capillaries.

    Continuous capillary
    Continuous capillaries limit the free exchange of anything dissolved in your blood. Vectormine/Shutterstock

    This is the blood brain barrier. It’s not so much a bag around your brain stopping things from getting in and out but more like walls on all the streets, even the very small ones.

    The only way pizza can get in is through special slots and these are just the right shape for the pizza box.

    The blood brain barrier is set up so there are specialised transporters (like pizza box slots) for all the required nutrients. So mostly, the only things that can get in are things that there are transporters for or things that look very similar (on a molecular scale).

    The analogy does fall down a little bit because the pizza box slot applies to nutrients that dissolve in water. Things that are highly soluble in fat can often bypass the slots in the wall.

    Why do we have a blood-brain barrier?

    The blood brain barrier is thought to exist for a few reasons.

    First, it protects the brain from toxins you might eat (think chemicals that plants make) and viruses that often can infect the rest of your body but usually don’t make it to your brain.

    It also provides protection by tightly regulating the movement of nutrients and waste in and out, providing a more stable environment than in the rest of the body.

    Lastly, it serves to regulate passage of immune cells, preventing unnecessary inflammation which could damage cells in the brain.

    What it means for medicines

    One consequence of this tight regulation across the blood brain barrier is that if you want a medicine that gets to the brain, you need to consider how it will get in.

    There are a few approaches. Highly fat-soluble molecules can often pass into the brain, so you might design your drug so it is a bit greasy.

    Person holds tablet and glass
    The blood-brain barrier stops many medicines getting into the brain. Ron Lach/Pexels

    Another option is to link your medicine to another molecule that is normally taken up into the brain so it can hitch a ride, or a “pro-drug”, which looks like a molecule that is normally transported.

    Using it to our advantage

    You can also take advantage of the blood brain barrier.

    Opioids used for pain relief often cause constipation. They do this because their target (opioid receptors) are also present in the nervous system of the intestines, where they act to slow movement of the intestinal contents.

    Imodium (Loperamide), which is used to treat diarrhoea, is actually an opioid, but it has been specifically designed so it can’t cross the blood brain barrier.

    This design means it can act on opioid receptors in the gastrointestinal tract, slowing down the movement of contents, but does not act on brain opioid receptors.

    In contrast to Imodium, Ozempic and Victoza (originally designed for type 2 diabetes, but now popular for weight-loss) both have a long fat attached, to improve the length of time they stay in the body.

    A consequence of having this long fat attached is that they can cross the blood-brain barrier, where they act to suppress appetite. This is part of the reason they are so effective as weight-loss drugs.

    So while the blood brain barrier is important for protecting the brain it presents both a challenge and an opportunity for development of new medicines.

    Sebastian Furness, ARC Future Fellow, School of Biomedical Sciences, The University of Queensland

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

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  • Knit for Health & Wellness – by Betsan Corkhill

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Betsan Corkhill, a physiotherapist, has more than just physiotherapy in mind when it comes to the therapeutic potential of knitting (although yes, also physiotherapy!), and much of this book is about the more psychological benefits that go way beyond “it’s a relaxing pastime”.

    She makes the case for how knitting (much like good mental health) requires planning, action, organization, persistence, focus, problem-solving, and flexibility—and thus the hobby develops and maintains all the appropriate faculties for those things, which will then be things you get to keep in the rest of your life, too.

    Fun fact: knitting, along with other similar needlecrafts, was the forerunner technology for modern computer programming! And indeed, early computers, the kind with hole-punch data streams, used very similar pattern-storing methods to knitting patterns.

    So, for something often thought of as a fairly mindless activity for those not in the know, knitting has a lot to offer for what’s between your ears, as well as potentially something for keeping your ears warm later.

    One thing this book’s not, by the way: a “how to” guide for learning to knit. It assumes you either have that knowledge already, or will gain it elsewhere (there are many tutorials online).

    Bottom line: if you’re in the market for a new hobby that’s good for your brain, this book will give you great motivation to give knitting a go!

    Click here to check out Knit For Health & Wellness, and get knitting!

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