The Four Pillar Plan – by Dr. Rangan Chatterjee

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Dr. Rangan Chatterjee, a medical doctor, felt frustrated with how many doctors in his field focus on treating the symptoms of disease, rather than the cause. Sometimes, of course, treating the symptom is necessary too! But neglecting the cause is a recipe for long-term woes.

What he does differently is take lifestyle as a foundation, and even that, he does differently than many authors on the topic. How so, you may wonder?

Rather than look first at exercise and diet, he starts with “relax”. His rationale is reasonable: diving straight in with marathon training or a whole new diet plan can be unsustainable without this as a foundation to fall back on.

Many sources look first at exercise (because it can be a very simple “prescription”) before diet (often more complex)… but how does one exercise well with the wrong fuel in the tank? So Dr. Chatterjee’s titular “Four Pillars” come in the following order:

  1. Relax
  2. Eat
  3. Move
  4. Sleep

He also goes for “move” rather than “exercise” as the focus here is more on minimizing time spent sitting, and thus involving a lot of much more frequent gentle activities… rather than intensive training programs and the like.

And as for sleep? Yes, that comes last because—no matter how important it is—the other things are easier to directly control. After all, one can improve conditions for sleep, but one cannot simply choose to sleep better! So with the other three things covered first, good sleep is the fourth and final thing to fall into place.

All in all, this is a great book to cut through the catch-22 problem of lifestyle factors negatively impacting each other.

Click here to check out “The 4 Pillar Plan” and start improving your life in the most impactful ways!

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Recommended

  • Healthy Heart, Healthy Brain – by Dr. Bradley Bale & Dr. Amy Doneen
  • Under Pressure: A Guide To Controlling High Blood Pressure – by Dr. Frita Fisher
    Confronting hypertension head-on, “Under Pressure” is an essential guide for 35-45s on managing blood pressure and warding off silent killers—one easy read at a time.

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  • 6 Worst Foods That Cause Dementia

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    How many do you consume?

    The hit list

    Dr. Li bids us avoid:

    High carb, low fiber foods: consuming a diet high in carbohydrates, particularly refined carbs like cakes, white bread, pizza, and sugary syrups, can significantly harm brain health. Over time, imbalanced (i.e. not balanced with fiber) carbohydrate consumption leads to the growth of visceral fat (not the same as subcutaneous fat, which is the squishy bits just under your skin; visceral fat is further underneath, around your viscera), , which triggers systemic inflammation and oxidative stress. These processes disrupt communication between brain cells, impair memory, and increase the risk of diseases like Alzheimer’s and Parkinson’s. High carb diets can also contribute to metabolic syndrome—a cluster of conditions, including diabetes, obesity and high blood pressure—that damage blood vessels, leading to strokes and vascular dementia.

    Trans fats: these are region-bound, as they’re banned in some places and not others—check your local regulations. Found in processed foods such as fried items, baked goods, packaged snacks, and margarine, trans fats are created through hydrogenation, which makes fats more stable at room temperature. These artificial fats raise bad cholesterol, lower good cholesterol, and promote atherosclerosis. This damages the brain by reducing oxygen supply, triggering chronic inflammation, and increasing the risk of Alzheimer’s and dementia. 

    Sodas: regular consumption of sodas, whether sugary or artificially sweetened, is harmful to brain health. A single can of soda contains around 9 teaspoons of sugar, which overwhelms metabolism, contributes to insulin resistance, and leads to inflammation. These effects damage blood vessels and brain tissue, disrupt neuron function, and increase the risk of type 2 diabetes and dementia. Furthermore, insulin resistance caused by excessive sugar intake can impair neuronal survival, activate immune responses, and exacerbate cognitive decline. As for the artificial sweeteners, the mechanism of harm depends on the sweetener (and some can also mess up insulin response, for reasons that are not entirely clear yet, but they measurably do), but even picking the healthiest artificial sweetener, training your palate to enjoy hyper-sweetened things will tend to lead to more sugar-laden food choices in other parts of one’s diet.

    Processed foods: arguably a broad category that encompasses some of the above, but it’s important to consider it separately for catch-all purposes: these convenience foods, laden with artificial preservatives, colors, and sweeteners, harm brain health through chronic inflammation and usually a lack of essential nutrients. Processed foods are also a significant source of microplastics, which have been found to accumulate in the arteries, contributing to plaque build-up, atherosclerosis, and reduced blood flow to the brain. This combination of inflammation and oxidative stress from microplastics damages brain cells, paving the way for cognitive decline and dementia.

    Seafood with high mercury levels: large fish such as tuna, swordfish, sharks, and tilefish accumulate high amounts of mercury, a potent neurotoxin. Fish that are larger, older, and/or higher up the food chain will have the most mercury (and other cumulative contaminants, for that matter, but we’re considering mercury here). Mercury disrupts essential brain chemicals like dopamine and serotonin, triggering oxidative stress and damaging brain cells. Chronic exposure to mercury leads to inflammation and neuroinflammation, both of which increase the risk of Alzheimer’s and dementia. 

    Alcohol: contrary to popular belief, any amount of alcohol is detrimental to brain health. While red wine is often promoted for its health benefits, the purported positive effects come from polyphenols, not the alcohol itself, and (for example) resveratrol from red wine cannot be delivered in meaningful doses without drinking an impossibly large quantity. Alcohol is a neurotoxin that can damage or kill brain cells, impair neuronal communication, and lead to cognitive decline. Excessive drinking results in hangover symptoms like headaches and brain fog, which are indicators of its harmful impact on the brain. Chronic alcohol consumption exacerbates neuron death, increases inflammation, and raises the risk of dementia.

    As for what to eat instead?

    Dr. Li recommends including foods such as:

    • foods rich in omega-3s that aren’t mercury-laden fish, e.g. flaxseeds, chia seeds, walnuts, and hemp seeds, as they reduce inflammation, protect blood vessel linings, and prevent vascular dementia.
    • berries, and in particular he recommends organic strawberries, which are rich in ellagic acid and anthocyanins, which improve memory, reduce depressive symptoms, and enhance cognitive function.

    For more on all of these, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Reduce Your Alzheimer’s Risk!

    Take care!

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  • 5 Ways To Avoid Hearing Loss

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    Hear Ye, Hear Ye

    Hearing loss is often associated with getting older—but it can strike at any age. In the US, for example…

    • Around 13% of adults have hearing difficulties
    • Nearly 27% of those over 65 have hearing difficulties

    Complete or near-complete hearing loss is less common. From the same source…

    • A little under 2% of adults in general had a total or near-total inability to hear
    • A little over 4% of those over 65 had a total or near-total inability to hear

    Source: CDC | Hearing Difficulties Among Adults: United States, 2019

    So, what to do if we want to keep our hearing as it is?

    Avoid loud environments

    An obvious one, but it bears stating for the sake of being methodical. Loud environments damage our ears, but how loud is too loud?

    You can check how loud an environment is by using a free smartphone app, such as:

    Decibel Pro: dB Sound Level Meter (iOS / Android)

    An 82 dB environment is considered safe for 16 hours. That’s the equivalent of, for example moderate traffic.

    Every 3 dB added to that halves the safe exposure time, for example:

    • An 85 dB environment is considered safe for 8 hours. That’s the equivalent of heavier traffic, or a vacuum cleaner.
    • A 94 dB environment is considered safe for 1 hour. That might be a chainsaw, a motorcycle, or a large sporting event.

    Many nightclubs or concert venues often have environments of 110 dB and more. So the safe exposure time would be under two minutes.

    Source: NIOSH | Noise and Hearing Loss

    With differences like that per 3 dB increase, then you may want to wear hearing protection if you’re going to be in a noisy environment.

    Discreet options include things like these -20 dB silicone ear plugs that live in a little case on one’s keyring.

    Stop sticking things in your ears

    It’s said “nothing smaller than your elbow should go in your ear canal”. We’ve written about this before:

    What’s Good (And What’s Not) Against Earwax

    Look after the rest of your health

    Our ears are not islands unaffected by the rest of our health, and indeed, they’re larger and more complex organs than we think about most of the time, since we only tend to think about the (least important!) external part.

    Common causes of hearing loss that aren’t the percussive injuries we discussed above include:

    • Diabetes
    • High blood pressure
    • Smoking
    • Infections
    • Medications

    Lest that last one sound a little vague, it’s because there are hundreds of medications that have hearing loss as a potential side-effect. Here’s a list so you can check if you’re taking any of them:

    List of Ototoxic Medications That May Cause Tinnitus or Hearing Loss

    Get your hearing tested regularly.

    There are online tests, but we recommend an in-person test at a local clinic, as it won’t be subject to the limitations and quirks of the device(s) you’re using. Pretty much anywhere that sells hearing aids will probably offer you a free test, so take advantage of it!

    And, more generally, if you suddenly notice you lost some or all of your hearing in one or more ears, then get thee to a doctor, and quickly.

    Treat it as an emergency, because there are many things that can be treated if and only if they are caught early, before the damage becomes permanent.

    Use it or lose it

    This one’s important. As we get older, it’s easy to become more reclusive, but the whole “neurons that fire together, wire together” neuroplasticity thing goes for our hearing too.

    Our brain is, effectively, our innermost hearing organ, insofar as it processes the information it receives about sounds that were heard.

    There are neurological hearing problems that can show up without external physical hearing damage (auditory processing disorders being high on the list), but usually these things are comorbid with each other.

    So if we want to maintain our ability to process the sounds our ears detect, then we need to practice that ability.

    Important implication:

    That means that if you might benefit from a hearing aid, you should get it now, not later.

    It’s counterintuitive, we know, but because of the neurological consequences, hearing aids help people retain their hearing, whereas soldiering on without can hasten hearing loss.

    On the topic of hearing difficulty comorbidities…

    Tinnitus (ringing in the ears) is, paradoxically, associated with both hearing loss, and with hyperacusis (hearing supersensitivity, which sounds like a superpower, but can be quite a problem too).

    Learn more about managing that, here:

    Tinnitus: Quieting The Unwanted Orchestra In Your Ears

    Take care!

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  • The Best Kind Of Fiber For Overall Health?

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    The Fiber Of Good Health

    We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:

    Why You’re Probably Not Getting Enough Fiber (And How To Fix It)

    Fiber’s important for many aspects of health, not least of all the heart:

    What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure

    As well, of course, as being critical for gut health:

    Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)

    But is all fiber “prebiotic fiber”, and/or are some better than others?

    Beta-glucan

    A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:

    • pectin
    • β-glucan
    • wheat dextrin
    • resistant starch
    • cellulose (control)

    As for health metrics, they measured:

    • body weight
    • adiposity
    • indirect calorimetry
    • glucose tolerance
    • gut microbiota
    • metabolites thereof

    What they found was…

    ❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.

    All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞

    ~ Dr. Elizabeth Howard et al.

    If you’d like to read more, the study itself is here:

    Impact of Plant-Based Dietary Fibers on Metabolic Homeostasis in High-Fat Diet Mice via Alterations in the Gut Microbiota and Metabolites

    If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.

    It also acts indirectly as a GLP-1 agonist, by the way:

    The right fiber may help you lose weight

    You may be wondering: what is β-glucan found in?

    It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.

    Is it available as a supplement?

    More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.

    As an aside, cordyceps itself has many other healthful properties too:

    Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.

    Enjoy!

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Related Posts

  • Healthy Heart, Healthy Brain – by Dr. Bradley Bale & Dr. Amy Doneen
  • Safe Effective Sleep Aids For Seniors

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    Safe Efective Sleep Aids For Seniors

    Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:

    Review of Safety and Efficacy of Sleep Medicines in Older Adults

    Let’s break it down…

    What’s not so great

    Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.

    Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.

    Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.

    See also: Benzodiazepine and z-drug withdrawal

    (and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)

    Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.

    What about cannabis products?

    We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.

    How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.

    Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.

    See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature

    Melatonin: a powerful helper with a good safety profile

    We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.

    Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:

    Melatonin: A Safe Natural Sleep Supplement

    Herbal options: which really work?

    Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.

    See: Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

    Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).

    But here’s one study that found it helped significantly:

    The effects of chamomile extract on sleep quality among elderly people: A clinical trial

    Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!

    Technological interventions

    We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:

    White Noise Is Good; Pink Noise Is Better

    Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.

    We reviewed some sleep apps; you might like those too:

    The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down

    Enjoy, and rest well!

    Don’t Forget…

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  • Sun, Sea, And Sudden Killers To Avoid

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    Stay Safe From Heat Exhaustion & Heatstroke!

    For most of us, summer is upon us now. Which can be lovely… and also bring new, different health risks. Today we’re going to talk about heat exhaustion and heatstroke.

    What’s the difference?

    Heat exhaustion is a milder form of heatstroke, but the former can turn into the latter very quickly if left untreated.

    Symptoms of heat exhaustion include:

    • Headache
    • Nausea
    • Cold sweats
    • Light-headedness

    Symptoms of heatstroke include the above and also:

    • Red/flushed-looking skin
    • High body temperature (104ºF / 40ºC)
    • Disorientation/confusion
    • Accelerated heart rate

    Click here for a handy downloadable infographic you can keep on your phone

    What should we do about it?

    In the case of heatstroke, call 911 or the equivalent emergency number for the country where you are.

    Hopefully we can avoid it getting that far, though:

    Prevention first

    Here are some top tips to avoid heat exhaustion and thus also avoid heatstroke. Many are common sense, but it’s easy to forget things—especially in the moment, on a hot sunny day!

    • Hydrate, hydrate, hydrate
      • (Non-sugary) iced teas, fruit infusions, that sort of thing are more hydrating than water alone
      • Avoid alcohol
        • If you really want to imbibe, rehydrate between each alcoholic drink
    • Time your exercise with the heat in mind
      • In other words, make any exercise session early or late in the day, not during the hottest period
    • Use sunscreen
      • This isn’t just for skin health (though it is important for that); it will also help keep you cooler, as it blocks the UV rays that literally cook your cells
    • Keep your environment cool
      • Shade is good, air conditioning / cooling fans can help.
      • A wide-brimmed hat is portable shade just for you
    • Wear loose, breathable clothing
      • We write about health, not fashion, but: light breathable clothes that cover more of your body are generally better healthwise in this context, than minimal clothes that don’t, if you’re in the sun.
    • Be aware of any medications you’re taking that will increase your sensitivity to heat.
      • This includes medications that are dehydrating, and includes most anti-depressants, many anti-nausea medications, some anti-allergy medications, and more.
      • Check your labels/leaflets, look up your meds online, or ask your pharmacist.

    Treatment

    If prevention fails, treatment is next. Again, in the case of heatstroke, it’s time for an ambulance.

    If symptoms are “only” of heat exhaustion and are more mild, then:

    • Move to a cooler location
    • Rehydrate again
    • Remove clothing that’s confining or too thick
      • What does confining mean? Clothing that’s tight and may interfere with the body’s ability to lose heat.
        • For example, you might want to lose your sports bra, but there is no need to lose a bikini, for instance.
    • Use ice packs or towels soaked in cold water, applied to your body, especially wear circulation is easiest to affect, e.g. forehead, wrists, back of neck, under the arms, or groin.
    • A cool bath or shower, or a dip in the pool may help cool you down, but only do this if there’s someone else around and you’re not too dizzy.
      • This isn’t a good moment to go in the sea, no matter how refreshing it would be. You do not want to avoid heatstroke by drowning instead.

    If full recovery doesn’t occur within a couple of hours, seek medical help.

    Stay safe and have fun!

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  • Body Scrubs: Benefits, Risks, and Guidance

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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

    ❝I was wondering whether I should be using a body scrub in the shower, rather than just soap.  What should guide me in the choice of a body scrub, and are there any risks to be aware of?❞

    Body scrubs are great for giving skin a healthy glow, but are best used sparingly—over-exfoliation leads to the opposite effect (unhappy skin, premature skin aging, etc).

    As for contents:

    • microplastics are now banned in most places, but you might want to check any products (and their containers!) are BPA-free, pthalate free, etc.
    • fragrances in body scrubs are usually a bad idea, and many essential oils have been shown to be endocrine-disruptors, which you do not want:

    About the microplastics, harmful artificial chemicals in general, and what constitutes “etc”:

    Consumer behavior and exposure to parabens, bisphenols, triclosan, dichlorophenols, and benzophenone-3: Results from a crowdsourced biomonitoring study

    About the fragrances’ (including “natural” essential oils’) endocrine-disrupting shenanigans:

    Endocrine-disrupting chemicals: an Endocrine Society scientific statement

    So, what might you want to use instead?

    If you’re feeling adventurous, you might like to try treating yourself to a pineapple-based mask instead (a muslin cloth soaked in pineapple juice will work just fine; please don’t waterboard yourself though), as the bromelain enzymes (found very generously in pineapple juice) break down dead cells without the need for scrubbing.

    Another option is a homemade salt- or sugar-scrub. Put your salt or sugar into a jar, add enough warm water to cover it, leave it for about a day, adding more water if it seems in danger of drying out, until it recrystallizes with a high water content keeping it malleable to the touch; congratulations, you now have a very simple scrub. This should still not be used more than, say, once per week, though.

    Last but not least, you might consider investing in a konjac sponge; they gently remove dead skin without damaging living skin. Here’s an example product on Amazon, for your convenience

    For more on gentle-yet-effective skincare, you might like to read:

    Clean: The New Science of Skin and the Beauty of Doing Less

    Enjoy!

    Don’t Forget…

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    Learn to Age Gracefully

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