Slowing the Progression of Cataracts

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Understanding Cataracts

Cataracts are natural and impact everyone.

That’s a bit of a daunting opening line, but as Dr. Michele Lee, a board-certified ophthalmologist, explains, cataracts naturally develop with age, and can be accelerated by factors such as trauma, certain medications, and specific eye conditions.

We know how important your vision is to you (we’ve had great feedback about the book Vision for Life) as well as our articles on how glasses impact your eyesight and the effects of using eye drops.

While complete prevention isn’t possible, steps such as those mentioned below can be taken to slow their progression.

Here is an overview of the video’s first 3 takeaways. You can watch the whole video below.

Protect Your Eyes from Sunlight

Simply put, UV light damages lens proteins, which (significantly) contributes to cataracts. Wearing sunglasses can supposedly prevent up to 20% of cataracts caused by UV exposure.

Moderate Alcohol Consumption

We all, at some level, know that alcohol consumption doesn’t do us any good. Your eye health isn’t an exception to the rule; alcohol has been shown to contribute to cataract development.

If you’re looking at reducing your alcohol use, try reading this guide on lowering, or eradicating, alcohol consumption.

Avoid Smoking

Smokers are 2-3 times more likely to develop cataracts. Additionally, ensure good ventilation while cooking to avoid exposure to harmful indoor smoke.

See all 5 steps in the below video:

How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • Scheduling Tips for Overrunning Tasks

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    Your Questions, Our Answers!

    Q: Often I schedule time for things, but the task takes longer than I think, or multiplies while I’m doing it, and then my schedule gets thrown out. Any ideas?

    A: A relatable struggle! Happily, there are remedies:

    • Does the task really absolutely need to be finished today? If not, just continue it in scheduled timeslots until it’s completed.
    • Some tasks do indeed need to be finished today (hi, writer of a daily newsletter here!), so it can be useful to have an idea of how long things really take, in advance. While new tasks can catch us unawares, recurring or similar-to-previous tasks can be estimated based on how long they took previously. For this reason, we recommend doing a time audit every now and again, to see how you really use your time.
    • A great resource that you should include in your schedule is a “spare” timeslot, ideally at least one per day. Call it a “buffer” or a “backup” or whatever (in my schedule it’s labelled “discretionary”), but the basic idea is that it’s a scheduled timeslot with nothing scheduled in it, and it works as an “overflow” catch-all.

    Additionally:

    • You can usually cut down the time it takes you to do tasks by setting “Deep Work” rules for yourself. For example: cut out distractions, single-task, work in for example 25-minute bursts with 5-minute breaks, etc
    • You can also usually cut down the time it takes you to do tasks by making sure you’re prepared for them. Not just task-specific preparation, either! A clear head on, plenty of energy, the resources you’ll need (including refreshments!) to hand, etc can make a huge difference to efficiency.

    See Also: Time Optimism and the Planning Fallacy

    Do you have a question you’d like to see answered here? Hit reply or use the feedback widget at the bottom; we’d love to hear from you!

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  • California Becomes Latest State To Try Capping Health Care Spending

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    California’s Office of Health Care Affordability faces a herculean task in its plan to slow runaway health care spending.

    The goal of the agency, established in 2022, is to make care more affordable and accessible while improving health outcomes, especially for the most disadvantaged state residents. That will require a sustained wrestling match with a sprawling, often dysfunctional health system and powerful industry players who have lots of experience fighting one another and the state.

    Can the new agency get insurers, hospitals, and medical groups to collaborate on containing costs even as they jockey for position in the state’s $405 billion health care economy? Can the system be transformed so that financial rewards are tied more to providing quality care than to charging, often exorbitantly, for a seemingly limitless number of services and procedures?

    The jury is out, and it could be for many years.

    California is the ninth state — after Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington — to set annual health spending targets.

    Massachusetts, which started annual spending targets in 2013, was the first state to do so. It’s the only one old enough to have a substantial pre-pandemic track record, and its results are mixed: The annual health spending increases were below the target in three of the first five years and dropped beneath the national average. But more recently, health spending has greatly increased.

    In 2022, growth in health care expenditures exceeded Massachusetts’ target by a wide margin. The Health Policy Commission, the state agency established to oversee the spending control efforts, warned that “there are many alarming trends which, if unaddressed, will result in a health care system that is unaffordable.”

    Neighboring Rhode Island, despite a preexisting policy of limiting hospital price increases, exceeded its overall health care spending growth target in 2019, the year it took effect. In 2020 and 2021, spending was largely skewed by the pandemic. In 2022, the spending increase came in at half the state’s target rate. Connecticut and Delaware, by contrast, both overshot their 2022 targets.

    It’s all a work in progress, and California’s agency will, to some extent, be playing it by ear in the face of state policies and demographic realities that require more spending on health care.

    And it will inevitably face pushback from the industry as it confronts unreasonably high prices, unnecessary medical treatments, overuse of high-cost care, administrative waste, and the inflationary concentration of a growing number of hospitals in a small number of hands.

    “If you’re telling an industry we need to slow down spending growth, you’re telling them we need to slow down your revenue growth,” says Michael Bailit, president of Bailit Health, a Massachusetts-based consulting group, who has consulted for various states, including California. “And maybe that’s going to be heard as ‘we have to restrain your margins.’ These are very difficult conversations.”

    Some of California’s most significant health care sectors have voiced disagreement with the fledgling affordability agency, even as they avoid overtly opposing its goals.

    In April, when the affordability office was considering an annual per capita spending growth target of 3%, the California Hospital Association sent it a letter saying hospitals “stand ready to work with” the agency. But the proposed number was far too low, the association argued, because it failed to account for California’s aging population, new investments in Medi-Cal, and other cost pressures.

    The hospital group suggested a spending increase target averaging 5.3% over five years, 2025-29. That’s slightly higher than the 5.2% average annual increase in per capita health spending over the five years from 2015 to 2020.

    Five days after the hospital association sent its letter, the affordability board approved a slightly less aggressive target that starts at 3.5% in 2025 and drops to 3% by 2029. Carmela Coyle, the association’s chief executive, said in a statement that the board’s decision still failed to account for an aging population, the growing need for mental health and addiction treatment, and a labor shortage.

    The California Medical Association, which represents the state’s doctors, expressed similar concerns. The new phased-in target, it said, was “less unreasonable” than the original plan, but the group would “continue to advocate against an artificially low spending target that will have real-life negative impacts on patient access and quality of care.”

    But let’s give the state some credit here. The mission on which it is embarking is very ambitious, and it’s hard to argue with the motivation behind it: to interject some financial reason and provide relief for millions of Californians who forgo needed medical care or nix other important household expenses to afford it.

    Sushmita Morris, a 38-year-old Pasadena resident, was shocked by a bill she received for an outpatient procedure last July at the University of Southern California’s Keck Hospital, following a miscarriage. The procedure lasted all of 30 minutes, Morris says, and when she received a bill from the doctor for slightly over $700, she paid it. But then a bill from the hospital arrived, totaling nearly $9,000, and her share was over $4,600.

    Morris called the Keck billing office multiple times asking for an itemization of the charges but got nowhere. “I got a robotic answer, ‘You have a high-deductible plan,’” she says. “But I should still receive a bill within reason for what was done.” She has refused to pay that bill and expects to hear soon from a collection agency.

    The road to more affordable health care will be long and chock-full of big challenges and unforeseen events that could alter the landscape and require considerable flexibility.

    Some flexibility is built in. For one thing, the state cap on spending increases may not apply to health care institutions, industry segments, or geographic regions that can show their circumstances justify higher spending — for example, older, sicker patients or sharp increases in the cost of labor.

    For those that exceed the limit without such justification, the first step will be a performance improvement plan. If that doesn’t work, at some point — yet to be determined — the affordability office can levy financial penalties up to the full amount by which an organization exceeds the target. But that is unlikely to happen until at least 2030, given the time lag of data collection, followed by conversations with those who exceed the target, and potential improvement plans.

    In California, officials, consumer advocates, and health care experts say engagement among all the players, informed by robust and institution-specific data on cost trends, will yield greater transparency and, ultimately, accountability.

    Richard Kronick, a public health professor at the University of California-San Diego and a member of the affordability board, notes there is scant public data about cost trends at specific health care institutions. However, “we will know that in the future,” he says, “and I think that knowing it and having that information in the public will put some pressure on those organizations.”

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    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.

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    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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  • Safe Effective Sleep Aids For Seniors

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    Safe Efective Sleep Aids For Seniors

    Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:

    Review of Safety and Efficacy of Sleep Medicines in Older Adults

    Let’s break it down…

    What’s not so great

    Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.

    Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.

    Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.

    See also: Benzodiazepine and z-drug withdrawal

    (and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)

    Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.

    What about cannabis products?

    We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.

    How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.

    Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.

    See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

    Melatonin: a powerful helper with a good safety profile

    We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.

    Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:

    Melatonin: A Safe Natural Sleep Supplement

    Herbal options: which really work?

    Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.

    See: Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

    Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).

    But here’s one study that found it helped significantly:

    The effects of chamomile extract on sleep quality among elderly people: A clinical trial

    Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!

    Technological interventions

    We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:

    White Noise Is Good; Pink Noise Is Better

    Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.

    We reviewed some sleep apps; you might like those too:

    The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

    Enjoy, and rest well!

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  • Currants vs Grapes – 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 currants to grapes, we picked the currants.

    Why?

    First, a note on nomenclature: when we say “currants”, we are talking about actual currants, of the Ribes genus, and in this case (as per the image) red ones. We are not talking about “currants” that are secretly tiny grapes that also get called currants in the US. So, there are important botanical differences here, beyond how they have been cultivated; they are literally entirely different plants.

    So, about those differences…

    In terms of macros, currants have nearly 5x the fiber, while grapes are slightly higher in carbs. So there’s an easy choice here in terms of fiber and on the glycemic index front; currants win easily.

    In the category of vitamins, currants have more of vitamins B5, B9, C, and choline, while grapes have more of vitamins A, B1, B2, B3, B6, E, and K. So, a win for grapes in this round.

    When it comes to minerals, currants have more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while grapes have more manganese. A win, therefore, for currants again this time.

    In terms of polyphenols, currants have a lot more in terms of total polyphenols, including (as a matter of interest) approximately 5x the resveratrol content compared to grapes—and that’s compared to black grapes, which are the “best” kind of grapes for such. Grapes really aren’t a very good source of resveratrol; people just really like the idea of red wine being a health food, so it has been talked up a lot and got a popular reputation despite its extreme paucity of nutritional value.

    In any case, adding up the sections makes for a clear overall win for currants, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    21 Most Beneficial Polyphenols & What Foods Have Them

    Enjoy!

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  • Chickpeas vs Pinto Beans – Which is Healthier?

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    Our Verdict

    When comparing chickpeas to pinto beans, we picked the pinto beans.

    Why?

    Both are great! And an argument could be made for either…

    In terms of macros, pinto beans have slightly more fiber and slightly more protein, while chickpeas have slightly more carbs, and thus predictably higher net carbs. In the category of those proteins, they both have a comparable spread of amino acods, with pinto beans having very slightly more of each amino acid. All this adds up to a clear, but moderate, win for pinto beans.

    When it comes to vitamins, technically chickpeas have more of vitamins A, B3, B5, C, K, and choline, but the margins are so small as to be almost meaningless. Meanwhile, pinto beans have more of vitamins B1, B6, and E, and/but the only one where the margin is enough to really care about is vitamin E (a little over 2x what chickpeas have). So, an argument could be made either way, but we’re going to call this category a tie.

    The story with minerals is similar; chickpeas have more copper, iron, manganese, phosphorus, and zinc, all with small margins, while pinto beans have more potassium and selenium, and/but also less sodium. We’d call this either a tie, or a very slight win for chickpeas.

    Adding up the sections gives for a very modest win for pinto beans, but as we say, an argument could be made for either.

    Certainly, enjoy both!

    Want to learn more?

    You might like to read:

    Take care!

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  • A New Tool For Bone Regeneration

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    When it comes to rebuilding bones, one of the tools in the orthopedic surgeon’s toolbox is bone grafts. This involves, to oversimplify it a bit, gluing particles of bone to where bone needs rebuilding. However, this comes with problems, most notably:

    • that the bone tissue and the adhesive “glue” need to be prepared separately and mixed in situ, which is fiddly, to say the least
    • that the resultant mixture mixed in situ will usually be unevenly mixed, resulting in weak bonding and degradation over time
    • having any more of one part or the other in any given site means that bone regeneration and adhesion become a “pick one” matter, when both are critically needed

    You may be wondering: why can’t they mix them before putting them in?

    And the answer is: because then either the glue will set the bone prematurely (and now we have a clump of bone outside of the body which is not what we wanted), or else the glue will have issues with setting in situ, and now we have bone tissue running down the inside of someone’s leg and setting somewhere else, which is also not what we want.

    These kinds of problems may seem a little more “arts and crafts” than “orthopedic surgery”, but they are the kind of nitty-gritty real-life real challenges that actually get in the way of healing patients’ bones.

    The new solution

    Biomaterial research scientists have developed an injectable hydrogel (containing all the necessary ingredients* that uses light to achieve cross-linking of bone particles and mineralization without any of the above being necessary. In again oversimplified terms: they inject the hydrogel where it’s needed, and then irradiate the site with harmless visible light which instantly sets it in place. As to how the light gets in there: it’s just very shiny, like candling an egg to see inside, or like how you can still approximately see bright light even with your eyes closed.

    *alginate (natural polysaccharide derived from brown algae), RGD peptide-containing mussel** adhesive protein, calcium ions, phosphonodiols, and a photoinitiator.

    **unclear whether this would trigger a shellfish allergy. Probably kosher per “פיקוח נפש” and Talmud Yoma 85b, but we are a health science newsletter, not Talmudic scholars, so please talk to your Rabbi. Probably halal per Qur’an 5:4 and failing that, the same principle as previously mentioned, expressed in Qur’an 5:3 and 6:119, but once again, your humble writer here is no Mufti, so please talk to your Imam. As for if you are vegetarian or vegan, then that is for you to decide whether to take a “medications with animal ingredients are unfortunate but necessary” stance, as most do. This vegan writer would (she’d grumble about it, though, and at least try to find an acceptable alternative first).

    Back to the more general practicalities…

    How it works, in less oversimplified terms:

    ❝The coacervate-based formulation, which is immiscible in water, ensures that the hydrogel retains its shape and position after injection into the body. Upon visible light irradiation, cross-linking occurs, and amorphous calcium phosphate, which functions as a bone graft material, is simultaneously formed. This eliminates the need for separate bone grafts or adhesives, enabling the hydrogel to provide both bone regeneration and adhesion.❞

    See the paper: Visible light-induced simultaneous bioactive amorphous calcium phosphate mineralization and in situ crosslinking of coacervate-based injectable underwater adhesive hydrogels for enhanced bone regeneration

    “That’s great, but I was hoping for something I can do right now, ideally at home”

    If getting glued back together was not on your bucket list, that’s understandable. There’s still a lot you can do for bone density; here’s a quick overview:

    Too much information?

    If that was too much information all at once, then we recommend this as your one-stop article:

    The Bare-Bones Truth About Osteoporosis

    Want more information?

    We are but a humble newsletter and can only include so much per day, but we highly recommend this book we reviewed a little while back, which goes into everything in a lot more detail than we can here:

    The Whole-Body Approach to Osteoporosis: How To Improve Bone Strength And Reduce Your Fracture Risk – by Keith McCormick

    Enjoy!

    Don’t Forget…

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    Learn to Age Gracefully

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