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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Radical Longevity – by Dr. Ann Gittleman
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Dr. Gittleman takes a comprehensive approach, advising us about avoiding AGEs, freeing up fascia, stimulating cellular rejuvenation, the mind-gut connection, keeping the immune system healthy, and more.
The “plan” promised by the subtitle involves identifying the key factors of nutrition and lifestyle most impactful to you, and adjusting them accordingly, in a multistep, author-walks-the-reader-by-the-hand process.
There’s also, for those who prefer it, a large section (seven chapters) on a body part/system by body part/system approach, e.g. brain health, heart health, revitalizing skin, reversing hair loss, repairing bones, muscles, joints, etc.
The writing style is quite casual,butalso with a mind to education, with its call-out boxes, bullet-point summaries, and so forth. There is a “select references” section, but if one wants to find studies, it’s often necessary to go looking, as there aren’t inline citations.
Bottom line: we’d love to see better referencing, but otherwise this is a top-tier anti-aging book, and a lot more accessible than most, without skimping on depth and breadth.
Click here to check out Radical Longevity, and get rejuvenating radically!
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Flexible Dieting – by Alan Aragon
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This is the book from which we were working, for the most part, in our recent Expert Insights feature with Alan Aragon. We’ll re-iterate here: despite not being a Dr. Aragon, he’s a well-published research scientist with decades in the field of nutritional science, as well as being a personal trainer and fitness educator.
As you may gather from our other article, there’s a lot more to this book than “eat what you like”. Specifically, as the title suggests, there’s a lot of science—decades of it, and while we had room to cite a few studies in our article, he cites many many more; several citations per page of a 288-page book.
So, that sets the book apart from a lot of its genre; instead of just “here’s what some gym-bro thinks”, it’s “here’s what decades of data says”.
Another strength of this book is how clearly he explains such a lot of science—he explains terms as they come up, as well as having a generous glossary. He also explains things clearly and simply without undue dumbing down—just clarity of communication.
The style is to-the-point and instructional; it’s neither full of fitness-enthusiast hype nor dry academia, and keeps a light and friendly conversational tone throughout.
Bottom line: if you’d like to get your diet in order and you want to do it right while also knowing which things still need attention (and why) and which you can relax about (and why), then this book will get you there.
Click here to check out Flexible Dieting, and take an easy, relaxed control of yours!
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Oat Milk vs Almond Milk – Which is Healthier?
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Our Verdict
When comparing oat milk to almond milk, we picked the almond milk.
Why?
This one’s quite straightforward, and no, it’s not just our bias for almonds
Rather, almonds contain a lot more vitamins and minerals, all of which usually make it into the milk.
Oat milk is still a fine choice though, and has a very high soluble fiber content, which is great for your heart.
Just make sure you get versions without added sugar or other unpleasantries! You can always make your own at home, too.
You can read a bit more about the pros and cons of various plant milks here:
Enjoy!
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Goji Berries: Which Benefits Do They Really Have?
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Are Goji Berries Really A Superfood?
Goji berries are popularly considered a superfood, and sold for everything from anti-aging effects, to exciting benefits* that would get this email directed to your spam folder if we described them.
*We searched so you don’t have to: there doesn’t seem to be much research to back [that claim that we can’t mention], but we did find one paper on its “invigorating” benefits for elderly male rats. We prefer to stick to human studies where we can!
So how does the science stack up for the more mainstream claims?
Antioxidant effects
First and most obvious for this fruit that’s full of helpful polysaccharides, carotenoids, phenolic acids, and flavonoids, yes, they really do have strong antioxidant properties:
Immune benefits
Things that are antioxidant are generally also anti-inflammatory, and often have knock-on benefits for the immune system. That appears to be the case here.
For example, in this small-but-statistically-significant study (n=60) in healthy adults (aged 55–72 years)
❝The GoChi group showed a statistically significant increase in the number of lymphocytes and levels of interleukin-2 and immunoglobulin G compared to pre-intervention and the placebo group, whereas the number of CD4, CD8, and natural killer cells or levels of interleukin-4 and immunoglobulin A were not significantly altered. The placebo group showed no significant changes in any immune measures.
Whereas the GoChi group showed a significant increase in general feelings of well-being, such as fatigue and sleep, and showed a tendency for increased short-term memory and focus between pre- and post-intervention, the placebo group showed no significant positive changes in these measures.❞
“GoChi” here is a brand name for goji berries, and it’s not clear from the abstract whether the company funded the study:
Here’s another study, this time n=150, and ages 65–70 years old. This time it’s with a different brand (“Lacto-Wolfberry”, a milk-with-goji supplement drink) and it’s also unclear whether the company funded the study. However, taking the data at face value:
❝In conclusion, long-term dietary supplementation with Lacto-Wolfberry in elderly subjects enhances their capacity to respond to antigenic challenge without overaffecting their immune system, supporting a contribution to reinforcing immune defense in this population. ❞
In other words: it allowed those who took it to get measurably more benefit from the flu vaccinations that they received, without any ill effects.
Anticancer potential
This one’s less contentious (the immune benefits seemed very credible; we’d just like to see more transparent research to say for sure), so in the more clearly-evidenced case against cancer we’ll just drop a few quick studies, clipped for brevity:
- Goji berry (Lycium barbarum) inhibits the proliferation, adhesion, and migration of oral cancer cells
- A closer look at immunomodulatory properties of goji berries extract in human colon cancer cells
- Lycium barbarum polysaccharides induce apoptosis in human prostate cancer cells and inhibits prostate cancer growth
- Identification of goji berry cyclic peptides and anticervical carcinoma activity
- Antiproliferative effects of Lycium barbarum’s (goji berry) fractions on breast cancer Cell Lines
You get the idea: it helps!
Bonus benefit for the eyes
Goji berries also help against age-related macular degeneration. The research for this is in large part secondary, i.e. goji berries contain things x, y, and z, and then separate studies say that those things help against age-related macular degeneration.
We did find some goji-specific studies though! One of them was for our old friends the “Lacto-Wolfberry” people and again, wasn’t very transparent, so we’ll not take up extra time/space with that one here.
Instead, here’s a much clearer, transparent, and well-referenced study with no conflicts of interest, that found:
❝Overall, daily supplementation with Goji berry for 90d improves MPOD by increasing serum Z levels rather than serum L levels in early AMD patients. Goji berry may be an effective therapeutic intervention for preventing the progression of early AMD.❞
- MPOD = Macular Pigment Optical Density, a standard diagnostic tool for age-related macular degeneration
- AMD = Age-related Macular Degeneration
(that whole paper is very compelling reading, if you have time)
If you want a quicker read, we offer:
How To Avoid Age-Related Macular Degeneration
and also…
Where to get goji berries?
You can probably find them at your local health food store, if not the supermarket. However, if you’d like to buy them online, here’s an example product on Amazon for your convenience
Enjoy!
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Water Bath + More Cookbook for Beginners – by Sarah Roslin
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Whether you want to be prepared for the next major crisis that shuts down food supply chains, or just learn a new skill, this book provides the tools!
Especially beneficial if you also grow your own vegetables, but even you just buy those… Home-canned food is healthy, contains fewer additives and preservatives, and costs less in the long run.
Roslin teaches an array of methods, including most importantly:
- fermentation and pickling
- water bath canning, and
- pressure canning.
As for what’s inside? She covers not just vegetables, but also fruit, seafood, meat… Basically, anything that can be canned.
The book explains the tools and equipment you will need as well as how to perform it safely—as well as common mistakes to avoid!
Lest we be intimidated by the task of acquiring appropriate equipment, she also walks us through what we’ll need in that regard too!
Last but not least, there’s also a (sizeable) collection of simple, step-by-step recipes, catering to a wide variety of tastes.
Bottom line: a highly valuable resource that we recommend heartily.
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The Coffee-Cortisol Connection, And Two Ways To Tweak It For Health
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Health opinions on coffee vary from “it’s an invigorating, healthful drink” to “it will leave you a shaking frazzled wreck”. So, what’s the truth and can we enjoy it healthily? Dr. Alan Mandell weighs in:
Enjoy it, but watch out!
Dr. Mandell is speaking only for caffeinated coffee in this video, and to this end, he’s conflating the health effects of coffee and caffeine. A statistically reasonable imprecision, since most people drink coffee with its natural caffeine in, but we’ll make some adjustment to his comments below, to disambiguate which statements are true for coffee generally, and which are true for caffeine:
- Drinking
coffeecaffeine first thing in the morning may not be ideal due to dehydration from overnight water loss. Coffeecaffeine is a diuretic, which means an increase in urination, thus further dehydrating the body.- Coffee contains great antioxidants, which are of course beneficial for the health in general.
- Cortisol, the body’s stress hormone, is generally at its peak in the morning. This is, in and of itself, good and correct—it’s how we wake up.
Coffeecaffeine consumption raises cortisol levels even more, leading to increased alertness and physical readiness, but it is possible to have too much of a good thing, and in this case, problems can arise because…- Elevated cortisol from early
coffeecaffeine drinking can build tolerance, leading to the need for morecoffeecaffeine over time. - It’s better, therefore, to defer drinking
coffeecaffeine until later in the morning when cortisol levels naturally drop. - All of this means that drinking
coffeecaffeine first thing can disrupt the neuroendocrine system, leading to fatigue, depression, and general woe. - Hydrate first thing in the morning before consuming
coffeecaffeine to keep the body balanced and healthy.
What you can see from this is that coffee and caffeine are not, in fact, interchangeable words, but the basic message is clear and correct: while a little spike of cortisol in the morning is good, natural, and even necessary, a big spike is none of those things, and caffeine can cause a big spike, and since for most people caffeine is easy to build tolerance to, there will indeed consistently be a need for more, worsening the problem.
In terms of hydration, it’s good to have water (or better yet, herbal tea) on one’s nightstand to drink when one wakes up.
If coffee is an important morning ritual for you, consider finding a good decaffeinated version for at least your first cup (this writer is partial to Lavazza’s “Dek Intenso”—which is not the same as their main decaf line, by the way, so do hold out for the “Dek Intenso” if you want to try my recommendation).
Decaffeinated coffee is hydrating and will not cause a cortisol spike (unless for some reason you find coffee as a concept very stressful in which case, yes, the stressor will cause a stress response).
Anyway, for more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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- Drinking
