Saunas: Health Benefits (& Caveats)
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The Heat Is On
In Tuesday’s newsletter, we asked you your (health-related) opinion on saunas, and got the above-depicted, below-described, set of responses:
- About 53% said it is “a healthful activity with many benefits”
- About 25% said it is “best avoided; I feel like I’m dying in there”
- About 12% said “it feels good and therefore can’t be all bad”
So what does the science say?
The heat of saunas carries a health risk: True or False?
False, generally speaking, for any practical purposes. Of course, anything in life comes with a health risk, but statistically speaking, your shower at home is a lot more dangerous than a sauna (risk of slipping with no help at hand).
It took a bit of effort to find a paper on the health risks of saunas, because all the papers on PubMed etc coming up for those keywords were initially papers with “reduces the risk of…”, i.e. ways in which the sauna is healthy.
However, we did find one:
❝Contraindications to sauna bathing include unstable angina pectoris, recent myocardial infarction, and severe aortic stenosis.
Sauna bathing is safe, however, for most people with coronary heart disease with stable angina pectoris or old myocardial infarction.
Very few acute myocardial infarctions and sudden deaths occur in saunas, but alcohol consumption during sauna bathing increases the risk of hypotension, arrhythmia, and sudden death, and should be avoided. ❞
~ Dr. Matti Hannuksela & Dr. Samer Ellahham
Source: Benefits and risks of sauna bathing
So, very safe for most people, safe even for most people with heart disease, but there are exceptions so check with your own doctor of course.
And drinking alcohol anywhere is bad for the health, but in a sauna it’s a truly terrible idea. As an aside, please don’t drink alcohol in the shower, either (risk of slipping with no help at hand, and this time, broken glass too).
On the topic of it being safe for most people’s hearts, see also:
Beneficial effects of sauna bathing for heart failure patients
As an additional note, those who have a particular sensitivity to the heat, may (again please check with your own doctor, as your case may vary) actually benefit from moderate sauna use, to reduce the cardiovascular strain that your body experiences during heatwaves (remember, you can get out of a sauna more easily than you can get out of a heatwave, so for many people it’s a lot easier to do moderation and improve thermoregulatory responses):
Sauna usage can bring many health benefits: True or False?
True! Again, at least for most people. As well as the above-discussed items, here’s one for mortality rates in healthy Finnish men:
Not only that, also…
❝The Finnish saunas have the most consistent and robust evidence regarding health benefits and they have been shown to decrease the risk of health outcomes such as hypertension, cardiovascular disease, thromboembolism, dementia, and respiratory conditions; may improve the severity of musculoskeletal disorders, COVID-19, headache and flu, while also improving mental well-being, sleep, and longevity.
Finnish saunas may also augment the beneficial effects of other protective lifestyle factors such as physical activity.
The beneficial effects of passive heat therapies may be linked to their anti-inflammatory, cytoprotective and anti-oxidant properties and synergistic effects on neuroendocrine, circulatory, cardiovascular and immune function.
Passive heat therapies, notably Finnish saunas, are emerging as potentially powerful and holistic strategies to promoting health and extending the healthspan in all populations. ❞
~ Dr. Jari Laukkanen & Dr. Setor Kunutsor
(the repeated clarification of “Finnish sauna” is not a matter of fervent nationalism, by the way, but rather a matter of disambiguating it from Swedish sauna, which has some differences, most notably a lack of steam)
That reminds us: in Scandinavia, it is usual to use a sauna naked, and in Finland in particular, it is a common social activity amongst friends, coworkers, etc. In the US, many people are not so comfortable with nudity, and indeed, many places that provide saunas, may require the wearing of swimwear. But…
Just one problem: if you’re wearing swimwear because you’ve just been swimming in a pool, you now have chlorinated water soaked into your swimwear, which in the sauna, will become steam + chlorine gas. That’s not so good for your health (and is one reason, beyond tradition and simple normalization, for why swimwear is usually not permitted in Finnish saunas).
Want to read more?
You might like our previous main feature,
Turning Up The Heat Against Diabetes & Alzheimer’s ← you guessed it, sauna may be beneficial against these too
Take care!
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The Breathing Cure – by Patrick McKeown
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We’ve previously reviewed this author’s “The Oxygen Advantage”, which as you might guess from the title, was also about breathing. So, what’s different here?
While The Oxygen Advantage was mostly about improving good health with optimized breathing, and with an emphasis on sports too, The Breathing Cure is more about the two-way relationship between ill health and disordered breathing (and how to fix it).
Many kinds of illnesses can affect our breathing, and our breathing can affect many types of illness; McKeown covers a lot of these, including the obvious things like respiratory diseases (including COVID and Long COVID, as well as non-infectious respiratory conditions like asthma), but also things like diabetes and heart disease, as well as peri-disease things like chronic pain, and demi-disease things like periods and menopause.
In each case (and more), he examines what things make matters better or worse, and how to improve them.
While the style itself is just as pop-science as The Oxygen Advantage, this time it relies less on anecdote (though there are plenty of anecdotes too), and leans more heavily on a generous chapter-by-chapter scientific bibliography, with plenty of citations to back up claims.
Bottom line: if you’d like to breathe better, this book can help in very many ways.
Click here to check out The Breathing Cure, and breathe easy!
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Ozempic’s cousin drug liraglutide is about to get cheaper. But how does it stack up?
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Fourteen years ago, the older drug cousin of semaglutide (Ozempic and Wegovy) came onto the market. The drug, liraglutide, is sold under the brand names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So other drug companies are working to develop “generic” versions. These are likely be a fraction of current cost, which is around A$400 a month.
So how does liraglutide compare with semaglutide?
Halfpoint/Shutterstock How do these drugs work?
Liraglutide was not originally developed as a weight-loss treatment. Like semaglutide (Ozempic), it originally treated type 2 diabetes.
The class of drugs liraglutide and semaglutide belong to are known as GLP-1 mimetics, meaning they mimic the natural hormone GLP-1. This hormone is released from your small intestines in response to food and acts in several ways to improve the way your body handles glucose (sugar).
How do they stop hunger?
Liraglutide acts in several regions of the unconscious part of your brain, specifically the hypothalamus, which controls metabolism, and parts of the brain stem responsible for communicating your body’s nutrient status to the hypothalamus.
Its actions here appear to reduce hunger in two different ways. First, it helps you to feel full earlier, making smaller meals more satisfying. Second, it alters your “motivational salience” towards food, meaning it reduces the amount of food you seek out.
Liraglutide’s original formulation, designed to treat type 2 diabetes, was marketed as Victoza. Its ability to cause weight loss was evident soon after it entered the market.
Shortly after, a stronger formulation, called Saxenda, was released, which was intended for weight loss in people with obesity.
How much weight can you lose with liraglutide?
People respond differently and will lose different amounts of weight. But here, we’ll note the average weight loss users can expect. Some will lose more (sometimes much more), others will lose less, and a small proportion won’t respond.
The first GLP-1 mimicking drug was exenatide (Bayetta). It’s still available for treating type 2 diabetes, but there are currently no generics. Exenatide does provide some weight loss, but this is quite modest, typically around 3-5% of body weight.
For liraglutide, those using the drug to treat obesity will use the stronger one (Saxenda), which typically gives about 10% weight loss.
Semaglutide, with the stronger formulation called Wegovy, typically results in 15% weight loss.
The newest GLP-1 mimicking drug on the market, tirzepatide (Mounjaro for type 2 diabetes and Zepbound for weight loss), results in weight loss of around 25% of body weight.
What happens when you stop taking them?
Despite the effectiveness of these medications in helping with weight loss, they do not appear to change people’s weight set-point.
So in many cases, when people stop taking them, they experience a rebound toward their original weight.
People often regain weight when when they stop taking the drug. Mohammed_Al_Ali/Shutterstock What is the dose and how often do you need to take it?
Liraglutide (Victoza) for type 2 diabetes is exactly the same drug as Saxenda for weight loss, but Saxenda is a higher dose.
Although the target for each formulation is the same (the GLP-1 receptor), for glucose control in type 2 diabetes, liraglutide has to (mainly) reach the pancreas.
But to achieve weight loss, it has to reach parts of the brain. This means crossing the blood-brain barrier – and not all of it makes it, meaning more has to be taken.
All the current formulations of GLP-1 mimicking drug are injectables. This won’t change when liraglutide generics hit the market.
However, they differ in how frequently they need to be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide much more attractive, but we won’t see semaglutide as a generic until 2033.)
What are the side effects?
Because all these medicines have the same target in the body, they mostly have the same side effects.
The most common are a range of gastrointestinal upsets including nausea, vomiting, bloating, constipation and diarrhoea. These occur, in part, because these medications slow the movement of food out of the stomach, but are generally managed by increasing the dose slowly.
Recent clinical data suggests the slowing in emptying of the stomach can be problematic for some people, and may increase the risk of of food entering the lungs during operations, so it is important to let your doctor know if you are taking any of these drugs.
Because these are injectables, they can also lead to injection-site reactions.
Gastrointestinal side effects are most common. Halfpoint/Shutterstock During clinical trials, there were some reports of thyroid disease and pancreatitis (inflammation of the pancreas). However, it is not clear that these can be attributed to GLP-1 mimicking drugs.
In animals, GLP-1 mimicking drugs drugs have been found to negatively alter the growth of the embryo. There is currently no controlled clinical trial data on their use during pregnancy, but based on animal data, these medicines should not be used during pregnancy.
Who can use them?
The GLP-1 mimicking drugs for weight loss (Wegovy, Saxenda, Zepbound/Mounjaro) are approved for use by people with obesity and are meant to only be used in conjunction with diet and exercise.
These drugs must be prescribed by a doctor and for obesity are not covered by the Pharmaceutical Benefits Scheme, which is one of the reasons why they are expensive. But in time, generic versions of liraglutide are likely to be more affordable.
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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Willpower: A Muscle To Flex, Or Spoons To Conserve?
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Willpower: A Muscle To Flex, Or Spoons To Conserve?
We have previously written about motivation; this one’s not about that.
Rather, it’s about willpower itself, and especially, the maintenance of such. Which prompts the question…
Is willpower something that can be built up through practice, or something that is a finite resource that can be expended?
That depends on you—and your experiences.
- Some people believe willpower is a metaphorical “muscle” that must be exercised to be built up
- Some people believe willpower is a matter of metaphorical “spoons” that can be used up
A quick note on spoon theory: this traces its roots to Christine Miserandino’s 2003 essay about chronic illness and the management of limited energy. She details how she explained this to a friend in a practical fashion, she gave her a bunch of spoons from her kitchen, as an arbitrary unit of energy currency. These spoons would then need to be used to “pay” for tasks done; soon her friend realised that if she wanted to make it through the day, she was going to have to give more forethought to how she would “spend” her spoons, or she’d run out and be helpless (and perhaps hungry and far from home) before the day’s end. So, the kind of forethought and planning that a lot of people with chronic illnesses have to give to every day’s activities.
You can read it here: But You Don’t Look Sick? The Spoon Theory
So, why do some people believe one way, and some believe the other? It comes down to our experiences of our own willpower being built or expended. Researchers (Dr. Vanda Siber et al.) studied this, and concluded:
❝The studies support the idea that what people believe about willpower depends, at least in part, on recent experiences with tasks as being energizing or draining.❞
Source: Autonomous Goal Striving Promotes a Nonlimited Theory About Willpower
In other words, there’s a difference between going out running each morning while healthy, and doing so with (for example) lupus.
On a practical level, this translates to practicable advice:
- If something requires willpower but is energizing, this is the muscle kind! Build it.
- If something requires willpower and is draining, this is the spoons kind! Conserve it.
Read the above two bullet-points as many times as necessary to cement them into your hippocampus, because they are the most important message of today’s newsletter.
Do you tend towards the “nonlimited” belief, despite getting tired? If so, here’s why…
There is something that can continue to empower us even when we get physically fatigued, and that’s the extent to which we truly get a choice about what we’re doing. In other words, that “Autonomous” at the front of the title of the previous study, isn’t just word salad.
- If we perceive ourselves as choosing to do what we are doing, with free will and autonomy (i.e., no externally created punitive consequences), we will feel much more empowered, and that goes for our willpower too.
- If we perceive ourselves as doing what we have to (or suffer the consequences), we’ll probably do it, but we’ll find it draining, and that goes for our willpower too.
Until such a time as age-related physical and mental decline truly take us, we as humans tend to gradually accumulate autonomy in our lives. We start as literal babies, then are children with all important decisions made for us, then adolescents building our own identity and ways of doing things, then young adults launching ourselves into the world of adulthood (with mixed results), to a usually more settled middle-age that still has a lot of external stressors and responsibilities, to old age, where we’ve often most things in order, and just ourselves and perhaps our partner to consider.
Consequently…
Age differences in implicit theories about willpower: why older people endorse a nonlimited theory
…which explains why the 30-year-old middle-manager might break down and burn out and stop going to work, while an octogenarian is busy training for a marathon daily before getting back to their daily book-writing session, without fail.
One final thing…
If you need a willpower boost, have a snack*. If you need to willpower boost to avoid snacking, then plan for this in advance by finding a way to keep your blood sugars stable. Because…
The physiology of willpower: linking blood glucose to self-control
*Something that will keep your blood sugars stable, not spike them. Nuts are a great example, unless you’re allergic to such, because they have a nice balance of carbohydrates, protein, and healthy fats.
Want more on that? Read: 10 Ways To Balance Blood Sugars
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Science of Stretch – by Dr. Leada Malek
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This book is part of a “Science of…” series, of which we’ve reviewed some others before (Yoga | HIIT | Pilates), and needless to say, we like them.
You may be wondering: is this just that thing where a brand releases the same content under multiple names to get more sales, and no, it’s not (long-time 10almonds readers will know: if it were, we’d say so!).
While flexibility and mobility are indeed key benefits in yoga and Pilates, they looked into the science of what was going on in yoga asanas and Pilates exercises, stretchy or otherwise, so the stretching element was not nearly so deep as in this book.
In this one, Dr. Malek takes us on a wonderful tour of (relevant) human anatomy and physiology, far deeper than most pop-science books go into when it comes to stretching, so that the reader can really understand every aspect of what’s going on in there.
This is important, because it means busting a lot of myths (instead of busting tendons and ligaments and things), understanding why certain things work and (critically!) why certain things don’t, how certain stretching practices will sabotage our progress, things like that.
It’s also beautifully clearly illustrated! The cover art is a fair representation of the illustrations inside.
Bottom line: if you want to get serious about stretching, this is a top-tier book and you won’t regret it.
Click here to check out Science of Stretching, and learn what you can do and how!
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How To Unfatty A Fatty Liver
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How To Unfatty A Fatty Liver
In Greek mythology, Prometheus suffered the punishment of being chained to a rock, where he would have his liver eaten by an eagle, whereupon each day his liver would grow back, only to be eaten again the next day.
We mere humans who are not Greek gods might not be able to endure quite such punishment to our liver, but it is an incredibly resilient and self-regenerative organ.
In fact, provided at least 51% of the liver is still present and correct, the other 49% will regrow. Similarly, damage done (such as by trying to store too much fat there due to metabolic problems, as in alcoholic or non-alcoholic fatty liver disease) will reverse itself in time, given the chance.
The difference between us and Prometheus
In the myth, Prometheus had his liver regrow overnight every night. Ours don’t recover quite so quickly.
Indeed, the science has good and bad news for us:
❝Liver recolonization models have demonstrated that hepatocytes have an unlimited regenerative capacity. However, in normal liver, cell turnover is very slow.❞
~ Michalopoulos and Bhusan (2020)
Read more: Liver regeneration: biological and pathological mechanisms and implications
If it regenerates, why do people need transplants, and/or die of liver disease?
There are some diseases of the liver that inhibit its regenerative abilities, or (as in the case of cancer) abuse them to our detriment. However, in the case of fatty liver disease, the reason is usually simple:
If the lifestyle factors that caused the liver to become fatty are still there, then its regenerative abilities won’t be able to keep up with the damage that is still being done.
Can we speed it up at all?
Yes! The first and most important thing is to minimize how much ongoing harm you are still doing to it, though.
- If you drink alcohol, stop. According to the WHO, the only amount of alcohol that is safe for you is zero.
- You might like our previous article: How To Reduce Or Quit Alcohol
- Consider your medications, and find out which place a strain on the liver. Many medications are not optional; you’re taking them for an important reason, so don’t quit things without checking with your doctor. Medications that strain the liver include, but are by no means limited to:
- Many painkillers, including acetaminophen/paracetamol (e.g. Tylenol), and ibuprofen
- Some immunosuppresent drugs, including azathioprine
- Some epilepsy drugs, including phenytoin
- Some antibiotics, including amoxicillin
- Statins in general
Note: we are not pharmacists, nor doctors, let alone your doctors.
Check with yours about what is important for you to take, and what alternatives might be safe for you to consider.
Dietary considerations
While there are still things we don’t know about the cause(s) of non-alcoholic fatty liver disease, there is a very strong association with a diet that is:
- high in salt
- high in refined carbohydrates
- e.g. white flour and white flour products such as white bread and white pasta; also the other main refined carbohydrate: sugar
- high in red meat
- high in non-fermented dairy
- high in fried foods.
So, consider minimizing those, and instead getting plenty of fiber, and plenty of lean protein (not from red meat, but poultry and fish are fine iff not fried; beans and legumes are top-tier, though).
Also, hydrate. Most people are dehydrated most of the time, and that’s bad for all parts of the body, and the liver is no exception. It can’t regenerate if it’s running on empty!
Read more: Foods To Include (And Avoid) In A Healthy Liver Diet
How long will it take to heal?
In the case of alcoholic fatty liver disease, it should start healing a few days after stopping drinking. Then, how long it takes to fully recover depends on the extent of the damage; it could be weeks or months. In extreme cases, years, but that is rare. Usually if the damage is that severe, a transplant is needed.
In the case of non-alcoholic fatty liver disease, again it depends on the extent of the damage, but it is usually a quicker recovery than the alcoholic kind—especially if eating a Mediterranean diet.
Read more: How Long Does It Take For Your Liver To Repair Itself?
Take good care of yourself!
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- If you drink alcohol, stop. According to the WHO, the only amount of alcohol that is safe for you is zero.
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Even small diet tweaks can lead to sustainable weight loss
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It’s a well-known fact that to lose weight, you either need to eat less or move more. But how many calories do you really need to cut out of your diet each day to lose weight? It may be less than you think.
To determine how much energy (calories) your body requires, you need to calculate your total daily energy expenditure (TDEE). This is comprised of your basal metabolic rate (BMR) – the energy needed to sustain your body’s metabolic processes at rest – and your physical activity level. Many online calculators can help determine your daily calorie needs.
If you reduce your energy intake (or increase the amount you burn through exercise) by 500-1,000 calories per day, you’ll see a weekly weight loss of around one pound (0.45kg).
But studies show that even small calorie deficits (of 100-200 calories daily) can lead to long-term, sustainable weight-loss success. And although you might not lose as much weight in the short-term by only decreasing calories slightly each day, these gradual reductions are more effective than drastic cuts as they tend to be easier to stick with.
Small diet changes can still lead to weight loss in the long run. Monkey Business Images/ Shutterstock Hormonal changes
When you decrease your calorie intake, the body’s BMR often decreases. This phenomenon is known as adaptive thermogenesis. This adaptation slows down weight loss so the body can conserve energy in response to what it perceives as starvation. This can lead to a weight-loss plateau – even when calorie intake remains reduced.
Caloric restriction can also lead to hormonal changes that influence metabolism and appetite. For instance, thyroid hormones, which regulate metabolism, can decrease – leading to a slower metabolic rate. Additionally, leptin levels drop, reducing satiety, increasing hunger and decreasing metabolic rate.
Ghrelin, known as the “hunger hormone”, also increases when caloric intake is reduced, signalling the brain to stimulate appetite and increase food intake. Higher ghrelin levels make it challenging to maintain a reduced calorie diet, as the body constantly feels hungrier.
Insulin, which helps regulate blood sugar levels and fat storage, can improve in sensitivity when we reduce calorie intake. But sometimes, insulin levels decrease instead, affecting metabolism and leading to a reduction in daily energy expenditure. Cortisol, the stress hormone, can also spike – especially when we’re in a significant caloric deficit. This may break down muscles and lead to fat retention, particularly in the stomach.
Lastly, hormones such as peptide YY and cholecystokinin, which make us feel full when we’ve eaten, can decrease when we lower calorie intake. This may make us feel hungrier.
Fortunately, there are many things we can do to address these metabolic adaptations so we can continue losing weight.
Weight loss strategies
Maintaining muscle mass (either through resistance training or eating plenty of protein) is essential to counteract the physiological adaptations that slow weight loss down. This is because muscle burns more calories at rest compared to fat tissue – which may help mitigate decreased metabolic rate.
Portion control is one way of decreasing your daily calorie intake. Fevziie/ Shutterstock Gradual caloric restriction (reducing daily calories by only around 200-300 a day), focusing on nutrient-dense foods (particularly those high in protein and fibre), and eating regular meals can all also help to mitigate these hormonal challenges.
But if you aren’t someone who wants to track calories each day, here are some easy strategies that can help you decrease daily calorie intake without thinking too much about it:
1. Portion control: reducing portion sizes is a straightforward way of reducing calorie intake. Use smaller plates or measure serving sizes to help reduce daily calorie intake.
2. Healthy swaps: substituting high-calorie foods with lower-calorie alternatives can help reduce overall caloric intake without feeling deprived. For example, replacing sugary snacks with fruits or swapping soda with water can make a substantial difference to your calorie intake. Fibre-rich foods can also reduce the calorie density of your meal.
3. Mindful eating: practising mindful eating involves paying attention to hunger and fullness cues, eating slowly, and avoiding distractions during meals. This approach helps prevent overeating and promotes better control over food intake.
4. Have some water: having a drink with your meal can increase satiety and reduce total food intake at a given meal. In addition, replacing sugary beverages with water has been shown to reduce calorie intake from sugars.
4. Intermittent fasting: restricting eating to specific windows can reduce your caloric intake and have positive effects on your metabolism. There are different types of intermittent fasting you can do, but one of the easiest types is restricting your mealtimes to a specific window of time (such as only eating between 12 noon and 8pm). This reduces night-time snacking, so is particularly helpful if you tend to get the snacks out late in the evening.
Long-term behavioural changes are crucial for maintaining weight loss. Successful strategies include regular physical activity, continued mindful eating, and periodically being diligent about your weight and food intake. Having a support system to help you stay on track can also play a big role in helping you maintain weight loss.
Modest weight loss of 5-10% body weight in people who are overweight or obese offers significant health benefits, including improved metabolic health and reduced risk of chronic diseases. But it can be hard to lose weight – especially given all the adaptations our body has to prevent it from happening.
Thankfully, small, sustainable changes that lead to gradual weight loss appear to be more effective in the long run, compared with more drastic lifestyle changes.
Alexandra Cremona, Lecturer, Human Nutrition and Dietetics, University of Limerick
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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