The Cough Doctor

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The Cough Doctor

This is Dr. Peter Small, who worked in epidemiology since the beginning of HIV epidemic. He became a pioneer in the field of molecular epidemiology. As such, his work was a guiding beacon for the public health response to the resurgence of tuberculosis. He’s travelled the world spending years in various institutions studying all manner of respiratory illnesses…. These have ranged from tuberculosis to pneumonia to lung cancer and (back to epidemiology) Covid-19.

He’s now the Chief Medical Officer at…

Hyfe

Hyfe, a medical AI company, was founded in 2020. Its objective: to build acoustic tools for respiratory diagnostics and monitoring.

In other words: it records coughs and collects data about coughing.

❝It’s ironic how much people focus on counting steps while ignoring cough, which is far more consequential. Hyfe is a science-driven company with the technology to make cough count. Particularly now, with increased awareness of cough and the rapid growth of digital health driven by Covid-19, this technology can improve the lives of patients, the care provided by doctors, and the efficiency of health systems.❞

~ Dr. Peter Small, CMO, Hyfe

How does it do it?

Hyfe’s AI monitors the number of times a person coughs and the sound of the cough through any smartphone or other smart device.

This data collected over time provides increasingly more reliable information than a single visit to the doctor! By constantly listening and analyzing, it can detect patterns that might otherwise go unnoticed.

How big is this “big data” effort?

Hyfe maintains the largest cough dataset in the world. This means it can compare the sound of a patient’s cough with more than 400 million cough-like sounds from 83 countries across all continents.

The human brain doesn’t handle big numbers well. So, just to illustrate: if the average cough is 1 second long, that means it’d take more than 12 years to listen to them all.

Hyfe, meanwhile, can:

  • listen to many things simultaneously
  • index them all against user and location,
  • use its ever-growing neural net to detect and illustrate patterns.

It’s so attentive, that it can learn to distinguish between different people’s coughs in the same household.

❝Companies like Google Health see even basic information such as getting an accurate count of the number of times a person coughs a day as a useful resource, and part of a larger need to collect and chronicle more health information to refine the way doctors diagnose disease and manage treatments in the future.❞

~ Time Magazine

What are the public health implications?

The most obvious application is to note when there’s a spike in coughing, and see how such spikes grow and spread (if they do), to inform of contagion risks.

Another is to cross-reference it with data about local environmental allergens. Knowing how things like pollution and even pollen affect individuals differently could be helpful in identifying (and managing) chronic conditions like asthma.

What are the private health implications?

❝It’s going to transform the whole clinical approach for this common and chronic symptom. Patients will come in, have the data on how much they are coughing, and the physician can suggest a treatment based on that information to see if it makes the coughs better❞

~ Dr. Peter Small

Dr. Small’s colleague Dr. Cai, speaking for Google Health on this project, sees even more utility for diagnostics:

❝When I was in medical school, never ever did they teach us that we could listen to somebody cough and identify whether that person has TB (tuberculosis), COPD, or a tumor. But I keep seeing more and more studies of people coughing into a microphone, and an algorithm can detect whether somebody has TB with 95% specificity and sensitivity, or if someone has pneumonia or an exacerbation of COPD❞

~ Dr. Lawrence Cai

And the privacy implications?

Perhaps you don’t quite fancy the idea of not being able to cough without Google knowing about it. Hyfe’s software is currently opt-in, but…

If you cough near someone else’s Hyfe app, their app will recognize you’re not the app’s user, and start building a profile for you. Of course, that won’t be linked to your name, email address, or other IDs, as it would if you were the app’s user.

Hyfe will ask to connect to your social media, to collect more information about you and your friends.

Whether you’d like to try this or perhaps you’re just curious to learn more about this fascinating project, you can check out:

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  • They Were Injured at the Super Bowl Parade. A Month Later, They Feel Forgotten.

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    KFF Health News and KCUR are following the stories of people injured during the Feb. 14 mass shooting at the Kansas City Chiefs Super Bowl celebration. Listen to how one Kansas family is coping with the trauma.

    Jason Barton didn’t want to attend the Super Bowl parade this year. He told a co-worker the night before that he worried about a mass shooting. But it was Valentine’s Day, his wife is a Kansas City Chiefs superfan, and he couldn’t afford to take her to games since ticket prices soared after the team won the championship in 2020.

    So Barton drove 50 miles from Osawatomie, Kansas, to downtown Kansas City, Missouri, with his wife, Bridget, her 13-year-old daughter, Gabriella, and Gabriella’s school friend. When they finally arrived home that night, they cleaned blood from Gabriella’s sneakers and found a bullet in Bridget’s backpack.

    Gabriella’s legs were burned by sparks from a ricocheted bullet, Bridget was trampled while shielding Gabriella in the chaos, and Jason gave chest compressions to a man injured by gunfire. He believes it was Lyndell Mays, one of two men charged with second-degree felony murder.

    “There’s never going to be a Valentine’s Day where I look back and I don’t think about it,” Gabriella said, “because that’s a day where we’re supposed to have fun and appreciate the people that we have.”

    One month after the parade in which the U.S. public health crisis that is gun violence played out on live television, the Bartons are reeling from their role at its epicenter. They were just feet from 43-year-old Lisa Lopez-Galvan, who was killed. Twenty-four other people were injured. Although the Bartons aren’t included in that official victim number, they were traumatized, physically and emotionally, and pain permeates their lives: Bridget and Jason keep canceling plans to go out, opting instead to stay home together; Gabriella plans to join a boxing club instead of the dance team.

    During this first month, Kansas City community leaders have weighed how to care for people caught in the bloody crossfire and how to divide more than $2 million donated to public funds for victims in the initial outpouring of grief.

    The questions are far-reaching: How does a city compensate people for medical bills, recovery treatments, counseling, and lost wages? And what about those who have PTSD-like symptoms that could last years? How does a community identify and care for victims often overlooked in the first flush of reporting on a mass shooting: the injured?

    The injured list could grow. Prosecutors and Kansas City police are mounting a legal case against four of the shooting suspects, and are encouraging additional victims to come forward.

    “Specifically, we’re looking for individuals who suffered wounds from their trying to escape. A stampede occurred while people were trying to flee,” said Jackson County Prosecutor Jean Peters Baker. Anyone who “in the fleeing of this event that maybe fell down, you were trampled, you sprained an ankle, you broke a bone.”

    Meanwhile, people who took charge of raising money and providing services to care for the injured are wrestling with who gets the money — and who doesn’t. Due to large donations from celebrities like Taylor Swift and Travis Kelce, some victims or their families will have access to hundreds of thousands of dollars for medical expenses. Other victims may simply have their counseling covered.

    The overall economic cost of U.S. firearm injuries is estimated by a recent Harvard Medical School study at $557 billion annually. Most of that — 88% — represented quality-of-life losses among those injured by firearms and their families. The JAMA-published study found that each nonfatal firearm injury leads to roughly $30,000 in direct health care spending per survivor in the first year alone.

    In the immediate aftermath of the shootings, as well-intentioned GoFundMe pages popped up to help victims, executives at United Way of Greater Kansas City gathered to devise a collective donation response. They came up with “three concentric circles of victims,” said Jessica Blubaugh, the United Way’s chief philanthropy officer, and launched the #KCStrong campaign.

    “There were folks that were obviously directly impacted by gunfire. Then the next circle out is folks that were impacted, not necessarily by gunshots, but by physical impact. So maybe they were trampled and maybe they tore a ligament or something because they were running away,” Blubaugh said. “Then third is folks that were just adjacent and/or bystanders that have a lot of trauma from all of this.”

    PTSD, Panic, and the Echo of Gunfire

    Bridget Barton returned to Kansas City the day after the shooting to turn in the bullet she found in her backpack and to give a statement at police headquarters. Unbeknownst to her, Mayor Quinton Lucas and the police and fire chiefs had just finished a press conference outside the building. She was mobbed by the media assembled there — interviews that are now a blur.

    “I don’t know how you guys do this every day,” she remembered telling a detective once she finally got inside.

    The Bartons have been overwhelmed by well wishes from close friends and family as they navigate the trauma, almost to the point of exhaustion. Bridget took to social media to explain she wasn’t ignoring the messages, she’s just responding as she feels able — some days she can hardly look at her phone, she said.

    A family friend bought new Barbie blankets for Gabriella and her friend after the ones they brought to the parade were lost or ruined. Bridget tried replacing the blankets herself at her local Walmart, but when she was bumped accidentally, it triggered a panic attack. She abandoned her cart and drove home.

    “I’m trying to get my anxiety under control,” Bridget said.

    That means therapy. Before the parade, she was already seeing a therapist and planning to begin eye movement desensitization and reprocessing, a form of therapy associated with treating post-traumatic stress disorder. Now the shooting is the first thing she wants to talk about in therapy.

    Since Gabriella, an eighth grader, has returned to middle school, she has dealt with the compounding immaturity of adolescence: peers telling her to get over it, pointing finger guns at her, or even saying it should have been her who was shot. But her friends are checking on her and asking how she’s doing. She wishes more people would do the same for her friend, who took off running when the shooting started and avoided injury. Gabriella feels guilty about bringing her to what turned into a horrifying experience.

    “We can tell her all day long, ‘It wasn’t your fault. She’s not your responsibility.’ Just like I can tell myself, ‘It wasn’t my fault or my responsibility,’” Bridget said. “But I still bawled on her mom’s shoulder telling her how sorry I was that I grabbed my kid first.”

    The two girls have spent a lot of time talking since the shooting, which Gabriella said helps with her own stress. So does spending time with her dog and her lizard, putting on makeup, and listening to music — Tech N9ne’s performance was a highlight of the Super Bowl celebration for her.

    In addition to the spark burns on Gabriella’s legs, when she fell to the concrete in the pandemonium she split open a burn wound on her stomach previously caused by a styling iron.

    “When I see that, I just picture my mom trying to protect me and seeing everyone run,” Gabriella said of the wound.

    It’s hard not to feel forgotten by the public, Bridget said. The shooting, especially its survivors, have largely faded from the headlines aside from court dates. Two additional high-profile shootings have occurred in the area since the parade. Doesn’t the community care, she wonders, that her family is still living with the fallout every day?

    “I’m going to put this as plainly as possible. I’m f—ing pissed because my family went through something traumatic,” Bridget vented in a recent social media post. “I don’t really want anything other [than], ‘Your story matters, too, and we want to know how you’re doing.’ Have we gotten that? Abso-f—lutely not.”

    ‘What Is the Landscape of Need?’

    Helped in part by celebrities like Swift and Kelce, donations for the family of Lopez-Galvan, the lone fatality, and other victims poured in immediately after the shootings. Swift and Kelce donated $100,000 each. With the help of an initial $200,000 donation from the Kansas City Chiefs, the United Way’s #KCStrong campaign took off, reaching $1 million in the first two weeks and sitting at $1.2 million now.

    Six verified GoFundMe funds were established. One solely for the Lopez-Galvan family has collected over $406,000. Smaller ones were started by a local college student and Swift fans. Churches have also stepped up, and one local coalition had raised $183,000, money set aside for Lopez-Galvan’s funeral, counseling services for five victims, and other medical bills from Children’s Mercy Kansas City hospital, said Ray Jarrett, executive director of Unite KC.

    Money for Victims Rolls In

    Donations poured in for those injured at the Super Bowl Parade in Kansas City after the Feb. 14 shootings. The largest, starting with a $200,000 donation from the Kansas City Chiefs, is at the United Way of Greater Kansas City. Six GoFundMe sites also popped up, due in part to $100,000 donations each from Taylor Swift and Travis Kelce. Here’s a look at the totals as of March 12.United Way#KCStrong: $1.2 million.Six Verified GoFundMe AccountsLisa Lopez-Galvan GoFundMe (Taylor Swift donated): $406,142Reyes Family GoFundMe (Travis Kelce donated): $207,035Samuel Arellano GoFundMe: $11,896Emily Tavis GoFundMe: $9,518Cristian Martinez’s GoFundMe for United Way: $2,967Swifties’ GoFundMe for Children’s Mercy hospital: $1,060ChurchesResurrection (Methodist) “Victims of Violence Fund”: $53,358‘The Church Loves Kansas City’: $183,000 

    Meanwhile, those leading the efforts found models in other cities. The United Way’s Blubaugh called counterparts who’d responded to their own mass shootings in Orlando, Florida; Buffalo, New York; and Newtown, Connecticut.

    “The unfortunate reality is we have a cadre of communities across the country who have already faced tragedies like this,” Blubaugh said. “So there is an unfortunate protocol that is, sort of, already in place.”

    #KCStrong monies could start being paid out by the end of March, Blubaugh said. Hundreds of people called the nonprofit’s 211 line, and the United Way is consulting with hospitals and law enforcement to verify victims and then offer services they may need, she said.

    The range of needs is staggering — several people are still recovering at home, some are seeking counseling, and many weren’t even counted in the beginning. For instance, a plainclothes police officer was injured in the melee but is doing fine now, said Police Chief Stacey Graves.

    Determining who is eligible for assistance was one of the first conversations United Way officials had when creating the fund. They prioritized three areas of focus: first were the wounded victims and their families, second was collaborating with organizations already helping victims in violence intervention and prevention and mental health services, and third were the first responders.

    Specifically, the funds will be steered to cover medical bills, or lost wages for those who haven’t been able to work since the shootings, Blubaugh said. The goal is to work quickly to help people, she said, but also to spend the money in a judicious, strategic way.

    “We don’t have a clear sightline of the entire landscape that we’re dealing with,” Blubaugh said. “Not only of how much money do we have to work with, but also, what is the landscape of need? And we need both of those things to be able to make those decisions.”

    Firsthand Experience of Daily Kansas City Violence

    Jason used his lone remaining sick day to stay home with Bridget and Gabriella. An overnight automation technician, he is the family’s primary breadwinner.

    “I can’t take off work, you know?” he said. “It happened. It sucked. But it’s time to move on.”

    “He’s a guy’s guy,” Bridget interjected.

    On Jason’s first night back at work, the sudden sound of falling dishes startled Bridget and Gabriella, sending them into each other’s arms crying.

    “It’s just those moments of flashbacks that are kicking our butts,” Bridget said.

    Tell Us About Your Experience

    We are continuing to report on the effects of the parade shooting on the people who were injured and the community as a whole. Do you have an experience you want to tell us about, or a question you think we should look into? Message KCUR’s text line at (816) 601-4777. Your information will not be used in an article without your permission.

    In a way, the shooting has brought the family closer. They’ve been through a lot recently. Jason survived a heart attack and cancer last year. Raising a teenager is never easy.

    Bridget can appreciate that the bullet lodged in her backpack, narrowly missing her, and that Gabriella’s legs were burned by sparks but she wasn’t shot.

    Jason is grateful for another reason: It wasn’t a terrorist attack, as he initially feared. Instead, it fits into the type of gun violence he’d become accustomed to growing up in Kansas City, which recorded its deadliest year last year, although he’d never been this close to it before.

    “This crap happens every single day,” he said. “The only difference is we were here for it.”

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Workout Advice For Busy People

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    Hampton at Hybrid Calisthenics always has very sound advice in his uplifting videos, and this one’s no exception:

    Key tips for optimizing workouts without burning out

    “We all have the same 24 hours” is a folly when in fact, some of us have more responsibilities and/or other impediments to getting things done (e.g. disabilities).

    A quick word on disabilities first: sometimes people are quick to point out Paralympian athletes, and “if they can do it, so can you!” and forget that these people are in the top percentile of the top percentile of the top percentile of human performance. If you wouldn’t disparagingly say “if Simone Biles/Hussein Bolt/Michael Phelps can do it, so can you”, then don’t for Paralympians either 😉

    Now, as for Hampton’s advice, he recommends:

    Enjoy short, intense workouts:

    • You can get effective results in under 30 minutes (or even just a few minutes per day) with compound exercises (e.g., squats, pull-ups).
    • Focus on full-body movements also saves time!
    • Push closer to failure when possible to maximize efficiency. It’s the last rep where most of the strength gains are made! Same deal with cardiovascular fitness, too. Nevertheless, do take safety into account in both cases, of course.

    Time your rest periods:

    • Resting for 2–3 minutes between sets ensures optimal recovery.
    • Avoid getting distracted during rest by setting a timer to stay focused.
    • 10almonds tip: use this time to practice a mindfulness meditation. That will greatly reduce the chance of you becoming distracted.

    Remember holistic fitness:

    • Fitness isn’t just about exercise; diet, sleep, and stress management are equally important for your fitness as much as for the rest of your health.
    • Better sleep and reduced stress will help you exercise more consistently and avoid junk food.

    Address burnout:

    • If feeling too exhausted to apply these tips, focus on getting better rest and reducing stress first.
    • Taking a short break to reset can help in the long run.

    For more on all of this, enjoy:

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  • Owning Your Weight – by Henri Marcoux

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    A lot of diet books—which this isn’t—presuppose that the reader wants to lose weight, and varyingly encourage and shame the reader into trying to do so.

    Dr. Henri Marcoux takes a completely different approach.

    He starts by assuming we are—whether consciously or not—the weight we want to be, and looks at the various physical and psychological factors that influence us to such. Ranging from food poverty to eating our feelings to social factors and more, he bids us examine our relationship with food and eating—not just in the sense of mindful eating, but from multiple scientific angles too.

    From this, Dr. Marcoux gives us questions and suggestions to ensure that our relationship with food and eating is what we want it to be, for us.

    Much of the latter part of the book covers not just how to go about the requisite lifestyle changes… But also how to implement things in a way that sticks, and is a genuine pleasure to implement. If this sounds over-the-top, the truth is that it’s just because it honestly is a lower-stress way of living.

    Bottom line: if you want to gain or lose weight, there’s a good chance this book will help you. If you want to be happier and healthier at the weight you are, there’s a good chance this book will help you with that, too.

    Click here to check out Owning Your Weight, and take control of yours!

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  • The Best Foods For Collagen Production

    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.

    Dr. Andrea Suarez gives us the low-down on collagen synthesis and maintenance. Collagen is the most abundant protein in our body, and it can be fairly described as “the stuff that holds us together”. It’s particularly important for joints and bones too, though many people’s focus on it is for the skin. Whatever your priorities, collagen levels are something it pays to be mindful of, as they usually drop quite sharply after a certain age. What certain age? Well, that depends a lot on you, and your diet and lifestyle. But it can start to decline from the age of 30 with often noticeable drop-offs in one’s mid-40s and again in one’s mid-60s.

    Showing us what we’re made of

    There’s a lot more to having good collagen levels than just how much collagen we consume (which for vegetarians/vegans, will be “none”, unless using the “except if for medical reasons” exemption, which is probably a little tenuous in the case of collagen but nevertheless it’s a possibility; this exemption is usually one that people use for, say, a nasal spray vaccine that contains gelatine, or a medicinal tablet that contains lactose, etc).

    Rather, having good collagen levels is also a matter of what we eat that allows us to synthesize our own collagen (which includes: its ingredients, and various “helper” nutrients), as well as what dietary adjustments we make to avoid our extant collagen getting broken down, degraded, and generally lost.

    Here’s what Dr. Suarez recommends:

    Protein-rich foods (but watch out)

    • Protein is essential for collagen production.
    • Sources: fish, soy, lean meats (but not red meats, which—counterintuitively—degrade collagen), eggs, lentils.
    • Egg whites are high in lysine, vital for collagen synthesis.
    • Bone broth is a natural source of collagen.

    Omega-3 fatty acids

    • Omega-3s are anti-inflammatory and protect skin collagen.
    • Sources: walnuts, chia seeds, flax seeds, fatty fish (e.g. mackerel, sardines).

    Leafy greens

    • Leafy dark green vegetables (e.g. kale, spinach) are rich in vitamins C and B9.
    • Vitamin C is crucial for collagen synthesis and acts as an antioxidant.
    • Vitamin B9 supports skin cell division and DNA repair.

    Red fruits & vegetables

    • Red fruits/vegetables (e.g. tomatoes, red bell peppers) contain lycopene, an antioxidant that protects collagen from UV damage (so, that aspect is mostly relevant for skin, but antioxidants are good things to have in all of the body in any case).

    Orange-colored vegetables

    • Carrots and sweet potatoes are rich in vitamin A, which helps in collagen repair and synthesis.
    • Vitamin A is best from food, not supplements, to avoid potential toxicity.

    Fruits rich in vitamin C

    • Citrus fruits, kiwi, and berries are loaded with vitamin C and antioxidants, essential for collagen synthesis and skin health.

    Soy

    • Soy products (e.g. tofu, soybeans) contain isoflavones, which reduce inflammation and inhibit enzymes that degrade collagen.
    • Soy is associated with lower risks of chronic diseases.

    Garlic

    • Garlic contains sulfur, taurine, and lipoic acid, important for collagen production and repair.

    What to avoid:

    • Reduce foods high in advanced glycation end products (AGEs), which damage collagen and promote inflammation.
    • AGEs are found in fried, roasted, or grilled fatty proteinous foods (e.g. meat, including synthetic meat, and yes, including grass-fed nicely marketed meat—although processed meat such as bacon and sausages are even worse than steaks etc).
    • Switch to cooking methods like boiling or steaming to reduce AGE levels.
    • Processed foods, sugary pastries, and red meats contribute to collagen degradation.

    General diet tips:

    • Incorporate more plant-based, antioxidant-rich foods.
    • Opt for slow cooking to reduce AGEs.
    • Since sustainability is key, choose foods you enjoy for a collagen-boosting diet that you won’t seem like a chore a month later.

    For more on all of this, enjoy:

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    We Are Such Stuff As Fish Are Made Of ← our main feature research review about collagen

    Take care!

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  • Nonverbal Epiphany – by Dr. Stephen Furlich

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    The subtitle of this book, “Steps To Improve Your Nonverbal Communication” suggests that this is principally an instructional book—it’s not. Rather, it’s mostly informational, and it is left to the reader to interpret what to do with that information.

    But, what a lot of information!

    And well-sourced, too: this book has scientific paper citations at a rate of one or two per page, with many diagrams and infographics too. It is, in effect, a treasure trove of physiological, psychological, and sociological data when it comes to nonverbal communication and the various factors that influence it.

    So, what can you hope to gain from this book? A lot of sorting out of science vs suppositions, mostly.

    From digit ratios to crossed arms, from eye-contact to attire, do things really mean what we’ve been told they mean?

    And if they don’t, will people perceive them that way anyway, or will textbook rules go out the window in a real conversation? How about in real nonverbal interactions?

    (What’s a nonverbal interaction? It’s the behavior exhibited between strangers in the street, it’s the impression given and received by your profile picture, things like that).

    Bottom line is that this book is data, data, and more data. If ever you wanted to sort the psychology from the pseudoscience, this is the book for you.

    Pick Up Nonverbal Epiphany on Amazon today!

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  • Parsnips vs Potatoes – Which is Healthier?

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    Our Verdict

    When comparing parsnips to potatoes, we picked the parsnips.

    Why?

    To be more specific, we’re looking at russet potatoes, and in both cases we’re looking at cooked without fat or salt, skin on. In other words, the basic nutritional values of these plants in edible form, without adding anything. With this in mind, once we get to the root of things, there’s a clear winner:

    Looking at the macros first, potatoes have more carbs while parsnips have more fiber. Potatoes do have more protein too, but given the small numbers involved when it comes to protein we don’t think this is enough of a plus to outweigh the extra fiber in the parsnips.

    In the category of vitamins, again a champion emerges: parsnips have more of vitamins B1, B2, B5, B9, C, E, and K, while potatoes have more of vitamins B3, B6, and choline. So, a 7:3 win for parsnips.

    When it comes to minerals, parsnips have more calcium copper, manganese, selenium, and zinc, while potatoes have more iron and potassium. Potatoes do also have more sodium, but for most people most of the time, this is not a plus, healthwise. Disregarding the sodium, this category sees a 5:2 win for parsnips.

    In short: as with most starchy vegetables, enjoy both in moderation if you feel so inclined, but if you’re picking one, then parsnips are the nutritionally best choice here.

    Want to learn more?

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