The Breathing Cure – by Patrick McKeown

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We’ve previously reviewed this author’s “The Oxygen Advantage”, which as you might guess from the title, was also about breathing. So, what’s different here?

While The Oxygen Advantage was mostly about improving good health with optimized breathing, and with an emphasis on sports too, The Breathing Cure is more about the two-way relationship between ill health and disordered breathing (and how to fix it).

Many kinds of illnesses can affect our breathing, and our breathing can affect many types of illness; McKeown covers a lot of these, including the obvious things like respiratory diseases (including COVID and Long COVID, as well as non-infectious respiratory conditions like asthma), but also things like diabetes and heart disease, as well as peri-disease things like chronic pain, and demi-disease things like periods and menopause.

In each case (and more), he examines what things make matters better or worse, and how to improve them.

While the style itself is just as pop-science as The Oxygen Advantage, this time it relies less on anecdote (though there are plenty of anecdotes too), and leans more heavily on a generous chapter-by-chapter scientific bibliography, with plenty of citations to back up claims.

Bottom line: if you’d like to breathe better, this book can help in very many ways.

Click here to check out The Breathing Cure, and breathe easy!

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Recommended

  • The Power Foods Diet – by Dr. Neal Barnard
  • Food for Thought – by Lorraine Perretta
    Upgrade your brain health with “Food for Thought.” Discover 50 brain-healthy recipes and the science behind ingredients that boost memory, cognition, and more.

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  • What You Should Have Been Told About The Menopause Beforehand

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    What You Should Have Been Told About Menopause Beforehand

    Dr. Jen Gunter provides important information on menopause.

    This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.

    When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?

    And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!

    So, what does Dr. Gunter want us to know?

    It’s a time of changes, not an end

    The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.

    And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.

    Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and not to mention but we’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).

    However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.

    Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.

    Bridges can be dangerous to cross! But they can also get us safely where we’re going.

    Ok, so how do we manage those things?

    Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.

    See also: Meet Goop’s Number One Enemy

    For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).

    This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.

    Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.

    To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:

    Dr. Gunter’s Guide To The Hormone Menoverse

    What about natural therapies?

    There are some non-hormonal things that work, but these are mostly things that:

    • give a statistically significant reduction in symptoms
    • give the same statistically significant reduction in symptoms as placebo

    As Dr. Gunter puts it:

    ❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.

    In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.

    Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”

    You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞

    ~ Gunter, 2023

    However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!

    For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:

    Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended

    Want to know more?

    Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.

    Enjoy!

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  • Who you are and where you live shouldn’t determine your ability to survive cancer

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    In Canada, nearly everyone has a cancer story to share. It affects one in every two people, and despite improvements in cancer survivorship, one out of every four people affected by cancer still will die from it.

    As a scientist dedicated to cancer care, I work directly with patients to reimagine a system that was never designed for them in the first place – a system in which your quality of care depends on social drivers like your appearance, your bank statements and your postal code.

    We know that poverty, poor nutrition, housing instability and limited access to education and employment can contribute to both the development and progression of cancer. Quality nutrition and regular exercise reduce cancer risk but are contingent on affordable food options and the ability to stay active in safe, walkable neighbourhoods. Environmental hazards like air pollution and toxic waste elevate the risk of specific cancers, but are contingent on the built environment, laws safeguarding workers and the availability of affordable housing.

    On a health-system level, we face implicit biases among care providers, a lack of health workforce competence in addressing the social determinants of health, and services that do not cater to the needs of marginalized individuals.

    Indigenous peoples, racialized communities, those with low income and gender diverse individuals face the most discrimination in health care, resulting in inadequate experiences, missed diagnosis and avoidance of care. One patient living in subsidized housing told me, “You get treated like a piece of garbage – you come out and feel twice as bad.”

    As Canadians, we benefit from a taxpayer funded health-care system that encompasses cancer care services. The average Canadian enjoys a life expectancy of more than 80 years and Canada boasts high cancer survival rates. While we have made incredible strides in cancer care, we must work together to ensure these benefits are equally shared amongst all people in Canada. We need to redesign systems of care so that they are:

    1. Anti-oppressive. We must begin by understanding and responding to historical and systemic racism that shapes cancer risk, access to care and quality of life for individuals facing marginalizing conditions. Without tackling the root causes, we will never be able to fully close the cancer care gap. This commitment involves undoing intergenerational trauma and harm through public policies that elevate the living and working conditions of all people.
    2. Patient-centric. We need to prioritize patient needs, preferences and values in all aspects of their health-care experience. This means tailoring treatments and services to individual patient needs. In policymaking, it involves creating policies that are informed by and responsive to the real-life experiences of patients. In research, it involves engaging patients in the research process and ensuring studies are relevant to and respectful of their unique perspectives and needs. This holistic approach ensures that patients’ perspectives are central to all aspects of health care.
    3. Socially just. We must strive for a society in which everyone has equal access to resources, opportunities and rights, and systemic inequalities and injustices are actively challenged and addressed. When redesigning the cancer care system, this involves proactive practices that create opportunities for all people, particularly those experiencing the most marginalization, to become involved in systemic health-care decision-making. A system that is responsive to the needs of the most marginalized will ultimately work better for all people.

    Who you are, how you look, where you live and how much money you make should never be the difference between life and death. Let us commit to a future in which all people have the resources and support to prevent and treat cancer so that no one is left behind.

    This article is republished from HealthyDebate under a Creative Commons license. Read the original article.

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  • Should We Skip Shampoo?

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    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝What’s the science on “no poo”? Is it really better for hair? There are so many mixed reports out there.❞

    First, for any unfamiliar: this is not about constipation; rather, it is about skipping shampoo, and either:

    • Using an alternative cleaning agent, such as vinegar and/or sodium bicarbonate
    • Using nothing at all, just conditioner when wet and brushing when dry

    Let’s examine why the trend became a thing: the thinking went “shampoo does not exist in nature, and most of our body is more or less self-cleaning; shampoos remove oils from hair, and the body has to produce more sebum to compensate, resulting in a rapid cycle of dry and greasy hair”.

    Now let’s fact-check each of those:

    • shampoo does not exist in nature: true (except in the sense that everything that exists can be argued to exist in nature, since nature encompasses everything—but the point is that shampoo is a purely artificial human invention)
    • most of our body is more or less self-cleaning: true, but our hair is not, for the same reason our nails are not: they’re not really a living part of the overall organism that is our body, so much as a keratinous protrusion of neatly stacked and hardened dead cells from our body. Dead things are not self-cleaning.
    • shampoos remove oils from hair: true; that is what they were invented for and they do it well
    • the body has to produce more sebum to compensate, resulting in a rapid cycle of dry and greasy hair: false; or at least, there is no evidence for this.

    Our hair’s natural oils are great at protecting it, and also great at getting dirt stuck in it. For the former reason we want the oil there; for the latter reason, we don’t.

    So the trick becomes: how to remove the oil (and thus the dirt stuck in it) and then put clean oil back (but not too much, because we don’t want it greasy, just, shiny and not dry)?

    The popular answer is: shampoo to clean the hair, conditioner to put an appropriate amount of oil* back.

    *these days, mostly not actually oil, but rather silicon-based substitutes, that do the same job of protecting hair and keeping it shiny and not brittle, without attracting so much dirt. Remember also that silicon is inert and very body safe; its molecules are simply too large to be absorbed, which is why it gets used in hair products, some skin products, and lube.

    See also: Water-based Lubricant vs Silicon-based Lubricant – Which is Healthier?

    If you go “no poo”, then what will happen is either you dry your hair out much worse by using vinegar or (even worse) bicarbonate of soda, or you just have oil (and any dirt stuck in it) in your hair for the life of the hair. As in, each individual strand of hair has a lifespan, and when it falls out, the dirt will go with it. But until that day, it’s staying with you, oil and dirt and all.

    If you use a conditioner after using those “more natural” harsh cleaners* that aren’t shampoo, then you’ll undo a lot of the damage done, and you’ll probably be fine.

    *in fact, if you’re going to skip shampoo, then instead of vinegar or bicarbonate of soda, dish soap from your kitchen may actually do less damage, because at least it’s pH-balanced. However, please don’t use that either.

    If you’re going to err one way or the other with regard to pH though, erring on the side of slightly acidic is much better than slightly alkaline.

    More on pH: Journal of Trichology | The Shampoo pH can Affect the Hair: Myth or Reality?

    If you use nothing, then brushing a lot will mitigate some of the accumulation of dirt, but honestly, it’s never going to be clean until you clean it.

    Our recommendation

    When your hair seems dirty, and not before, wash it with a simple shampoo (most have far too many unnecessary ingredients; it just needs a simple detergent, and the rest is basically for marketing; to make it foam completely unnecessarily but people like foam, to make it thicker so it feels more substantial, to make it smell nice, to make it a color that gives us confidence it has ingredients in it, etc).

    Then, after rinsing, enjoy a nice conditioner. Again there are usually a lot of unnecessary ingredients, but an argument can be made this time for some being more relevant as unlike with the shampoo, many ingredients are going to remain on your hair after rinsing.

    Between washes, if you have long hair, consider putting some hair-friendly oil (such as argan oil or coconut oil) on the tips daily, to avoid split ends.

    And if you have tight curly hair, then this advice goes double for you, because it takes a lot longer for natural oils to get from your scalp to the ends of your hair. For those of us with straight hair, it pretty much zips straight on down there within a day or two; not so if you have beautiful 4C curls to take care of!

    For more on taking care of hair gently, check out:

    Gentler Hair Care Options, According To Science

    Take care!

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Related Posts

  • The Power Foods Diet – by Dr. Neal Barnard
  • How To Avoid UTIs

    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.

    Psst… A Word To The Wise

    Urinary Tract Infections (UTIs) can strike at any age, but they get a lot more common as we get older:

    • About 10% of women over 65 have had one
    • About 30% of women over 85 have had one

    Source: Urinary tract infection in older adults

    Note: those figures are almost certainly very underreported, so the real figures are doubtlessly higher. However, we print them here as they’re still indicative of a disproportionate increase in risk over time.

    What about men?

    Men do get UTIs too, but at a much lower rate. The difference in average urethra length means that women are typically 30x more likely to get a UTI.

    However! If a man does get one, then assuming the average longer urethra, it will likely take much more treatment to fix:

    Case study: 26-Year-Old Man With Recurrent Urinary Tract Infections

    Risk factors you might want to know about

    While you may not be able to do much about your age or the length of your urethra, there are some risk factors that can be more useful to know:

    Catheterization

    You might logically think that having a catheter would be the equivalent of having a really long urethra, thus keeping you safe, but unfortunately, the opposite is true:

    Read more: Review of Catheter-Associated Urinary Tract Infections

    Untreated menopause

    Low estrogen levels can cause vaginal tissue to dry, making it easier for pathogens to grow.

    For more information on menopausal HRT, see:

    What You Should Have Been Told About Menopause Beforehand

    Sexual activity

    Most kinds of sexual activity carry a risk of bringing germs very close to the urethra. Without wishing to be too indelicate: anything that’s going there should be clean, so it’s a case for washing your hands/partner(s)/toys etc.

    For the latter, beyond soap and water, you might also consider investing in a UV sanitizer box ← This example has a 9” capacity; if you shop around though, be sure to check the size is sufficient!

    Kidney stones and other kidney diseases

    Anything that impedes the flow of urine can raise the risk of a UTI.

    See also: Keeping Your Kidneys Healthy (Especially After 60)

    Diabetes

    How much you can control this one will obviously depend on which type of diabetes you have, but diabetes of any type is an immunocompromizing condition. If you can, managing it as well as possible will help many aspects of your health, including this one.

    More on that:

    How To Prevent And Reverse Type 2 Diabetes

    Note: In the case of Type 1 Diabetes, the above advice will (alas) not help you to prevent or reverse it. However, reducing/avoiding insulin resistance is even more important in cases of T1D (because if your exogenous insulin stops working, you die), so the advice is good all the same.

    How do I know if I have a UTI?

    Routine screening isn’t really a thing, since the symptoms are usually quite self-evident. If it hurts/burns when you pee, the most likely reason is a UTI.

    Get it checked out; the test is a (non-invasive) urinalysis test. In other words, you’ll give a urine sample and they’ll test that.

    Anything else I can do to avoid it?

    Yes! We wrote previously about the benefits of cranberry supplementation, which was found even to rival antibiotics:

    ❝…recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the [need for] administration of antibiotics❞

    ~ Luís et al. (2017)

    Read more: Health Benefits Of Cranberries

    Take care!

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  • What Too Much Exercise Does To Your Body And Brain

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    “Get more exercise” is a common rallying-cry for good health, but it is possible to overdo it. And, this is not just a matter of extreme cases of “exercise addiction”, but even going much above certain limits can already result in sabotaging one’s healthy gains. But how, and where does the line get drawn?

    Too Much Of A Good Thing

    The famous 150 minutes per week of moderate exercise (or 75 minutes of intense exercise) is an oft-touted figure. This video, on the other hand, springs for 5 hours of moderate exercise or 2.5 hours intense exercise as a good guideline.

    We’re advised that going over those guidelines doesn’t necessarily increase health benefits, and on the contrary, may reduce or even reverse them. For example, we are told…

    • Light to moderate running reduces the risk of death, but running intensely more than 3 times a week can negate these benefits.
    • Extreme endurance exercises, like ultra-marathons, may cause heart damage, heart rhythm disorders, and artery enlargement.
    • Women who exercise strenuously every day have a higher risk of heart attacks and strokes compared to those who exercise moderately.
    • Excessive exercise in women can lead to the “female athlete triad” (loss of menstruation, osteoporosis, and eating disorders).
    • In men, intense exercise can lower libido due to fatigue and reduced testosterone levels.
    • Both men and women are at increased risk of overuse injuries (e.g., tendinitis, stress fractures) and impaired immunity from excessive exercise.
    • There is a 72-hour window of impaired immunity after intense exercise, increasing the risk of infections.

    Exercise addiction is rare, though, with this video citing “around 1 million people in the US suffer from exercise addiction”.

    For more on finding the right balance, 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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  • Calculate (And Enjoy) The Perfect Night’s Sleep

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    This is Dr. Michael Breus, a clinical psychologist and sleep specialist, and he wants you to get a good night’s sleep, every night.

    First, let’s assume you know a lot of good advice about how to do that already in terms of environment and preparation, etc. If you want a recap before proceeding, then we recommend:

    Get Better Sleep: Beyond The Basics

    Now, what does he want to add?

    Wake up refreshed

    Of course, how obtainable this is will depend on the previous night’s sleep, but there is something important we can do here regardless, and it’s: beat sleep inertia.

    Sleep inertia is what happens when we wake up groggy (for reasons other than being ill, drugged, etc) rather than refreshed. It’s not actually related to how much sleep we have, though!

    Rather, it pertains to whether we woke up during a sleep cycle, or between cycles:

    • If we wake up between sleep cycles, we’ll avoid sleep inertia.
    • If we wake up during a sleep cycle, we’ll be groggy.

    Deep sleep generally occurs in 90-minute blocks, albeit secretly that is generally 3× 20 minute blocks in a trenchcoat, with transition periods between, during which the brainwaves change frequency.

    REM sleep generally occurs in 20 minute blocks, and will usually arrive in series towards the end of our natural sleep period, to fit neatly into the last 90-minute cycle.

    Sometimes these will appear a little out of order, because we are complicated organic beings, but those are the general trends.

    In any case, the take-away here is: interrupt them at your peril. You need to wake up between cycles. There are two ways you can do this:

    1. Carefully calculate everything, and set a very precise alarm clock (this will work so long as you are correct in guessing how long it will take you to fall asleep)
    2. Use a “sunrise” lamp alarm clock, that in the hour approaching your set alarm time, will gradually increase the light. Because the body will not naturally wake up during a cycle unless a threat is perceived (loud noise, physical rousing, etc), the sunrise lamp method means that you will wake up between sleep cycles at some point during that hour (towards the beginning or end, depending on what your sleep balance/debt is like).

    Do not sleep in (even if you have a sleep debt); it will throw everything out.

    Caffeine will not help much in the morning

    Assuming you got a reasonable night’s sleep, your brain has been cleansed of adenosine (a sleepy chemical), and if you are suffering from sleep inertia, the grogginess is due to melatonin (a different sleepy chemical).

    Caffeine is an adenosine receptor blocker, so that will do nothing to mitigate the effects of melatonin in your brain that doesn’t have any meaningful quantity of adenosine in it in the morning.

    Adenosine gradually accumulates in the brain over the course of the day (and then gets washed out while we sleep), so if you’re sleepy in the afternoon (for reasons other than: you just had a nap and now have sleep inertia again), then caffeine can block that adenosine in the afternoon.

    Of course, caffeine is also a stimulant (it increases adrenaline levels and promotes vasoconstriction), but its effects at healthily small doses are modest for most people, and you’d do better by splashing cold water on your face and/or listening to some upbeat music.

    Learn more: The Two Sides Of Caffeine

    Time your naps correctly (if you take naps)

    Dr. Breus has a lot to say about this, based on a lot of clinical research, but as it’s entirely consistent with what we’ve written before (based on the exact same research), to save space we’ll link to that here:

    How To Be An Expert Nap-Artist (With No “Sleep-Hangovers”)

    Calculate your bedtime correctly

    Remember what we said about sleep cycles? This means that that famous “7–9 hours sleep” is actually “either 7½ or 9 hours sleep”—because those are multiples of 90 minutes, whereas 8 hours (for example) is not.

    So, consider the time you want to get up (ideally, this should be relatively early, and the same time every day), and then count backwards either 7½ or 9 hours sleep (you choose), add 20–30 minutes to fall asleep, and that’s your bedtime.

    So for example: if you want to have 7½ hours sleep and get up at 6am, then your bedtime is anywhere between 10pm and 10:10pm.

    Remember how we said not to sleep in, even if you have a sleep debt? Now is the time to pay it off, if you have one. If you normally sleep 7½ hours, then make tonight a 9-hour sleep (plus 20–30 minutes to fall asleep). This means you’ll still get up at 6am, but your bedtime is now anywhere between 8:30pm and 8:40pm.

    Want to know more from Dr. Breus?

    You might like this excellent book of his that we reviewed a while back:

    The Power of When – by Dr. Michael Breus

    Enjoy!

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