The Diabetes Drugs That Can Cut Asthma Attacks By 70%
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Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.
While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.
Great! Which drugs?
Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).
Specifically, researchers have found:
- Metformin is associated with a 30% reduction in asthma attacks
- GLP-1RAs are associated with a 40% reduction in asthma attacks
…and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.
In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.
The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.
Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.
Here’s the study itself, hot off the press, published on Monday:
JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks
“But what if I’m not diabetic?”
Good news:
More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎
And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.
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:
- 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)
- 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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Moore’s Clinically Oriented Anatomy – by Dr. Anne Argur & Dr. Arthur Dalley
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Imagine, if you will, Grey’s Anatomy but beautifully illustrated in color and formatted in a way that’s easy to read—both in terms of layout and searchability, and also in terms of how this book presents anatomy described in a practical, functional context, with summary boxes for each area, so that the primary concepts don’t get lost in the very many details.
(In contrast, if you have a copy of the famous Grey’s Anatomy, you’ll know it’s full of many pages of nothing but tiny dense text, a large amount of which is Latin, with occasional etchings by way of illustration)
Another way in which this does a lot better than the aforementioned seminal work is that it also describes and discusses very many common variations and abnormalities, both congenital and acquired, so that it’s not just a text of “what a theoretical person looks like inside”, but rather also reflects the diverse reality of the human form (we weren’t made identically in a production line, and so we can vary quite a bit).
The book is, of course, intended for students and practitioners of medicine and related fields, so what good is it to the lay person? Well, if you ask the average person where the gallbladder is and why we have one, they will gesture in the general direction of the abdomen, and sort of shrug sheepishly. You don’t have to be that person 🙂
Bottom line: if you’d like to know your acetabulum from your zygomatic arch, this is the best anatomy book this reviewer has yet seen.
Click here to check out Moore’s Clinically Oriented Anatomy, and prepare to be amazed!
PS: this one is expensive, but consider it a fair investment in your personal education, if you’re serious about it!
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Why Zebras Don’t Get Ulcers – by Dr. Robert M. Sapolsky
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The book does kick off with a section that didn’t age well—he talks of the stress induced globally by the Spanish Flu pandemic of 1918, and how that kind of thing just doesn’t happen any more. Today, we have much less existentially dangerous stressors!
However, the fact we went and had another pandemic really only adds weight to the general arguments of the book, rather than detracting.
We are consistently beset by “the slings and arrows of outrageous fortune” as Shakespeare would put it, and there’s a reason (or twenty) why many people go grocery-shopping with the cortisol levels of someone being hunted for sport.
So, why don’t zebras get ulcers, as they actually are hunted for food?
They don’t have rent to pay or a mortgage, they don’t have taxes, or traffic, or a broken washing machine, or a project due in the morning. Their problems come one at a time. They have a useful stress response to a stressful situation (say, being chased by lions), and when the danger is over, they go back to grazing. They have time to recover.
For us, we are (usually) not being chased by lions. But we have everything else, constantly, around the clock. So, how to fix that?
Dr. Sapolsky comprehensively describes our physiological responses to stress in quite different terms than many. By reframing stress responses as part of the homeostatic system—trying to get the body back into balance—we find a solution, or rather: ways to help our bodies recover.
The style is “pop-science” and is very accessible for the lay reader while still clearly coming from a top-level academic who is neck-deep in neuroendocrinological research. Best of both worlds!
Bottom line: if you try to take very day at a time, but sometimes several days gang up on you at once, and you’d like to learn more about what happens inside you as a result and how to fix that, this book is for you!
Click here to check out “Why Zebras Don’t Get Ulcers” and give yourself a break!
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The Exercise That Protects Your Brain
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The Neuroscientist In The Gym
This is Dr. Wendy Suzuki. She’s a neuroscientist, and an expert in the neurobiology of memory, as well as neuroplasticity, and the role of exercise in neuroprotection.
We’ve sneakily semi-featured her before when we shared her Big Think talk:
Brain Benefits In Three Months… Through Walking?
Today we’re going to expand on that a little!
A Quick Recap
To share the absolute key points of that already fairly streamlined rundown:
- Exercise boosts levels of neurotransmitters such as dopamine and serotonin (and, which wasn’t mentioned there, noradrenaline)
- These are responsible for motivation, happiness, and focus (amongst other things)
- Persistent exercise boosts certain regions of the brain in particular, most notably the pre-frontal cortex and the hippocampi*
- These are responsible for planning and memory (amongst other things)
Dr. Suzuki advocates for stepping up your exercise routine if you can, with more exercise generally being better than less (unless you have some special medical reason why that’s not the case for you).
*often referred to in the singular as the hippocampus, but you have one on each side of your brain (unless a serious accident/incident destroyed one, but you’ll know if that applies to you, unless you lost both, in which case you will not remember about it).
What kind(s) of workout?
While a varied workout is best for overall health, for these brain benefits specifically, what’s most important is that it raises your heart rate.
This is why in her Big Think talk we shared before, she talks about the benefits of taking a brisk walk daily. See also:
If that’s not your thing, though (and/or is for whatever reason an inaccessible form of exercise for you), there is almost certainly some kind of High Intensity Interval Training that is a possibility for you. That might sound intimidating, but if you have a bit of floor and can exercise for one minute at a time, then HIIT is an option for you:
How To Do HIIT (Without Wrecking Your Body)
Dr. Suzuki herself is an ardent fan of “intenSati” which blends cardio workouts with yoga for holistic mind-and-body fitness. In fact, she loves it so much that she became a certified exercise instructor:
How much is enough?
It’s natural to want to know the minimum we can do to get results, but Dr. Suzuki would like us to bear in mind that when it comes to our time spent exercising, it’s not so much an expense of time as an investment in time:
❝Exercise is something that when you spend time on it, it will buy you time when you start to work❞
Read more: A Neuroscientist Experimented on Her Students and Found a Powerful Way to Improve Brain Function
Ok, but we really want to know how much!
Dr. Suzuki recommends at least three to four 30-minute exercise sessions per week.
Note: this adds up to less than the recommended 150 minutes of moderate exercise per week, but high-intensity exercise counts for twice the minutes for these purposes, e.g. 1 minute of high-intensity exercise is worth 2 minutes of moderate exercise.
How soon will we see benefits?
Benefits start immediately, but stack up cumulatively with continued long-term exercise:
❝My lab showed that a single workout can improve your ability to shift and focus attention, and that focus improvement will last for at least two hours. ❞
…which is a great start, but what’s more exciting is…
❝The more you’re working out, the bigger and stronger your hippocampus and prefrontal cortex gets. Why is that important?
Because the prefrontal cortex and the hippocampus are the two areas that are most susceptible to neurodegenerative diseases and normal cognitive decline in aging. ❞
In other words, while improving your heart rate through regular exercise will help prevent neurodegeneration by the usual mechanism of reducing neuroinflammation… It’ll also build the parts of your brain most susceptible to decline, meaning that when/if decline sets in, it’ll take a lot longer to get to a critical level of degradation, because it had more to start with.
Read more:
Inspir Modern Senior Living | Dr. Wendy Suzuki Boosts Brain Health with Exercise
Want more from Dr. Suzuki?
You might enjoy her TED talk:
Click Here If The Embedded Video Doesn’t Load Automatically
Prefer text? TED.com has a transcript for you
Prefer lots of text? You might like her book, which we haven’t reviewed yet but will soon:
Enjoy!
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- Exercise boosts levels of neurotransmitters such as dopamine and serotonin (and, which wasn’t mentioned there, noradrenaline)
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The Salt Fix – by Dr. James DiNicolantonio
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This book has a bold premise: high salt consumption is not, as global scientific consensus holds, a serious health risk, but rather, as the title suggests, a health fix.
Dr. DiNicolantonio, a pharmacist, explains how “our ancestors crawled out of the sea millions of years ago and we still crave that salt”, giving this as a reason why we should consume salt ad libitum, aiming for 8–10g per day, and thereafter a fair portion of the book is given over to discussing how many health conditions are caused/exacerbated by sugar, and that therefore we have demonized the wrong white crystal (scientific consensus is that there are many white crystals that can cause us harm).
Indeed, sugar can be a big health problem, but reading it at such length felt a lot like when all a politician can talk about is how their political rival is worse.
A lot of the studies the author cites to support the idea of healthy higher salt consumption rates were on non-human animals, and it’s always a lottery as to whether those results translate to humans or not. Also, many of the studies he’s citing are old and have methodological flaws, while others we could not find when we looked them up.
One of the sources cited is “my friend Jose tried this and it worked for him”.
Bottom line: sodium is an essential mineral that we do need to live, but we are not convinced that this book’s ideas have scientific merit. But are they well-argued? Also no.
Click here to check out The Salt Fix for yourself! It’s a fascinating book.
(Usually, if we do not approve of a book, we simply do not review it. We like to keep things positive. However, this one came up in Q&A, so it seemed appropriate to share our review. Also, the occasional negative review may reassure you, dear readers, that when we praise a book, we mean it)
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What’s Lurking In Your Household Air?
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As individuals, we can’t do much about the outside air. We can try to spend more time in green spaces* and away from traffic, and we can wear face-masks—as was popular in Tokyo and other such large cities long before the pandemic struck.
*The well-known mental health benefits aside (and contrary to British politician Amber Rudd’s famous assertion in a televised political debate that “clean air doesn’t grow on trees”), clean air comes mostly from trees—their natural process of respiration scrubs not only carbon dioxide, but also pollutants, from the air before releasing oxygen without the pollutants. Neat!
See also this study: Site new care homes near trees and away from busy roads to protect residents’ lungs
We are fortunate to be living in a world where most of us in industrialized countries can exercise a great degree of control over our home’s climate. But, what to do with all that power?
Temperature
Let’s start with the basics. Outside temperature may vary, but you probably have heating and air conditioning. There’s a simple answer here; the optimal temperature for human comfort and wellbeing is 20℃ / 68℉:
Scientists Identify a Universal Optimal Temperature For Life on Earth
Note: this does not mean that that is the ideal global average temperature, because that would mean the polar caps are completely gone, the methane stored there released, many large cities underwater, currently hot places will be too hot for human life (e.g. outside temperatures above human body temperature), there will be mass extinctions of many kinds of animals and plants, including those we humans require for survival, and a great proliferation of many bugs that will kill us. Basically we need diversity for the planet to survive, arctic through to tropical and yes, even deserts (deserts are important carbon sinks!). The ideal global average temperature is about 14℃ (we currently have about 15℃ and rising).
But, for setting the thermostat in your home, 20℃ / 68℉ is perfect for most people, though down as far as 17℃ / 61℉ is fine too, provided other things such as humidity are in order. In fact, for sleeping, 18℃ / 62℉ is ideal. This is because the cooler temperature is one of the several things that tell our brain it is nighttime now, and thus trigger secretion of melatonin.
If you’re wondering about temperatures and respiratory viruses, by the way, check out:
The Cold Truth About Respiratory Infections: The Pathogens That Came In From The Cold
Humidity
Most people pay more attention to the temperature in their home than the humidity, and the latter is just as important:
❝Conditions that fall outside of the optimal range of 40–60% can have significant impacts on health, including facilitating infectious transmission and exacerbating respiratory diseases.
When humidity is too low, it can cause dryness and irritation of the respiratory tract and skin, making individuals more susceptible to infections.
When humidity is too high, it can create a damp environment that encourages the growth of harmful microorganisms like mould, bacteria, and viruses.❞
~ Dr. Gabriella Guarnieri et al.
So, if your average indoor humidity falls outside of that range, consider getting a humidifier or dehumidifier, to correct it. Example items on Amazon, for your convenience:
Humidity monitor | Humidifier | Dehumidifier
See also, about a seriously underestimated killer:
Pneumonia: Prevention Is Better Than Cure
Now, one last component to deal with, for perfect indoor air:
Pollution
We tend to think of pollution as an outdoors thing, and indeed, the pollution in your home will (hopefully!) be lower than that of a busy traffic intersection. However…
- The air you have inside comes from outside, and that matters if you’re in an urban area
- Even in suburban and rural areas, general atmospheric pollutants will reach you, and if you’ve ever been subject to wildfire smoke, you’ll know that’s no fun either.
- Gas appliances in the home cause indoor pollution, even when carbon monoxide is within levels considered acceptable. This polluting effect is much stronger for open gas flames (such as on gas cookers/stoves, or gas fires), than for closed gas heating systems (such as a gas-powered boiler for central heating).
- Wood stoves/fireplaces are not an improvement, in fact they are worse, and don’t get us started on coal. You should not be breathing these things, and definitely should not be burning them in an enclosed space.
- That air conditioning, humidifier, dehumidifier? They may be great for temperature and humidity, but please clean/change the filter more often than you think is necessary, or things will grow there and then your device will be adding pathogens to the air as it goes.
- Plug-in air-freshening devices? They may smell clean, but they are effectively spraying cleaning fluids into your lungs. So please don’t.
So, what of air purifiers? They can definitely be of benefit. for example:
But watch out! Because if you don’t clean/change the filter regularly, guess what happens! That’s right, it’ll be colonized with bacteria/fungus and then be blowing those at you.
And no, not all of them will be visible to the naked eye:
Is Unnoticed Environmental Mold Harming Your Health?
Taking a holistic approach
The air is a very important factor for the health of your lungs (and thus, for the health of everything that’s fed oxygen by your lungs), but there are more things we can do as well:
Seven Things To Do For Good Lung Health!
Take care!
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