Strategic Wellness
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Strategic Wellness: planning ahead for a better life!
This is Dr. Michael Roizen. With hundreds of peer-reviewed publications and 14 US patents, his work has been focused on the importance of lifestyle factors in healthy living. He’s the Chief Wellness Officer at the world-famous Cleveland Clinic, and is known for his “RealAge” test and related personalized healthcare services.
If you’re curious about that, you can take the RealAge test here.
(they will require you inputting your email address if you do, though)
What’s his thing?
Dr. Roizen is all about optimizing health through lifestyle factors—most notably, diet and exercise. Of those, he is particularly keen on optimizing nutritional habits.
Is this just the Mediterranean Diet again?
Nope! Although: he does also advocate for that. But there’s more, he makes the case for what he calls “circadian eating”, optimally timing what we eat and when.
Is that just Intermittent Fasting again?
Nope! Although: he does also advocate for that. But there’s more:
Dr. Roizen takes a more scientific approach. Which isn’t to say that intermittent fasting is unscientific—on the contrary, there’s mountains of evidence for it being a healthful practice for most people. But while people tend to organize their intermittent fasting purely according to convenience, he notes some additional factors to take into account, including:
- We are evolved to eat when the sun is up
- We are evolved to be active before eating (think: hunting and gathering)
- Our insulin resistance increases as the day goes on
Now, if you’ve a quick mind about you, you’ll have noticed that this means:
- We should keep our eating to a particular time window (classic intermittent fasting), and/but that time window should be while the sun is up
- We should not roll out of bed and immediately breakfast; we need to be active for a bit first (moderate exercise is fine—this writer does her daily grocery-shopping trip on foot before breakfast, for instance… getting out there and hunting and gathering those groceries!)
- We should not, however, eat too much later in the day (so, dinner should be the smallest meal of the day)
The latter item is the one that’s perhaps biggest change for most people. His tips for making this as easy as possible include:
- Over-cater for dinner, but eat only one portion of it, and save the rest for an early-afternoon lunch
- First, however, enjoy a nutrient-dense protein-centric breakfast with at least some fibrous vegetation, for example:
- Salmon and asparagus
- Scrambled tofu and kale
- Yogurt and blueberries
Enjoy!
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Cynthia’s Thoughts on Intermittent Fasting
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The Myth of Breakfast and Snacking
Here at 10almonds we love addressing misconceptions in the health world.
When it comes to eating habits and fasting, we’ve written our own pieces on how to break your fast (otherwise known as break-fast, or breakfast), alongside a general breakdown of intermittent fasting, and a much-requested piece on fasting specifically for women.
Cynthia Thurlow, though, instead of just writing a few articles, has dedicated the majority of her working years to intermittent fasting and, in her TEDx talk (below), makes a strong argument challenging the long-held belief that breakfast is the most important meal of the day.
Cynthia Thurlow’s Two Main Points
Thurlow argues that it’s not what you eat but when you eat that has a more profound impact on health and aging. And she argues this is crucial regardless of your age.
Complementing her views on fasting are her views on snacking; she argues that snacking all day long is outdated advice and can overtax the digestive system, leading to various health issues.
Practical Tips for Starting Intermittent Fasting
To begin intermittent fasting, Thurlow suggests starting with a 12-13 hour fasting window and gradually increasing it to 16 hours.
In terms of food choice, she recommends eating whole, unprocessed foods during eating periods as well as staying well-hydrated with water, coffee, or tea.
But you won’t see results immediately; Thurlow advises giving the strategy a solid 30 days to see results and consulting a healthcare provider if there are any existing health conditions.
You can dive deeper and join the 15 million other people who have listened to her thoughts on fasting by watching her TEDx talk below:
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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The Lymphatic System Against Cancer & More
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Ask Not What Your Lymphatic System Can Do For You…
Just kidding; we’ll cover that first, as it’s definitely not talked about enough.
The lymphatic system is the system in the body that moves lymph around. It’s made of glands, nodes, and vessels:
- The glands (such as the tonsils and the adenoids) and nodes filter out bacteria and produce white blood cells. Specific functions may be, well, specialized—beyond the scope of today’s article—but that’s the broad function.
- The vessels are the tubes that allow those things to be moved around, suspended in lymph.
What’s lymph? It’s a colorless water-like liquid that transports immune cells, nutrients (and waste) around the body (through the lymphatic system).
Yes, it works alongside your vasculature; when white blood cells aren’t being deployed en masse into your bloodstream to deal with some threat, they’re waiting in the wings in the lymphatic system.
While your blood is pumped around by your heart, lymph moves based on a variety of factors, including contractions of small specialized lymphatic muscles, the pressure gradient created by the combination of those and gravity, and the movements of your body itself.
Here’s a larger article than we have room for, with diagrams we also don’t have room for:
Modelling the lymphatic system
To oversimplify it in few words for the sake of moving on: you can most of the time: think of it as an ancillary network supporting your circulatory system that unlike blood, doesn’t deal with oxygen or sugars, but does deal with a lot of other things, including:
- water and salt balance
- immune cells and other aspects of immune function
- transports fats (and any fat-soluble vitamins in them) into circulation
- cleans up stuff that gets stuck between cells
- general detoxification
There’s a lot that can go wrong if lymph isn’t flowing as it should
Too much to list here, but to give an idea:
- Arthritis and many autoimmune diseases
- Cardiovascular disease and metabolic syndrome
- Obesity, diabetes, and organ failure
- Alzheimer’s and other dementias
- Lymphadenitis, lymphangitis, and lymphedenopathy
- Lymphomas and Hodgkin’s disease (both are types of lymphatic cancer)
- Cancers of other kinds, because of things not being cleaned up where and when they should be
Yikes! That’s a lot of important things for a mostly-forgotten system to be taking care of protecting us from!
What you can do for your lymphatic system, to avoid those things!
Happily, there are easy things we can do to give our lymph some love, such as:
Massage therapy (and foam rolling)
This is the go-to that many people/publications recommend. It’s good! It’s certainly not the most important thing to do, but it’s good.
You can even use a simple gadget like this one to help move the lymph around, without needing to learn arcane massage techniques.
Exercise (move your body!)
This is a lot more important. The more we move our body, the more lymph moves around. The more lymph moves around today, the more easily it will move around tomorrow. A healthy constant movement of lymph throughout the lymphatic system is key to keeping everything running smoothly.
If you pick only one kind of exercise, make it High-Intensity Interval Training (HIIT):
How To Do HIIT (Without Wrecking Your Body)
If for some reason you really can’t do that, just spend as much of your waking time as reasonably possible, moving, per:
For ideas on how to do that, check out…
Get thee to a kitchen
This is about getting healthy food that gives your body’s clean-up crew (the lymphatic system) an easier time of it.
Rather than trying to “eat clean” which can be a very nebulous term and it’s often not at all clear (and/or hotly debated) what counts as “clean”, instead, stick to foods that constitute an anti-inflammatory diet:
Take care!
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Vaping: A Lot Of Hot Air?
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Vaping: A Lot Of Hot Air?
Yesterday, we asked you for your (health-related) opinions on vaping, and got the above-depicted, below-described, set of responses:
- A little over a third of respondents said it’s actually more dangerous than smoking
- A little under a third of respondents said it’s no better nor worse, just different
- A little over 10% of respondents said it’s marginally less harmful, but still very bad
- A little over 10% of respondents said it’s a much healthier alternative to smoking
So what does the science say?
Vaping is basically just steam inhalation, plus the active ingredient of your choice (e.g. nicotine, CBD, THC, etc): True or False?
False! There really are a lot of other chemicals in there.
And “chemicals” per se does not necessarily mean evil green glowing substances that a comicbook villain would market, but there are some unpleasantries in there too:
- Potential harmful health effects of inhaling nicotine-free shisha-pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol
- Inflammatory and Oxidative Responses Induced by Exposure to Commonly Used e-Cigarette Flavoring Chemicals and Flavored e-Liquids without Nicotine
So, the substrate itself can cause irritation, and flavorings (with cinnamaldehyde, the cinnamon flavoring, being one of the worst) can really mess with our body’s inflammatory and oxidative responses.
Vaping can cause “popcorn lung”: True or False?
True and False! Popcorn lung is so-called after it came to attention when workers at a popcorn factory came down with it, due to exposure to diacetyl, a chemical used there.
That chemical was at that time also found in most vapes, but has since been banned in many places, including the US, Canada, the EU and the UK.
Vaping is just as bad as smoking: True or False?
False, per se. In fact, it’s recommended as a means of quitting smoking, by the UK’s famously thrifty NHS, that absolutely does not want people to be sick because that costs money:
Of course, the active ingredients (e.g. nicotine, in the assumed case above) will still be the same, mg for mg, as they are for smoking.
Vaping is causing a health crisis amongst “kids nowadays”: True or False?
True—it just happens to be less serious on a case-by-case basis to the risks of smoking.
However, it is worth noting that the perceived harmlessness of vapes is surely a contributing factor in their widespread use amongst young people—decades after actual smoking (thankfully) went out of fashion.
On the other hand, there’s a flipside to this:
Flavored vape restrictions lead to higher cigarette sales
So, it may indeed be the case of “the lesser of two evils”.
Want to know more?
For a more in-depth science-ful exploration than we have room for here…
BMJ | Impact of vaping on respiratory health
Take care!
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Reasons to Stay Alive – by Matt Haig
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We’ve previously reviewed Matt Haig’s (excellent) The Comfort Book, and now it’s time for his more famous book: Reasons To Stay Alive. So, what’s this one, beyond the obvious?
It narrates the experience of anxiety, depression, and suicidality, and discovering how to find beauty and joy in the world despite it all. It’s not that the author found a magical cure—he still experiences depression and anxiety (cannot speak for suicidality) but he knows now how to manage it, and live his life.
You may be wondering: is this book instructional; is it reproducible, or is it just an autobiography? It’s centered around his own experience and learnings, but it gives a huge sense of not feeling alone, of having hope, and it gives a template for making sense of one’s own experience, even if every person will of course have some points of differences, the commonalities are nonetheless of immense value.
The writing style is similar to The Comfort Book; it’s lots of small chapters, and all very easy-reading. Well, the subject matter is sometimes rather heavy, but the language is easy-reading! In other words, just the thing for when one is feeling easily overwhelmed, or not feeling up to reading a lot.
Bottom line: whether or not you suffer with anxiety and/or depression, whether or not you sometimes feel suicidal, the contents of this book are important, valuable insights for everyone.
Click here to check out Reasons To Stay Alive, and see through the highs and lows of life.
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Hack Your Hunger
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When it comes to dealing with hunger, a common-sense way of dealing with it is “eat something”. However, many people find that they then eat the wrong things, in the wrong quantities, and end up in a cycle of overeating and being hungry.
If this gets to the extreme, it can turn into a full-blown eating disorder:
Eating Disorders: More Varied (And Prevalent) Than People Think
…and even in more moderate presentations, the cycle of hunger and overeating is not great for the health. So, how to avoid that?
Listen to your body (but: actually listen)
Your body says: we’re running a little low on glycogen reserves so our energy’s going to start suffering in a few hours if we don’t eat some fruit, kill something and eat its fatty organs, or perhaps find some oily nuts.
You hear: eat something bright and sugary, shout at the dog, eat some fried food, got it!
Your body says: our water balance is a little off, we could do with some sodium, potassium, and perhaps some phosphorus to correct it.
You hear: eat something salty, got it, potato chips coming right up!
…and so on. Now, we know 10almonds readers are quite a health-conscious readership, so perhaps your responses are not quite like that. But the take-away point is still important: we need to listen to the whole message, and give the body what it actually needs, not what will just shut the message off the most quickly.
Here’s how: Intuitive Eating Might Not Be What You Think
Bonus: Interoception: Improving Our Awareness Of Body Cues
About those cravings…
As illustrated a little above, a lot of cravings might not be what they first appear, and in evolutionary terms, our body is centuries behind industrialization, in terms of adaptations, which means that even if we try to take the above into account, our responses can sometimes be inappropriate in the age of supermarkets.
See also: The Science of Hunger, And How To Sate Cravings
Natural appetite suppressants
Eating more is not always the answer, not even if it’s more healthy food. And hunger pangs can be especially inconvenient if, for example, we are fasting at present, which is by the way a very healthful thing for most people:
Learn more: Intermittent Fasting: What’s the truth?
One way to suppress hunger is simply to trigger the stomach into sending “full” signals, which involves filling it. Since you do not want to overeat, the trick here is imply to use high-volume food.
Consider for example: 30 grapes and 30 raisins have approximately the same calorie count (what with raisins being dried grapes, and the calories didn’t evaporate), but the bowl of fresh fruit is going to physically fill your stomach a lot more quickly than the tiny amount of dried fruit.
More on this: Some Surprising Truths About Hunger And Satiety
Protein is of course also an appetite suppressant, but it takes about 20 minutes for the signal to kick in. So a “hack” here is to snack on something proteinous at least 15 minutes before your main meal (for example, a portion of nuts while cooking, unless you’re allergic, or some dried fish unless you’re vegetarian/vegan; you get it, pick something high in protein and good for snacking, and have a small portion before your main meal).
Nor is protein the only option!
See also: 3 Natural Appetite Suppressants Better Than Ozempic
Scale it down
Related to the above, there is a feedback loop that occurs here. The more you eat, the more your stomach slowly grows to accommodate it; the less you eat, the more your stomach slowly shrinks because the body tries hard to be an efficient organism, and will not maintain something that isn’t being used.
So, there’s a bit of a catch-22; sate your hunger by filling your stomach with high volume foods, but filling it will cause it to grow?
The trick is: do the “eat until 80% full” thing. That’s full enough that you have had a nice meal and are not suffering, without stretching the stomach.
Enjoy your food
Seriously! Actually enjoy it. Which means paying full attention to it. Eating can and should be a wonderful experience, so it’s best savored rather than inhaling a bowl of something in 30 seconds.
Have you seen those dog bowls that have obstructions to slow down how quickly a dog eats? We can leverage that kind of trick too! While you might not want to eat from a dog bowl, how about having a little bowl of pistachio nuts rather than ready-to-eat peanuts? Or any shelled nuts that we must shell as we go. If you’re allergic to nuts, there are plenty of other foods with a high work-to-food ratio. Take some time and enjoy that pomegranate, for instance!
Not that we necessarily have to make things difficult for ourselves either; we can just take appropriate care to ensure a good dining experience. Life is for living, so why not enjoy it?
See also: Mindful Eating: How To Get More Out Of What’s On Your Plate
Enjoy!
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Two Things You Can Do To Improve Stroke Survival Chances
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Dr. Andrew’s Stroke Survival Guide
This is Dr. Nadine Andrew. She’s a Senior Research Fellow in the Department of Medicine at Monash University. She’s the Research Data Lead for the National Center of Healthy Aging. She is lead investigator on the NHMRC-funded PRECISE project… The most comprehensive stroke data linkage study to date! In short, she knows her stuff.
We’ve talked before about how sample size is important when it comes to scientific studies. It’s frustrating; sometimes we see what looks like a great study until we notice it has a sample size of 17 or something.
Dr. Andrew didn’t mess around in this regard, and the 12,386 participants in her Australian study of stroke patients provided a huge amount of data!
With a 95% confidence interval because of the huge dataset, she found that there was one factor that reduced mortality by 26%.
And the difference was…
Whether or not patients had a chronic disease management plan set up with their GP (General Practitioner, or “family doctor”, in US terms), after their initial stroke treatment.
45% of patients had this; the other 55% did not, so again the sample size was big for both groups.
Why this is important:
After a stroke, often a patient is discharged as early as it seems safe to do so, and there’s a common view that “it just takes time” and “now we wait”. After all, no medical technology we currently have can outright repair that damage—the body must repair itself! Medications—while critical*—can only support that and help avoid recurrence.
*How critical? VERY critical. Critical critical. Dr. Andrew found, some years previously, that greater levels of medication adherence (ie, taking the correct dose on time and not missing any) significantly improved survival outcomes. No surprise, right? But what may surprise is that this held true even for patients with near-perfect adherence. In other words: miss a dose at your peril. It’s that important.
But, as Dr. Andrew’s critical research shows, that’s no reason to simply prescribe ongoing meds and otherwise cut a patient loose… or, if you or a loved one are the patient, to allow yourself/them to be left without a doctor’s ongoing active support in the form of a chronic disease management plan.
What does a chronic disease management plan look like?
First, what it’s not:
- “Yes yes, I’m here if you need me, just make an appointment if something changes”
- “Let’s pencil in a check-up in three months”
- Etc
What it actually looks like:
It looks like a plan. A personal care plan, built around that person’s individual needs, risks, liabilities… and potential complications.
Because who amongst us, especially at the age where strokes are more likely, has an uncomplicated medical record? There will always be comorbidities and confounding factors, so a one-size-fits-all plan will not do.
Dr. Andrew’s work took place in Australia, so she had the Australian healthcare system in mind… We know many of our subscribers are from North America and other places. But read this, and you’ll see how this could go just as much for the US or Canada:
❝The evidence shows the importance of Medicare financially supporting primary care physicians to provide structured chronic disease management after a stroke.
We also provide a strong case for the ongoing provision of these plans within a universal healthcare system. Strategies to improve uptake at the GP level could include greater financial incentives and mandates, education for patients and healthcare professionals.❞
See her groundbreaking study for yourself here!
The Bottom Line:
If you or a loved one has a stroke, be prepared to make sure you get a chronic health management plan in place. Note that if it’s you who has the stroke, you might forget this or be unable to advocate for yourself. So, we recommend to discuss this with a partner or close friend sooner rather than later!
“But I’m quite young and healthy and a stroke is very unlikely for me”
Good for you! And the median age of Dr. Andrew’s gargantuan study was 70 years. But:
- do you have older relatives? Be aware for them, too.
- strokes can happen earlier in life too! You don’t want to be an interesting statistic.
Some stroke-related quick facts:
Stroke is the No. 5 cause of death and a leading cause of disability in the U.S.
Stroke can happen to anyone—any age, any time—and everyone needs to know the warning signs.
On average, 1.9 million brain cells die every minute that a stroke goes untreated.
Stroke is an EMERGENCY. Call 911 immediately.
Early treatment leads to higher survival rates and lower disability rates. Calling 911 lets first responders start treatment on someone experiencing stroke symptoms before arriving at the hospital.
Source: https://www.stroke.org/en/about-stroke
What are the warning signs for stroke?
Use the letters F.A.S.T. to spot a stroke and act quickly:
- F = Face Drooping—does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
- A = Arm Weakness—is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- S = Speech Difficulty—is speech slurred?
- T = Time to call 911
Source: https://www.stroke.org/en/about-stroke/stroke-symptoms
Last but not least, while we’re sharing resources:
Download the PDF Checklist: 8 Ways To Help Prevent a Second Stroke
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