Seven and a Half Lessons About the Brain – by Dr. Lisa Feldman Barrett

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We’ve reviewed books about neurology before, and we always try to review books that bring something new/different. So, what makes this one stand out?

Dr. Lisa Feldman Barrett, one of the world’s foremost neuroscientists, starts with an overview of how our unusual brain (definitely our species’ defining characteristic) came to be, and then devotes the rest of the book to mostly practical information.

She explains, in clear terms and without undue jargon, how the brain goes about such things as making constant predictions and useful assumptions about our environment, and reports these things to us as facts—which process is usually useful, and sometimes counterproductive.

We learn about how the apparently mystical trait of empathy works, in real flesh-and-blood terms, and why some kinds of empathy are more metabolically costly than others, and what that means for us all.

Unlike many such books, this one also looks at what is going on in the case of “different minds” that operate very dissimilarly to our own, and how this neurodiversity is important for our species.

Critically, she also looks at what else makes our brains stand out, the symphony of “5 Cs” that aren’t often found to the same extent all in the same species: creativity, communication, copying, cooperation, and compression. This latter being less obvious, but perhaps the most important; Dr. Feldman Barrett explains how we use this ability to layer summaries of our memories, perceptions, and assumptions, to allow us to think in abstractions—something that powers much of what we do that separates us from other animals.

Bottom line: if you’d like to learn more about that big wet organ between your ears, what it does for you, and how it goes about doing it, then this book gives a very practical foundation from which to build.

Click here to check out Seven and a Half Lessons about the Brain, and learn more about yours!

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    Dive into the potent health benefits of chlorella—packed with protein, antioxidants and omega-3s, it’s heart-healthy and may even fight cancer!

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  • Which Gadgets Help, & Which Are A Waste Of Time?

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    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 a 67- year old yoga teacher and runner. A lifelong runner, I started long distance running when I was 58. One of my friends loves rucking? I recently bought a rucking vest. Your thoughts? Any risks?

    As a perk of my yoga instructor job I get cryotherapy, red light therapy, infrared sauna, and Normatec boots for a nominal fee. Even though they are almost free, I don’t take advantage of them as I can’t find evidence of their value and don’t want to waste my time. Do you recommend any of them?❞

    On rucking and rucking vests

    First, for any unfamiliar, this is about walking/running/exercising in general, with a weighted backpack or weight vest.

    As for whether this is beneficial, it depends on your goals. Once upon a very long time ago when this writer was a soldier, it was vitally important to for me be able to [fall from the sky and then] run about 2km carrying a certain (hefty) amount of weight and still be able to fight at the other end of it, or else I would die. Thus, between deployments, I’d often carry a sturdy rucksack with concrete slabs in it, to keep myself accustomed to that burden (funny story: someone once tried to steal that when I had put it down while doing something—the would-be thief fell over instantly and then ran away empty-handed). And, here’s the thing: this kind of training did for me what I needed it to do for me. As a 67-year-old yoga teacher, your needs are probably very different.

    A common reason to use weight vests is in an effort against osteoporosis, but the evidence is lacking (or very weak, at best), as we wrote about a while back:

    Weight Vests Against Osteoporosis: Do They Really Build Bone?

    With regard to risks… Let’s put it this way: my old regiment, in addition to the usual soldierly problems like hearing damage and PTSD, has quite a reputation for producing veterans with spinal compression injuries. And that’s entirely because of the whole “running with a large amount of weight strapped to us” thing. So, you probably don’t want that.

    If you are going to do that though, then:

    • a weight best is a lot better than a backpack (better distribution of weight)
    • start with low weight and work up, and don’t push your limits

    We’re not the boss of you, so by all means do as you see fit, but unless there’s a special reason why being able to run with a heavy weight is important to you, then running with a light weight is already more than good enough.

    About those job perks

    Again, of course, it depends on what you hope to get out of them, but in some cases there is a lot of evidence for benefit.

    On cryotherapy: Ice Baths: To Dip Or Not To Dip? ← there are definite benefits for most people!

    On red light therapy: Red Light, Go! Casting Yourself In A Healthier Light ← there are some caveats re people who should not do this or at least should be very wary, but for most people, this does a lot of good, and is very well-evidenced to be beneficial

    On infrared saunas: we’re unaware of any special evidence in favor of these. However, traditional saunas have plenty of well-evidenced benefits: Saunas: Health Benefits (& Caveats)

    On Normatec boots: for the unfamiliar, this is a brand name for compression technology. Again, it depends on what you want to get out of it, though. If you are in good health, then what it’s generally being advertised for is to prevent/reduce exercise-induced muscle damage caused by the stress that endurance training can place on skeletal muscle. Just one problem—it doesn’t seem to work:

    ❝Athletes attempt to aid their recovery in various ways, one of which is through compression. Dynamic compression consists of intermittent pneumatic compression (IPC) devices, such as the NormaTec Recovery System and Recovery Pump

    Clinical Question: What are the effects of IPC on the reduction of Exercise-Induced Muscle Damage (EIMD) in endurance athletes following prolonged exercise? Summary of Key Findings: The current literature was searched to identify the effects of IPC, and 3 studies were selected: 2 randomized controlled trials and 1 randomized cross-over study. Two studies investigated the effect of IPC on delayed onset muscle soreness and plasma creatine kinase in ultramarathoners. The other looked at the impact of IPC on delayed onset muscle soreness in marathoners, ultramarathoners, triathletes, and cyclists.

    All studies concluded IPC was not an effective means of improving the reduction of EIMD in endurance-trained athletes.

    Read in full: The Effects of Intermittent Pneumatic Compression on the Reduction of Exercise-Induced Muscle Damage in Endurance Athletes: A Critically Appraised Topic

    However! If you have lipedema and/or lymphedema and want to manage that, then compression gear may help:

    Watch Out For Lipedema

    Take care!

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  • What’s Your Vascular Dementia Risk?

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    We often say that “what’s good for your heart is good for your brain”, and this is because the former feeds the latter, with oxygen and nutrients, and also clears away detritus like beta-amyloid (associated with Alzheimer’s) and alpha-synuclein (associated with Parkinson’s).

    For more on those, see: How To Clean Your Brain (Glymphatic Health Primer)

    For this reason, there are many risk factors that apply equally cardiovascular disease (CVD), and neurodegenerative diseases like Alzheimer’s and other vascular dementias, as well as stroke risk.

    The link between the two has also been studied; recently a team of scienists led by Dr. Anisa Dhana asked the question:

    ❝What is the association between cardiovascular health (CVH) and biomarkers of neurodegeneration, including neurofilament light chain and total tau?❞

    To answer this, they looked at data from more than 10,000 Americans aged 65+; of these, they were able to get serum samples from 5,470 of them, and tested those samples for the biomarkers of neurodegeneration mentioned above.

    They then tabulated the results with cardiovascular health scores based on the American Heart Association (AHA)’s “Life’s Simple 7” tool, and found, amongst other things:

    • 34.6% of participants carried the APOE e4 allele, a genetic risk factor for Alzheimer’s.
    • Higher CVH scores were associated with lower NfL levels, but not with t-tau concentrations.
    • APOE e4 carriers with high CVH had significantly lower NfL levels.
    • Race did not influence the CVH-NfL relationship.
    • Higher CVH was linked to a slower annual increase in NfL levels but did not affect t-tau changes.
    • Over 10 years, participants with the lowest CVH scores saw a 7.1% annual increase in NfL levels, while those with the highest CVH scores had a 5.2% annual increase.
    • Better CVH is linked to lower serum NfL levels, regardless of age, sex, or race.
    • CVH is particularly crucial for APOE e4 carriers

    In other words: higher cardiovascular health meant lower markers of neurodegeneration, and this not only still held true for APOE e4 carriers, but also, the benefits actually even more pronounced in those participants.

    You may be wondering: “but it said it helped with NfL levels, not t-tau concentrations?” And, indeed, it is so. But this means that the overall neurodegeneration risk is still inversely proportional to cardiovascular health; it just means it’s not a magical panacea and we must still do other things too.

    See also: How To Reduce Your Alzheimer’s Risk

    And as for the study, you can read the paper itself in full here:

    Cardiovascular Health and Biomarkers of Neurodegenerative Disease in Older Adults

    Life’s Simple 7

    We mentioned that they used the AHA’s “Life’s Simple 7” tool to assess cardiovascular health; it is indeed simple, but important. Here it is:

    MetricPoorIntermediateIdeal
    Current smokingYesFormer ≤12 moNever or quit >12 mo
    BMI, kg/m2≥3025–29.9<25
    Physical activityNone1–149 min/wk of moderate activity or 1–74 min/wk of vigorous activity or 1–149 min/wk of moderate and vigorous activity≥150 min/wk of moderate activity or ≥75 min/wk of vigorous activity or ≥150 min/wk of moderate and vigorous activity
    Diet pattern score*0–12–34–5
    Total cholesterol, mg/dL≥240200–239 or treated to goal<200
    Blood pressure, mm HgSBP ≥140 or DBP ≥90SBP 120–139 or DBP 80–89 or treated to goal<120/<80
    Fasting plasma glucose, mg/dL≥126100–125 or treated to goal<100

    *Each of the following 5 diet elements is given a score of 1: (1) ≥4.5 cups/day of fruits and vegetables; (2) ≥2 servings/week of fish; (3) ≥3 servings/day of whole grains; (4) no more than 36 oz/wk of sugar‐sweetened beverages; and (5) no more than 1500 mg/d of sodium.

    As the AHA notes,

    ❝Unfortunately, 99% of the U.S. adult population has at least one of seven cardiovascular health risks: tobacco use,
    poor diet, physical inactivity, unhealthy weight, high blood pressure, high cholesterol or high blood glucose.❞

    It then goes on to talk about the financial burden of this on employers, but this was taken from a workplace health resource, and we recognize the rest of it won’t be of pressing concern for most of our readers. In case you are interested though, here it is:

    American Heart Association | Life’s Simple 7® Journey to Health™

    For a more practical (if you’re just a private individual and employee healthcare is not your main concern) overview, see:

    American Heart Association’s Life’s Simple 7: Lifestyle Recommendations, Polygenic Risk, and Lifetime Risk of Coronary Heart Disease

    Want to know more?

    Here are some very good starting points for improving each of those 7 metrics, as necessary:

    1. Which Addiction-Quitting Methods Work Best?
    2. How To Lose Weight (Healthily!)
    3. The Doctor Who Wants Us To Exercise Less, & Move More
    4. Which Diet? Top Diets Ranked By Experts
    5. Lower Cholesterol Naturally, Without Statins
    6. 10 Ways To Lower Blood Pressure Naturally
    7. 10 Ways To Balance Your Blood Sugars

    Take care!

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  • Menopause: 50 Things You Need to Know – by Dr. Felice Gersh

    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.

    Can you list 50 important facts about the menopause? If not, you’ll surely find things to learn in here.

    The book is divided into three main sections:

    1. What to expect in perimenopause
    2. What to expect in early menopause
    3. What to expect in late menopause

    Each section comes with an alarming array of symptoms, ranging from perimenopause fatigue and acne to late menopause tooth loss and vaginal prolapse. This is not to say that everyone will experience everything (fortunately), but rather, that these are the things that can happen and should not arrive unexpected.

    Helpfully, of course, Dr. Gersh also gives advice on how to improve your energy and skin health, as well as keep your teeth and vagina in place. And similar professional insights for the rest of the “50 things you need to know”.

    The style is like one big (182 pages) patient information leaflet—thus, very clear, explaining everything, and offering reassurance where possible and also what things are reasonable cause for seeking personalized medical attention.

    Bottom line: if menopause is in your future, present, or very near past, this is an excellent book for you.

    Click here to check out Menopause: 50 Things You Need To Know, and know them!

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Related Posts

  • Super Gut – by Dr. William Davis
  • The Many Faces Of Cosmetic Surgery

    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.

    Cosmetic Surgery: What’s The Truth?

    In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:

    • About 48% said “Everyone should be able to get what they want, assuming informed consent”
    • About 28% said “It can ease discomfort to bring features more in line with normalcy”
    • 15% said “They should be available in the case of extreme disfigurement only”
    • 10% said “No elective cosmetic surgery should ever be performed; needless danger”

    Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion

    So what does the science say?

    The risks of cosmetic surgery outweigh the benefits: True or False?

    False, subjectively (but this is important).

    You may be wondering: how is science subjective?

    And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.

    Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):

    • Regret rate for elective cosmetic surgery in general: 20%
    • Regret rate for knee replacement (i.e., not cosmetic): 17.1%
    • Regret rate for hip replacement (i.e., not cosmetic): 4.8%
    • Regret rate for gender-affirming surgeries (for transgender patients): 1%

    So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!

    In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.

    Sources for the above numbers, by the way:

    But it’s just a vanity; therapy is what’s needed instead: True or False?

    False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.

    How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.

    • In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
    • In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.

    Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:

    Does cosmetic surgery improve psychosocial wellbeing?

    Some people will never be happy no matter how many surgeries they get: True or False?

    True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:

    ❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.

    For several reasons, it is important to recognise BDD in cosmetic surgery settings:

    Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.

    Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞

    ~ Dr. David Castle et al. (lightly edited for brevity)

    Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.

    Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.

    After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.

    And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:

    Thinking about cosmetic surgery? New standards will force providers to tell you the risks and consider if you’re actually suitable

    Take care!

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  • Mung Beans vs Black Beans – Which is Healthier?

    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.

    Our Verdict

    When comparing mung beans to black beans, we picked the black beans.

    Why?

    Both are great! But…

    In terms of macros, black beans have more protein, carbs, and fiber, as well as the lower glycemic index (although both are already low). So, a clear win for black beans here.

    In the category of vitamins, mung beans have more of vitamins A, B5, B9, and C, while black beans have more of vitamins B1, B6, E, K, and choline. Thus, a slight win for black beans this time.

    When it comes to minerals, mung beans have more selenium and zinc, while black beans have more calcium, copper, iron, magnesium, manganese, phosphorus, and potassium. An easy win for black beans.

    Of course, enjoy either or both—but if you’re going to pick one, we say black beans win the day.

    Want to learn more?

    You might like to read:

    Plant vs Animal Protein: Head-to-Head

    Take care!

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  • Ouch. That ‘Free’ Annual Checkup Might Cost You. Here’s Why.

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    When Kristy Uddin, 49, went in for her annual mammogram in Washington state last year, she assumed she would not incur a bill because the test is one of the many preventive measures guaranteed to be free to patients under the 2010 Affordable Care Act. The ACA’s provision made medical and economic sense, encouraging Americans to use screening tools that could nip medical problems in the bud and keep patients healthy.

    So when a bill for $236 arrived, Uddin — an occupational therapist familiar with the health care industry’s workings — complained to her insurer and the hospital. She even requested an independent review.

    “I’m like, ‘Tell me why am I getting this bill?’” Uddin recalled in an interview. The unsatisfying explanation: The mammogram itself was covered, per the ACA’s rules, but the fee for the equipment and the facility was not.

    That answer was particularly galling, she said, because, a year earlier, her “free” mammogram at the same health system had generated a bill of about $1,000 for the radiologist’s reading. Though she fought that charge (and won), this time she threw in the towel and wrote the $236 check. But then she dashed off a submission to the KFF Health News-NPR “Bill of the Month” project:

    “I was really mad — it’s ridiculous,” she later recalled. “This is not how the law is supposed to work.”

    The ACA’s designers might have assumed that they had spelled out with sufficient clarity that millions of Americans would no longer have to pay for certain types of preventive care, including mammograms, colonoscopies, and recommended vaccines, in addition to doctor visits to screen for disease. But the law’s authors didn’t reckon with America’s ever-creative medical billing juggernaut.

    Over the past several years, the medical industry has eroded the ACA’s guarantees, finding ways to bill patients in gray zones of the law. Patients going in for preventive care, expecting that it will be fully covered by insurance, are being blindsided by bills, big and small.

    The problem comes down to deciding exactly what components of a medical encounter are covered by the ACA guarantee. For example, when do conversations between doctor and patient during an annual visit for preventive services veer into the treatment sphere? What screenings are needed for a patient’s annual visit?

    A healthy 30-year-old visiting a primary care provider might get a few basic blood tests, while a 50-year-old who is overweight would merit additional screening for Type 2 diabetes.

    Making matters more confusing, the annual checkup itself is guaranteed to be “no cost” for women and people age 65 and older, but the guarantee doesn’t apply for men in the 18-64 age range — though many preventive services that require a medical visit (such as checks of blood pressure or cholesterol and screens for substance abuse) are covered.

    No wonder what’s covered under the umbrella of prevention can look very different to medical providers (trying to be thorough) and billers (intent on squeezing more dollars out of every medical encounter) than it does to insurers (who profit from narrower definitions).

    For patients, the gray zone has become a billing minefield. Here are a few more examples, gleaned from the Bill of the Month project in just the past six months:

    Peter Opaskar, 46, of Texas, went to his primary care doctor last year for his preventive care visit — as he’d done before, at no cost. This time, his insurer paid $130.81 for the visit, but he also received a perplexing bill for $111.81. Opaskar learned that he had incurred the additional charge because when his doctor asked if he had any health concerns, he mentioned that he was having digestive problems but had already made an appointment with his gastroenterologist. So, the office explained, his visit was billed as both a preventive physical and a consultation. “Next year,” Opasker said in an interview, if he’s asked about health concerns, “I’ll say ‘no,’ even if I have a gunshot wound.”

    Kevin Lin, a technology specialist in Virginia in his 30s, went to a new primary care provider to take advantage of the preventive care benefit when he got insurance; he had no physical complaints. He said he was assured at check-in that he wouldn’t be charged. His insurer paid $174 for the checkup, but he was billed an additional $132.29 for a “new patient visit.” He said he has made many calls to fight the bill, so far with no luck.

    Finally, there’s Yoori Lee, 46, of Minnesota, herself a colorectal surgeon, who was shocked when her first screening colonoscopy yielded a bill for $450 for a biopsy of a polyp — a bill she knew was illegal. Federal regulations issued in 2022 to clarify the matter are very clear that biopsies during screening colonoscopies are included in the no-cost promise. “I mean, the whole point of screening is to find things,” she said, stating, perhaps, the obvious.

    Though these patient bills defy common sense, room for creative exploitation has been provided by the complex regulatory language surrounding the ACA. Consider this from Ellen Montz, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare & Medicaid Services, in an emailed response to queries and an interview request on this subject: “If a preventive service is not billed separately or is not tracked as individual encounter data separately from an office visit and the primary purpose of the office visit is not the delivery of the preventive item or service, then the plan issuer may impose cost sharing for the office visit.”

    So, if the doctor decides that a patient’s mention of stomach pain does not fall under the umbrella of preventive care, then that aspect of the visit can be billed separately, and the patient must pay?

    And then there’s this, also from Montz: “Whether a facility fee is permitted to be charged to a consumer would depend on whether the facility usage is an integral part of performing the mammogram or an integral part of any other preventive service that is required to be covered without cost sharing under federal law.”

    But wait, how can you do a mammogram or colonoscopy without a facility?

    Unfortunately, there is no federal enforcement mechanism to catch individual billing abuses. And agencies’ remedies are weak — simply directing insurers to reprocess claims or notifying patients they can resubmit them.

    In the absence of stronger enforcement or remedies, CMS could likely curtail these practices and give patients the tools to fight back by offering the sort of clarity the agency provided a few years ago regarding polyp biopsies — spelling out more clearly what comes under the rubric of preventive care, what can be billed, and what cannot.

    The stories KFF Health News and NPR receive are likely just the tip of an iceberg. And while each bill might be relatively small compared with the stunning $10,000 hospital bills that have become all too familiar in the United States, the sorry consequences are manifold. Patients pay bills they do not owe, depriving them of cash they could use elsewhere. If they can’t pay, those bills might end up with debt-collection agencies and, ultimately, harm their credit score.

    Perhaps most disturbing: These unexpected bills might discourage people from seeking preventive screenings that could be lifesaving, which is why the ACA deemed them “essential health benefits” that should be free.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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