Solitary Fitness – by Charles Bronson
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Sometimes it can seem that every new diet and/or exercise regime you want to try will change your life, if just you first max out your credit card on restocking your kitchen and refurbishing your home gym, not to mention buying all the best supplements, enjoying the latest medical gadgets, and so on and so forth.
And often… Most of those things genuinely are good! And it’s great that such things are becoming more accessible and available.
But… Wouldn’t it be nice to know how to have excellent strength and fitness without any of that, even if just as a “bare bones” protocol to fall back on? That’s what Manson provides in this book.
The writing style is casual and friendly; Manson is not exactly an academic, but he knows his stuff when it comes to what works. And a good general rule of thumb is: if it’s something that he can do in his jail cell, we can surely do it in the comfort of our homes.
Bottom line: if you want functional strength and fitness with zero gimmicks, this is the book for you (as an aside, it’s also simply an interesting and recommendable read, sociologically speaking, but that’s another matter entirely).
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What happens in my brain when I get a migraine? And what medications can I use to treat it?
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Migraine is many things, but one thing it’s not is “just a headache”.
“Migraine” comes from the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.
Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.
Migraine is a disease with a huge personal and societal impact. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.
Francisco Gonzelez/Unsplash What’s happening in my brain?
The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:
The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.
The hypothalamus is shown here in red. Blamb/Shutterstock Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.
In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.
Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy.
What can you do about the acute attack?
A useful way to conceive of migraine treatment is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.
Aspirin
For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.
Triptans
For moderate to severe attacks, the mainstay of treatment is a class of medications called “triptans”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.
Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.
The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).
As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.
Triptans should be used cautiously in patients with heart disease. CDC/Unsplash Gepants
Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.
Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.
They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.
Ditans
Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.
However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a cost of approximately A$300 for eight wafers.
What about preventing migraines?
The first step is to see if lifestyle changes can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.
Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month benefit the most from starting preventives.
Some people will take medicines to prevent migraines. Tbel Abuseridze/Unsplash Almost all migraine preventives have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:
- tablets that lower blood pressure (candesartan, metoprolol, propranolol)
- antidepressants (amitriptyline, venlafaxine)
- anticonvulsants (sodium valproate, topiramate).
Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.
For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.
It is rare for noticeable benefits to be seen immediately, but with time these drugs typically reduce migraine frequency by 50% or more.
‘Nothing works for me!’
In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications block the action of CGRP.
The most common PBS-listed anti-CGRP medications are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.
These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also effective and PBS-listed for chronic migraine) which must be administered by a trained specialist.
Up to half of adolescents and one-third of young adults are needle-phobic. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.
Data over the past five years suggest anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.
Nonetheless, these are used only after a number of cheaper and more readily available first-line treatments (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.
Mark Slee, Associate Professor, Clinical Academic Neurologist, Flinders University and Anthony Khoo, Lecturer, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Brain As A Work-In-Progress
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And The Brain Goes Marching On!
In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:
- About 64% of people said “Never”
- About 16% of people said “25 years”
- About 9% of people said “65 years”
- About 5% of people said “13 years”
- About 3% of people said “18 years”
- About 3% of people said “45 years”
Some thoughts, before we get into the science:
An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:
- “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
- When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages
Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!
Why we picked those ages
We picked those ages as poll options for reasons people might be drawn to them:
- 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
- 18 years: age of legal majority in N. America and many other places
- 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
- 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
- 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research
Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!
Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.
So, what does the science say?
Our brains are never finished developing: True or False?
True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.
Glossary:
- Neurogenesis: the process of creating new brain cells
- Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs
We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.
For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:
How To Grow New Brain Cells (At Any Age)
Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.
Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:
Our brains are still developing up to the age of 25: True or False?
True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.
A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:
❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞
Source: Structural Magnetic Resonance Imaging of the Adolescent Brain
There are several things to note here:
- The above statement is talking about the physical size of the brain growing
- Nowhere does he say “and stops developing at 25”
However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.
This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.
The study didn’t misrepresent this, by the way, but the popular press did!
Another 2012 study looked at various metrics of brain development, and found:
- Synapse overproduction into the teens
- Cortex pruning into the late 20s
- Prefrontal pruning into middle age at least (they stopped looking)
- Myelination beyond middle age (they stopped looking)
Source: Experience and the developing prefrontal cortex ← check out figure 1, and make sure you’re looking at the human data not the rat data
So how’s the most recent research looking?
Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:
Brain charts for the human lifespan ← check out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!
Want to know how not to get caught out by science being misrepresented by the popular press? Check out:
How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)
Take care!
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Under Pressure: A Guide To Controlling High Blood Pressure – by Dr. Frita Fisher
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Hypertension kills a lot of people, and does so with little warning—it can be asymptomatic before it gets severe enough to cause harm, and once it causes harm, well, one heart attack or stroke is already one too many.
Aimed more squarely at people in the 35–45 danger zone (young enough to not be getting regular blood pressure checks, old enough that it may have been building up for decades), this is a very good primer on blood pressure, factors affecting it, what goes wrong, what to do about it, and how to make a good strategy for managing it for life.
The style is easy-reading, making this short (91 pages) book a very quick read, but an informative one.
Bottom line: if you are already quite knowledgeable about blood pressure and blood pressure management, this one’s probably not for you. But if you’re in the category of “what do those numbers mean again?”, then this is a very handy book to have, to get you up to speed so that you can handle things as appropriate.
Click here to check out Under Pressure, and get/keep yours under control!
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Where Nutrition Meets Habits!
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Where Nutrition Meets Habits…
This is Claudia Canu, MSc., INESEM. She’s on a mission to change the way we eat:
Often, diet is a case of…
- Healthy
- Easy
- Cheap
(choose two)
She wants to make it all three, and tasty too. She has her work cut out for her, but she’s already blazed quite a trail personally:
❝Nine months before turning 40 years old, I set a challenge for myself: Arrive to the day I turn 40 as the best possible version of myself, physically, mentally and emotionally.❞
~ Claudia Canu
In Her Own Words: My Journey To My Healthy 40s
And it really was quite a journey:
- September: Changes That Destabilize
- October: Looking for Focus
- November: New Habits
- December: Analyzing The First Results
- January: Traveling & Perfectionism
- February: Habits & Goals
- March: Connection, Cravings, & Organization
- April: Physical & Emotional Changes After 7 Months
- May: Reflections & Considerations
- June: Challenge Is Over
For those of us who’d like the short-cut rather than a nine-month quasi-spiritual journey… based on both her experience, and her academic and professional background in nutrition, her main priorities that she settled on were:
- Making meals actually nutritionally balanced, which meant re-thinking what she thought a meal “should” be
- Making nutritionally balanced meals that didn’t require a lot of skill and/or resources
- That’s it!
But, easier said than done… Where to begin?
She shares an extensive list of recipes, from meals to snacks (I thought I was the only one who made coffee overnight oats!), but the most important thing from her is:
Claudia’s 10 Guiding Principles:
- Buy only fresh ingredients that you are going to cook yourself. If you decide to buy pre-cooked ones, make sure they do not have added ingredients, especially sugar (in all its forms).
- Use easy and simple cooking methods.
- Change ingredients every time you prepare your meals.
- Prepare large quantities for three or four days.
- Store the food separately in tightly closed Tupperware.
- Organize yourself to always have ready-to-eat food in the fridge.
- When hungry, mix the ingredients in the ideal amounts to cover the needs of your body.
- Chew well and take the time to taste your food.
- Eat foods that you like and enjoy.
- Do not overeat but don’t undereat either.
We have only two quibbles with this fine list, which are:
About Ingredients!
Depending on what’s available around you, frozen and/or tinned “one-ingredient” foods can be as nutritional as (if not more nutritional than) fresh ones. By “one-ingredient” foods here we mean that if you buy a frozen pack of chopped onions, the ingredients list will be: “chopped onions”. If you buy a tin of tomatoes, the ingredients will say “Tomatoes” or at most “Tomatoes, Tomato Juice”, for example.
She does list the ingredients she keeps in; the idea that with these in the kitchen, you’ll never be in the position of “oh, we don’t have much in, I guess it’s a pizza delivery night” or “well there are some chicken nuggets at the back of the freezer”.
Check Out And Plan: 10 Types Of Ingredients You Should Always Keep In Your Kitchen
Here Today, Gone Tomorrow?
Preparing large quantities for three or four days can result in food for one or two days if the food is unduly delicious
But! Claudia has a remedy for that:
Read: How To Eliminate Food Cravings And What To Do When They Win
Anyway, there’s a wealth of resources in the above-linked pages, so do check them out!
Perhaps the biggest take-away is to ask yourself:
“What are my guiding principles when it comes to food?”
If you don’t have a ready answer, maybe it’s time to tackle that—whether Claudia’s way or your own!
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The No-Nonsense Meditation Book – by Dr. Steven Laureys
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We’ve reviewed books about meditation before, and when we review books, we try to pick ones that have something that make them stand out from the others. So, what stands out in this case?
The author is a medical doctor and neurologist, with decades of experience focusing on neuronal plasticity and multimodel neural imaging. So, a little beyond “think happy thoughts”-style woo.
The style of the book is pop-science in tone, but with a lot of hard clinical science underpinning it and referenced throughout, as one would expect of a scientist of Dr. Laurey’s stature (with hundreds of peer-reviewed papers in top-level journals).
You may be wondering: is this a “how-to” book or a “why-to” book or a “what-happens” book? It’s all three.
The “how-to” is also, as the title suggests, no-nonsense. We are talking maximum results for minimum mystery here.
Bottom line: if you’d like to be able to take up a meditative practice and know exactly what it’s doing to your brain (quietening these parts, stimulating and physically growing those parts, etc) then this is the book for you.
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Tilapia vs Cod – Which is Healthier?
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Our Verdict
When comparing tilapia to cod, we picked the tilapia.
Why?
Another case of “that which is more expensive is not necessarily the healthier”!
In terms of macros, tilapia has more protein and fats, as well as more omega-3 (and omega-6). On the downside, tilapia does have relatively more saturated fat, but at 0.94g/100g, it’s not exactly butter.
The vitamins category sees that tilapia has more of vitamins B1, B3, B5, B12, D, and K, while cod has more of vitamins B6, B9, and choline. A moderate win for tilapia.
When it comes to minerals, things are most divided; tilapia has more copper, iron, phosphorus, potassium, manganese, and selenium, while cod has more magnesium and zinc. An easy win for tilapia.
One other thing to note is that both of these fish contain mercury these days (and it’s worth noting: cod has nearly 10x more mercury). Mercury is, of course, not exactly a health food.
So, excessive consumption of either is not recommended, but out of the two, tilapia is definitely the one to pick.
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught: Know The Health Differences
Take care!
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