Seven Steps to Managing Your Memory – by Dr. Andrew Budson & Dr. Maureen O’Connor
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First, what this is not: a “how to improve your memory” book of the kind marketed to students and/or people who want to do memory-themed party tricks.
What this book actually is: exactly what the title and subtitle claim it to be: seven steps to managing your memory: what’s normal, what’s not, and what to do about it.
Drs. Budson & O’Connor cover:
- which memory errors can (and usually do) happen at any age
- how memory changes with normal aging, and
- what kinds of memory problems are not normal.
One thing that sets this book aside from a lot of its genre is that it also covers which kinds of memory loss are reversible—and, where appropriate, what can be undertaken to effect such a reversal.
The authors talk about what things have (and what things haven’t!) been shown to strengthen memory and reduce cognitive decline, and in the worst case scenario, what medications can help against Alzheimer’s disease and other dementias.
The style is halfway between pop-science and a science textbook. The structure of the book, with its headings, subheadings, bullet points, summaries, etc, helps the reader to process and remember the information.
Bottom line: if you’d like to get on top of managing your memory before you forget, then this book is for you.
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Their First Baby Came With Medical Debt. These Illinois Parents Won’t Have Another.
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JACKSONVILLE, Ill. — Heather Crivilare was a month from her due date when she was rushed to an operating room for an emergency cesarean section.
The first-time mother, a high school teacher in rural Illinois, had developed high blood pressure, a sometimes life-threatening condition in pregnancy that prompted doctors to hospitalize her. Then Crivilare’s blood pressure spiked, and the baby’s heart rate dropped. “It was terrifying,” Crivilare said.
She gave birth to a healthy daughter. What followed, though, was another ordeal: thousands of dollars in medical debt that sent Crivilare and her husband scrambling for nearly a year to keep collectors at bay.
The Crivilares would eventually get on nine payment plans as they juggled close to $5,000 in bills.
“It really felt like a full-time job some days,” Crivilare recalled. “Getting the baby down to sleep and then getting on the phone. I’d set up one payment plan, and then a new bill would come that afternoon. And I’d have to set up another one.”
Crivilare’s pregnancy may have been more dramatic than most. But for millions of new parents, medical debt is now as much a hallmark of having children as long nights and dirty diapers.
About 12% of the 100 million U.S. adults with health care debt attribute at least some of it to pregnancy or childbirth, according to a KFF poll.
These people are more likely to report they’ve had to take on extra work, change their living situation, or make other sacrifices.
Overall, women between 18 and 35 who have had a baby in the past year and a half are twice as likely to have medical debt as women of the same age who haven’t given birth recently, other KFF research conducted for this project found.
“You feel bad for the patient because you know that they want the best for their pregnancy,” said Eilean Attwood, a Rhode Island OB-GYN who said she routinely sees pregnant women anxious about going into debt.
“So often, they may be coming to the office or the hospital with preexisting debt from school, from other financial pressures of starting adult life,” Attwood said. “They are having to make real choices, and what those real choices may entail can include the choice to not get certain services or medications or what may be needed for the care of themselves or their fetus.”
Best-Laid Plans
Crivilare and her husband, Andrew, also a teacher, anticipated some of the costs.
The young couple settled in Jacksonville, in part because the farming community less than two hours north of St. Louis was the kind of place two public school teachers could afford a house. They saved aggressively. They bought life insurance.
And before Crivilare got pregnant in 2021, they enrolled in the most robust health insurance plan they could, paying higher premiums to minimize their deductible and out-of-pocket costs.
Then, two months before their baby was due, Crivilare learned she had developed preeclampsia. Her pregnancy would no longer be routine. Crivilare was put on blood pressure medication, and doctors at the local hospital recommended bed rest at a larger medical center in Springfield, about 35 miles away.
“I remember thinking when they insisted that I ride an ambulance from Jacksonville to Springfield … ‘I’m never going to financially recover from this,’” she said. “‘But I want my baby to be OK.’”
For weeks, Crivilare remained in the hospital alone as covid protocols limited visitors. Meanwhile, doctors steadily upped her medications while monitoring the fetus. It was, she said, “the scariest month of my life.”
Fear turned to relief after her daughter, Rita, was born. The baby was small and had to spend nearly two weeks in the neonatal intensive care unit. But there were no complications. “We were incredibly lucky,” Crivilare said.
When she and Rita finally came home, a stack of medical bills awaited. One was already past due.
Crivilare rushed to set up payment plans with the hospitals in Jacksonville and Springfield, as well as the anesthesiologist, the surgeon, and the labs. Some providers demanded hundreds of dollars a month. Some settled for monthly payments of $20 or $25. Some pushed Crivilare to apply for new credit cards to pay the bills.
“It was a blur of just being on the phone constantly with all the different people collecting money,” she recalled. “That was a nightmare.”
Big Bills, Big Consequences
The Crivilares’ bills weren’t unusual. Parents with private health coverage now face on average more than $3,000 in medical bills related to a pregnancy and childbirth that aren’t covered by insurance, researchers at the University of Michigan found.
Out-of-pocket costs are even higher for families with a newborn who needs to stay in a neonatal ICU, averaging $5,000. And for 1 in 11 of these families, medical bills related to pregnancy and childbirth exceed $10,000, the researchers found.
“This forces very difficult trade-offs for families,” said Michelle Moniz, a University of Michigan OB-GYN who worked on the study. “Even though they have insurance, they still have these very high bills.”
Nationwide polls suggest millions of these families end up in debt, with sometimes devastating consequences.
About three-quarters of U.S. adults with debt related to pregnancy or childbirth have cut spending on food, clothing, or other essentials, KFF polling found.
About half have put off buying a home or delayed their own or their children’s education.
These burdens have spurred calls to limit what families must pay out-of-pocket for medical care related to pregnancy and childbirth.
In Massachusetts, state Sen. Cindy Friedman has proposed legislation to exempt all these bills from copays, deductibles, and other cost sharing. This would parallel federal rules that require health plans to cover recommended preventive services like annual physicals without cost sharing for patients. “We want … healthy children, and that starts with healthy mothers,” Friedman said. Massachusetts health insurers have warned the proposal will raise costs, but an independent state analysis estimated the bill would add only $1.24 to monthly insurance premiums.
Tough Lessons
For her part, Crivilare said she wishes new parents could catch their breath before paying down medical debt.
“No one is in the right frame of mind to deal with that when they have a new baby,” she said, noting that college graduates get such a break. “When I graduated with my college degree, it was like: ‘Hey, new adult, it’s going to take you six months to kind of figure out your life, so we’ll give you this six-month grace period before your student loans kick in and you can get a job.’”
Rita is now 2. The family scraped by on their payment plans, retiring the medical debt within a year, with help from Crivilare’s side job selling resources for teachers online.
But they are now back in debt, after Rita’s recurrent ear infections required surgery last year, leaving the family with thousands of dollars in new medical bills.
Crivilare said the stress has made her think twice about seeing a doctor, even for Rita. And, she added, she and her husband have decided their family is complete.
“It’s not for us to have another child,” she said. “I just hope that we can put some of these big bills behind us and give [Rita] the life that we want to give her.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
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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Gut-Healthy Spaghetti Chermoula
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Chermoula is a Maghreb relish/marinade (it’s used for both purposes); it’s a little like chimichurri but with distinctly N. African flavors. The gut-healthiness starts there (it’s easy to forget that olives—unless fresh—are a fermented food full of probiotic Lactobacillus sp. and thus great for the gut even beyond their fiber content), and continues in the feta, the vegetables, and the wholewheat nature of the pasta. The dish can be enjoyed at any time, but it’s perfect for warm summer evenings—perhaps dining outside, if you’ve place for that.
You will need
- 9oz wholewheat spaghetti (plus low-sodium salt for its water)
- 10oz broccoli, cut into small florets
- 3oz cilantro (unless you have the soap gene)
- 3oz parsley (whether or not you included the cilantro)
- 3oz green olives, pitted, rinsed
- 1 lemon, pickled, rinsed
- 1 bulb garlic
- 3 tbsp pistachios, shelled
- 2 tbsp mixed seeds
- 1 tsp cumin
- 1 tsp chili flakes
- ½ cup extra virgin olive oil
- For the garnish: 3oz feta (or plant-based equivalent), crumbled, 3oz sun-dried tomatoes, diced, 1 tsp cracked black pepper
Note: why are we rinsing the things? It’s because while picked foods are great for the gut, the sodium can add up, so there’s no need to bring extra brine with them too. By doing it this way, there’ll be just the right amount for flavor, without overdoing it.
Method
(we suggest you read everything at least once before doing anything)
1) Cook the spaghetti as you normally would, but when it’s a minute or two from being done, add the broccoli in with it. When it’s done, drain and rinse thoroughly to get rid of excess starch and salt, and also because cooling it even temporarily (as in this case) lowers its glycemic index.
2) Put the rest of the ingredients into a food processor (except the olive oil and the garnish), and blitz thoroughly until no large coarse bits remain. When that’s done, add the olive oil, and pulse it a few times to combine. We didn’t add the olive oil previously, because blending it so thoroughly in that state would have aerated it in a way we don’t want.
3) Put ⅔ of the chermoula you just made into the pan you used for cooking the spaghetti, and set it over a medium heat. When it starts bubbling, return the spaghetti and broccoli to the pan, mixing gently but thoroughly. If the pasta threatens to stick, you can add a little more chermoula, but go easy on it. Any leftover chermoula that you didn’t use today, can be kept in the fridge and used later as a pesto.
4) Serve! Add the garnish as you do.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Less Obvious Probiotics Benefits
- Making Friends With Your Gut (You Can Thank Us Later)
- What Matters Most For Your Heart? ← spoiler: this is why, while we do watch the sodium, we care more about the fiber
- All about Olive Oil: Is “Extra Virgin” Worth It?
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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Egg Noodles vs Rice Noodles – Which is Healthier?
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Our Verdict
When comparing egg noodles to rice noodles, we picked the egg noodles.
Why?
It was close—these are both quite mediocre foods. They’re neither amazing for the health nor appalling for the health (in moderation). They are both relatively low in nutrients, but they are also low in anti-nutrients, i.e. things that have a negative effect on the health.
Their mineral profiles are similar; both are a source of selenium, manganese, phosphorus, copper, and iron. Not as good as many sources, but not devoid of nutrients either.
Their vitamin profiles are both pitiful; rice noodles have trace amounts of various vitamins, and egg noodles have only slightly more. While eggs themselves are nutritious, the processing has robbed them of much of their value.
In terms of macros, egg noodles have a little more fat (but the fats are healthier) and rice noodles have a lot more carbs, so this is the main differentiator, and is the main reason we chose the egg noodles over the rice noodles. Both have a comparable (small) amount of protein.
In short:
- They’re comparable on minerals, and vitamins here are barely worth speaking about (though egg noodles do have marginally more)
- Egg noodles have a little more fat (but the fats are healthier)
- Rice noodles have a lot more carbs (with a moderately high glycemic index, which is relatively worse—if you eat them with vegetables and fats, then that’ll offset this, but we’re judging the two items on merit, not your meal)
Learn more
You might like this previous main feature of ours:
Should You Go Light Or Heavy On Carbs?
Take care!
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The Doctor Who Wants Us To Exercise Less, & Move More
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Today we’re talking about Dr. Rangan Chatterjee. He’s a medical doctor with decades of experience, and he wants us all to proactively stay in good health, rather than waiting for things to go wrong.
Great! What’s his deal?
Dr. Chatterjee advises that we take care of the following four pillars of good health:
- Relaxation
- Food
- Movement
- Sleep
And, they’re not in this order at random. Usually advice starts with diet and exercise, doesn’t it?
But for Dr. Chatterjee, it’s useless to try to tackle diet first if one is stressed-to-death by other things. As for food next, he knows that a good diet will fuel the next steps nicely. Speaking of next steps, a day full of movement is the ideal setup to a good night’s sleep—ready for a relaxing next day.
Relaxation
Here, Dr. Chatterjee advises that we go with what works for us. It could be meditation or yoga… Or it could be having a nice cup of tea while looking out of the window.
What’s most important, he says, is that we should take at least 15 minutes per day as “me time”, not as a reward for when we’ve done our work/chores/etc, but as something integrated into our routine, preferably early in the day.
Food
There are no grand surprises here: Dr. Chatterjee advocates for a majority plant-based diet, whole foods, and importantly, avoiding sugar.
He’s also an advocate of intermittent fasting, but only so far as is comfortable and practicable. Intermittent fasting can give great benefits, but it’s no good if that comes at a cost of making us stressed and suffering!
Movement
This one’s important. Well, they all are, but this one’s particularly characteristic to Dr. Chatterjee’s approach. He wants us to exercise less, and move more.
The reason for this is that strenuous exercise will tend to speed up our metabolism to the point that we will be prompted to eat high calorie quick-energy foods to compensate, and when we do, our body will rush to store that as fat, understanding (incorrectly) that we are in a time of great stress, because why else would we be exerting ourselves that much?
Instead, he advocates for building as much natural movement into our daily routine as possible. Walking more, taking the stairs, doing the gardening/housework.
That said, he does also advise some strength-training on a daily basis—bodyweight exercises like squats and lunges are top of his list.
Sleep
Here, aside from the usual “sleep hygiene” advices (dark cool room, fresh bedding, etc), he also advises we do as he does, and take an hour before bedtime as a purely wind-down time. In gentle lighting, perhaps reading (not on a bright screen!), for example.
Ready to start the next day, relaxed and ready to go.
If you’d like to know more about Dr. Chatterjee’s approach…
You can check out his:
If you don’t know where to start, we recommend the blog! It has a lot of guests there too, including Wim Hof, Gabor Maté, Mindy Pelz, and come to think of it, a lot of other people we’ve also featured ideas from previously!
Enjoy!
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Nutrition To Combat Lymphedema & Lipedema
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Dr. Kelly Sturm is a rehab specialist (Doctor of Physical Therapy), and also a certified lymphedema therapist. Here’s what helps her patients with lymphedema and lipedema:
Don’t fan the flames
Lymphedema and lipedema are inflammatory lymphatic diseases affecting mostly women. As such, an anti-inflammatory diet will be important, but there are other factors too:
- Anti-inflammatory diet: this is to reduce the chronic inflammation associated with lymphatic diseases. This means eating plenty of fruit and vegetables, especially berries and leafy greens, and avoiding things like sugar, alcohol, caffeine, and processed foods. And of course, don’t smoke.
- Intermittent fasting: this also helps by giving the body a chance to correct itself; when the body isn’t digesting food, it has a lot more resources to devote to its favorite activity: maintenance. This results in lower inflammation, and better fat redistribution.
- Weight loss: not a bandwagon we often get on at 10almonds as it’s rarely the most important thing, but in this case it is of high importance (second only to dealing with the inflammation), as excess weight around the lymph nodes and vessels can lead to dysfunction and swelling. Thus, reducing the weight can ease that and allow the body to heal.
For more details on all of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Eat To Beat Inflammation ← also some non-dietary advice in there too
- Ask Not What Your Lymphatic System Can Do For You…
- Lose Weight, But Healthily ← more useful than just trying to run a calorie deficit
Take care!
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We analysed almost 1,000 social media posts about 5 popular medical tests. Most were utterly misleading
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When Kim Kardashian posted on Instagram about having had a full-body MRI, she enthused that the test can be “life saving”, detecting diseases in the earliest stages before symptoms arise.
What Kardashian neglected to say was there’s no evidence this expensive scan can bring benefits for healthy people. She also didn’t mention it can carry harms including unnecessary diagnoses and inappropriate treatments.
With this post in mind, we wanted to explore what influencers are telling us about medical tests.
In a new study published today in JAMA Network Open, we analysed nearly 1,000 Instagram and TikTok posts about five popular medical tests which can all do more harm than good to healthy people, including the full-body MRI scan.
We found the overwhelming majority of these posts were utterly misleading.
C-R-V/Shutterstock 5 controversial tests
Before we get into the details of what we found, a bit about the five tests included in our study.
While these tests can be valuable to some, all five carry the risk of overdiagnosis for generally healthy people. Overdiagnosis is the diagnosis of a condition which would have never caused symptoms or problems. Overdiagnosis leads to overtreatment, which can cause unnecessary side effects and stress for the person, and wasted resources for the health system.
As an example, estimates suggest 29,000 cancers a year are overdiagnosed in Australia alone.
Overdiagnosis is a global problem, and it’s driven in part by healthy people having tests like these. Often, they’re promoted under the guise of early screening, as a way to “take control” of your health. But most healthy people simply don’t need them.
These are the five tests we looked at:
The full-body MRI scan claims to test for up to 500 conditions, including cancer. Yet there is no proven benefit of the scan for healthy people, and a real risk of unnecessary treatment from “false alarm” diagnoses.
The “egg timer” test (technically known as the AMH, or anti-mullarian hormone test) is often falsely promoted as a fertility test for healthy women. While it may be beneficial for women within a fertility clinic setting, it cannot reliably predict the chance of a woman conceiving, or menopause starting. However, low results can increase fear and anxiety, and lead to unnecessary and expensive fertility treatments.
Multi-cancer early detection blood tests are being heavily marketed as the “holy grail of cancer detection”, with claims they can screen for more than 50 cancers. In reality, clinical trials are still a long way from finished. There’s no good evidence yet that the benefits will outweigh the harms of unnecessary cancer diagnoses.
The gut microbiome test of your stool promises “wellness” via early detection of many conditions, from flatulence to depression, again without good evidence of benefit. There’s also concern that test results can lead to wasted resources.
Testosterone testing in healthy men is not supported by any high-quality evidence, with concerns direct-to-consumer advertising leads men to get tested and take testosterone replacement therapy unnecessarily. Use of testosterone replacement therapy carries its own risk of potential harms with the long-term safety in relation to heart disease and mortality still largely unknown.
Multi-cancer early detection blood tests are heavily marketed. Yuri A/Shutterstock What we found
Together with an international group of health researchers, we analysed 982 posts pertaining to the above tests from across Instagram and TikTok. The posts we looked at came from influencers and account holders with at least 1,000 followers, some with a few million followers. In total, the creators of the posts we included had close to 200 million followers.
Even discounting the bots, that’s a massive amount of influence (and likely doesn’t reflect their actual reach to non-followers too).
The vast majority of posts were misleading, failing to even mention the possibility of harm arising from taking one of these tests. We found:
- 87% of posts mentioned test benefits, while only 15% mentioned potential harms
- only 6% of posts mentioned the risk of overdiagnosis
- only 6% of posts discussed any scientific evidence, while 34% of posts used personal stories to promote the test
- 68% of influencers and account holders had financial interests in promoting the test (for example, a partnership, collaboration, sponsorship or selling for their own profit in some way).
Further analysis revealed medical doctors were slightly more balanced in their posts. They were more likely to mention the harms of the test, and less likely to have a strongly promotional tone.
The vast majority of posts we looked at were misleading. DimaBerlin/Shutterstock As all studies do, ours had some limitations. For example, we didn’t analyse comments connected to posts. These may give further insights into the information being provided about these tests, and how social media users perceive them.
Nonetheless, our findings add to the growing body of evidence showing misleading medical information is widespread on social media.
What can we do about it?
Experts have proposed a range of solutions including pre-bunking strategies, which means proactively educating the public about common misinformation techniques.
However, solutions like these often place responsibility on the individual. And with all the information on social media to navigate, that’s a big ask, even for people with adequate health literacy.
What’s urgently needed is stronger regulation to prevent misleading information being created and shared in the first place. This is especially important given social media platforms including Instagram are moving away from fact-checking.
In the meantime, remember that if information about medical tests promoted by influencers sounds too good to be true, it probably is.
Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Ray Moynihan, Assistant Professor, Faculty of Health Sciences & Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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