The Myth of Normal – by Dr. Gabor Maté and Daniel Maté
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A lot of popular beliefs (and books!) start with the assumption that everyone is, broadly speaking, “normal”. That major diversions from “normal” happen only to other people… And that minor diversions from “normal” are just something to suck up and get over—magically effecting a return to “normalcy”.
Dr. Maté, however, will have none of these unhelpful brush-offs, and observes that in fact most if not all of us have been battered by the fates one way or another. We just:
- note that we have more similarities than differences, and
- tend to hide our own differences (to be accepted) or overlook other people’s (to make them more acceptable).
How is this more helpful? Well, the above approach isn’t always, but Mate has an improvement to offer:
We must see flawed humans (including ourselves) as the product of our environments… and/but see this a reason to look at improving those environments!
Beyond that…
The final nine chapters of the books he devotes to “pathways to wholeness” and, in a nutshell, recovery. Recovery from whatever it was for you. And if you’ve had a life free from anything that needs recovering from, then congratulations! You doubtlessly have at least one loved one who wasn’t so lucky, though, so this book still makes for excellent reading.
Dr. Maté was awarded the Order of Canada for his medical work and writing. His work has mostly been about addiction, trauma, stress, and childhood development. He co-wrote this book with his son, Daniel.
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Paving The Way To Good Health
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This is Dr. Michelle Tollefson. She’s a gynecologist, and a menopause and lifestyle medicine expert. She’s also a breast cancer survivor, and, indeed, thriver.
So, what does she want us to know?
A Multivector Approach To Health
There’s a joke that goes: a man is trapped in a flooding area, and as the floodwaters rise, he gets worried and begins to pray, but he is interrupted when some people come by on a raft and offer him to go with them. He looks at the rickety raft and says “No, you go on, God will spare me”. He returns to his prayer, and is further interrupted by a boat and finally a helicopter, and each time he gives the same response. He drowns, and in the afterlife he asks God “why didn’t you spare me from the flood?”, and God replies “I sent a raft, a boat, and a helicopter; what more did you want?!”
People can be a bit the same when it comes to different approaches to cancer and other serious illness. They are offered chemotherapy and say “No, thank you, eating fruit will spare me”.
Now, this is not to trivialize those who decline aggressive cancer treatments for other reasons such as “I am old and would rather not go through that; I’d rather have a shorter life without chemo than a longer life with it”—for many people that’s a valid choice.
But it is to say: lifestyle medicine is, mostly, complementary medicine.
It can be very powerful! It can make the difference between life and death! Especially when it comes to things like cancer, diabetes, heart disease, etc.
But it’s not a reason to decline powerful medical treatments if/when those are appropriate. For example, in Dr. Tollefson’s case…
Synergistic health
Dr. Tollefson, herself a lifestyle medicine practitioner and gynecologist (and having thus done thousands of clinical breast exams for other people, screening for breast cancer), says she owes her breast cancer survival to two things, or rather two categories of things:
- a whole-food, plant predominant diet, daily physical activity, prioritizing sleep, minimizing stress, and a strong social network
- a bilateral mastectomy, 16 rounds of chemotherapy, removal of her ovaries, and several reconstructive surgeries
Now, one may wonder: if the first thing is so good, why need the second?
Or on the flipside: if the second thing was necessary, what was the point of the first?
And the answer she gives is: the first thing was the reason she was able to make it through the second thing.
And on the next level: the second thing was the reason she’s still around to talk about the first thing.
In other words: she couldn’t have done it with just one or the other.
A lot of medicine in general, and lifestyle medicine in particular, is like this. If we note that such-and-such a thing decreases our risk of cancer mortality by 4%, that’s a small decrease, but it can add up (and compound!) if it’s surrounded by other things that also each decrease the risk by 12%, 8%, 15%, and so on.
Nor is this only confined to cancer, nor only to the positives.
Let’s take cardiovascular disease: if a person smokes, drinks, eats red meat, stresses, and has a wild sleep schedule, you can imagine those risk factors add up and compound.
If this person and another with a heart-healthy lifestyle both have a stroke (it can happen to anyone, even if it’s less likely in this case), and both need treatment, then two things are true:
- They are both still going to need treatment (medicines, and possibly a thrombectomy)
- The second person is most likely to recover, and most likely to recover more quickly and easily
The second person can be said to have paved the way to their recovery, with their lifestyle.
Which is really important, because a lot of people think “what’s the point in living so healthily if [disease] strikes anyway?” and the answer is:
A very large portion of your recovery is predicated on how you lived your life before The Bad Thing™ happened, and that can be the difference between bouncing back quickly and a long struggle back to health.
Or the difference between a long struggle back to health, or a short struggle followed by rapid decline and death.
In short:
Play the odds, improve your chances with lifestyle medicine. Enjoy those cancer-fighting fruits:
Top 8 Fruits That Prevent & Kill Cancer
…but also, get your various bits checked when appropriate; we know, mammograms and prostate checks etc are not usually the highlight of most people’s days, but they save lives. And if it turns out you need serious medical interventions, consider them seriously.
And, by all means, enjoy mood-boosting nutraceuticals such as:
12 Foods That Fight Depression & Anxiety
…but also recognize that sometimes, your brain might have an ongoing biochemical problem that a tablespoon of pumpkin seeds isn’t going to fix.
And absolutely, you can make lifestyle adjustments to reduce the risks associated with menopause, for example:
Menopause, & How Lifestyle Continues To Matter “Postmenopause”
…but also be aware that if the problem is “not enough estrogen”, sometimes to solution is “take estrogen”.
And so on.
Want to know Dr. Tollefson’s lifestyle recommendations?
Most of them will not be a surprise to you, and we mentioned some of them above (a whole-food, plant predominant diet, daily physical activity, prioritizing sleep, minimizing stress, and a strong social network), but for more specific recommendations, including numbers etc, enjoy:
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Toxic Gas That Sterilizes Medical Devices Prompts Safety Rule Update
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Over the past two years, Madeline Beal has heard frustration and even bewilderment during public meetings about ethylene oxide, a cancer-causing gas that is used to sterilize half of the medical devices in the U.S.
Beal, senior risk communication adviser for the Environmental Protection Agency, has fielded questions about why the agency took so long to alert people who live near facilities that emit the chemical about unusually high amounts of the carcinogenic gas in their neighborhoods. Residents asked why the EPA couldn’t close those facilities, and they wanted to know how many people had developed cancer from their exposure.
“If you’re upset by the information you’re hearing tonight, if you’re angry, if it scares you to think about risk to your family, those are totally reasonable responses,” Beal told an audience in Laredo, Texas, in September 2022. “We think the risk levels near this facility are too high.”
There are about 90 sterilizing plants in the U.S. that use ethylene oxide, and for decades companies used the chemical to sterilize medical products without drawing much attention. Many medical device-makers send their products to the plants to be sterilized before they are shipped, typically to medical distribution companies.
But people living around these facilities have been jolted in recent years by a succession of warnings about cancer risk from the federal government and media reports, an awareness that has also spawned protests and lawsuits alleging medical harm.
The EPA is expected to meet a March 1 court-ordered deadline to finalize tighter safety rules around how the toxic gas is used. The proposed changes come in the wake of a 2016 agency report that found that long-term exposure to ethylene oxide is more dangerous than was previously thought.
But the anticipated final rules — the agency’s first regulatory update on ethylene oxide emissions in more than a decade — are expected to face pushback. Medical device-makers worry stricter regulation will increase costs and may put patients at higher risk of infection from devices, ranging from surgical kits to catheters, due to deficient sterilization. The new rules are also not likely to satisfy the concerns of environmentalists or members of the public, who already have expressed frustration about how long it took the federal government to sound the alarm.
“We have been breathing this air for 40 years,” said Connie Waller, 70, who lives with her husband, David, 75, within two miles of such a sterilizing plant in Covington, Georgia, east of Atlanta. “The only way to stop these chemicals is to hit them in their pocketbook, to get their attention.”
The EPA says data shows that long-term exposure to ethylene oxide can increase the risk of breast cancer and cancers of the white blood cells, such as non-Hodgkin lymphoma, myeloma, and lymphocytic leukemia. It can irritate the eyes, nose, throat, and lungs, and has been linked to damage to the brain and nervous and reproductive systems. Children are potentially more vulnerable, as are workers routinely exposed to the chemical, EPA officials say. The agency calculates the risk based on how much of the gas is in the air or near the sterilizing facility, the distance a person is from the plant, and how long the person is exposed.
Waller said she was diagnosed with breast cancer in 2004 and that her husband was found to have non-Hodgkin lymphoma eight years later.
A 2022 study of communities living near a sterilization facility in Laredo found the rates of acute lymphocytic leukemia and breast cancer were greater than expected based on statewide rates, a difference that was statistically significant.
Beal, the EPA risk adviser, who regularly meets with community members, acknowledges the public’s concerns. “We don’t think it’s OK for you to be at increased risk from something that you have no control over, that’s near your house,” she said. “We are working as fast as we can to get that risk reduced with the powers that we have available to us.”
In the meantime, local and state governments and industry groups have scrambled to defuse public outcry.
Hundreds of personal injury cases have been filed in communities near sterilizing plants. In 2020, New Mexico’s then-attorney general filed a lawsuit against a plant in Santa Teresa, and that case is ongoing. In a case that settled last year in suburban Atlanta, a company agreed to pay $35 million to 79 people who alleged ethylene oxide used at the plant caused cancer and other injuries.
In Cook County, Illinois, a jury in 2022 awarded $363 million to a woman who alleged exposure to ethylene oxide gas led to her breast cancer diagnosis. But, in another Illinois case, a jury ruled that the sterilizing company was not liable for a woman’s blood cancer claim.
Greg Crist, chief advocacy officer for the Advanced Medical Technology Association, a medical device trade group that says ethylene oxide is an effective and reliable sterilant, attributes the spate of lawsuits to the litigious nature of trial attorneys.
“If they smell blood in the water, they’ll go after it,” Crist said.
Most states have at least one sterilizing plant. According to the EPA, a handful, like California and North Carolina, have gone further than the agency and the federal Clean Air Act to regulate ethylene oxide emissions. After a media and political firestorm raised awareness about the metro Atlanta facilities, Georgia started requiring sterilizing plants that use the gas to report all leaks.
The proposed rules the EPA is set to finalize would set lower emissions limits for chemical plants and commercial sterilizers and increase some safety requirements for workers within these facilities. The agency is expected to set an 18-month deadline for commercial sterilizers to come into compliance with the emissions rules.
That would help at facilities that “cut corners,” with lax pollution controls that allow emissions of the gas into nearby communities, said Richard Peltier, a professor of environmental health sciences at the University of Massachusetts-Amherst. Stronger regulation also prevents the plants from remaining under the radar. “One of the dirty secrets is that a lot of it is self-regulated or self-policed,” Peltier added.
But the proposed rules did not include protections for workers at off-site warehouses that store sterilized products, which can continue to emit ethylene oxide. They also did not require air testing around the facilities, prompting debate about how effective they would be in protecting the health of nearby residents.
Industry officials also don’t expect an alternative that is as broadly effective as ethylene oxide to be developed anytime soon, though they support researching other methods. Current alternatives include steam, radiation, and hydrogen peroxide vapor.
Increasing the use of alternatives can reduce industry dependence on “the crutch of ethylene oxide,” said Darya Minovi, senior analyst with the Union of Concerned Scientists, an advocacy group.
But meeting the new guidelines will be disruptive to the industry, Crist said. He estimates companies will spend upward of $500 million to comply with the new EPA rules and could struggle to meet the agency’s 18-month timetable. Sterilization companies will also have difficulty adjusting to new rules on how workers handle the gas without a dip in efficiency, Crist said.
The Food and Drug Administration, which regulates drugs and medical devices, is also watching the regulatory moves closely and worries the updated emissions rule could “present some unique challenges” if implemented as proposed, said Audra Harrison, an FDA spokesperson. “The FDA is concerned about the rule’s effects on the availability of medical devices,” she added.
Other groups, like the American Chemistry Council and the Texas Commission on Environmental Quality, the state’s environmental agency, assert that ethylene oxide use isn’t as dangerous as the EPA says. The EPA’s toxicity assessment has “severe flaws” and is “overly conservative,” the council said in an emailed statement. Texas, which has several sterilizing plants, has said ethylene oxide isn’t as high a cancer risk as the agency claims, an assessment that the EPA has rejected.
Tracey Woodruff, a researcher at the University of California-San Francisco who previously worked at the EPA, said it can be hard for the agency to keep up with regulating chemicals like ethylene oxide because of constrained resources, the technical complications of rulemaking, and industry lobbying.
But she’s hopeful the EPA can strike a balance between its desire to reduce exposure and the desire of the FDA not to disrupt medical device sterilization. And scrutiny can also help the device sterilization industry think outside the box.
“We continue to discover these chemicals that we’ve already been exposed to were toxic, and we have high exposures,” she said. “Regulation is an innovation forcer.”
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.
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The surprising ways ‘swimming off’ a hangover can be risky, even if alcohol has left your system
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It’s the morning after a big night and you’re feeling the effects of too much alcohol.
So it can be tempting to “refresh” and take the edge off a hangover with a swim at the beach, or a dip in the cool waters of your local river or pool.
But you might want to think twice.
The day after heavy drinking can affect your body, energy levels and perception of risk in many ways. This means you’re more likely to drown or make careless decisions – even without high levels of alcohol in your blood.
Wanderlust Media/Shutterstock Alcohol + water + summer = drowning
Alcohol is one of the main reasons why someone’s more likely to die due to drowning. And Australians consume a lot of it, including around the water.
The risk of drowning, and injury, including incidents involving alcohol, dramatically increases over the summer festive period – in particular on public holidays and long weekends.
Among people aged 18 and over who drowned in rivers where alcohol was involved, we found some 40% had a blood alcohol concentration of at least 0.20%. That’s four times the upper legal limit of 0.05% when driving a car on a full licence.
When we breathalysed people at four Australian rivers, we found higher levels of blood alcohol with higher temperatures, and particularly on public holidays.
At the beach, intoxication due to alcohol and/or drugs is involved in 23% of drowning deaths with an average blood alcohol concentration of 0.19%.
How about if you’re hungover?
Getting alcohol out of your body is a relatively slow process. On average, alcohol is metabolised at a rate of 0.015% per hour. So if someone stops drinking at 2am with a blood alcohol concentration of 0.20%, their alcohol levels don’t drop to zero until 4pm the next day.
Although hangovers can vary from person to person, typical symptoms include headache, muscle aches, fatigue, weakness, thirst, nausea, stomach pain, vertigo, irritability, sensitivity to light and sound, anxiety, sweating and increased blood pressure.
As well as feeling a bit dusty, the day after an evening of heavy drinking, you’re not so good at identifying risks and reacting to them.
In a pool, this might mean not noticing it’s too shallow to dive safely. In natural waterways, this might mean not noticing a strong river current or a rip current at the beach. Or someone might notice these hazards but swim or dive in anyway.
You don’t have to have alcohol in your blood to be affected. Fatigue can set in, leading you to make careless decisions. tismaja/Shutterstock In one study, we found that after a four-day Australian music festival where people drank heavily, even people who were sober (no longer had alcohol in their blood) were still affected.
Compared to baseline tests in the lab we ran three weeks before the festival, people who were sober the day after the festival had faster reaction times in a test to gauge their attention. But they made more mistakes. This suggests hangovers coupled with fatigue lead to quicker but more careless behaviour.
In and around water this could be the difference between life and death.
Positive blood alcohol readings, including of alcohol from the night before, are commonly implicated in drowning deaths as a result of risky behaviours such as jumping into the water, both at a river and along the coast. Jumping can cause physical injury or render you unconscious, leading to drowning.
Alcohol, including the day after drinking, can also make drowning more likely for a number of other reasons. It also reduces people’s coordination and reaction times.
What else is going on?
Alcohol makes the blood vessels near your skin open up (dilate). So more blood flows into them, making you feel hot. This means you may stay in colder water for longer, increasing your risk of hypothermia.
Alcohol can even make CPR (cardiopulmonary resuscitation) less effective, should you need to be resuscitated.
Normally, your body controls levels of certain minerals (or electrolytes) in the blood. But electrolyte imbalance is common after heavy drinking, including the day after. It’s the reason why hangover symptoms such as muscle pain can lead to cramps in your arms or legs. This can become dangerous when being in or on the water.
Low blood sugar levels the day after drinking is also common. This can lead to people becoming exhausted more quickly when doing physical activities, including swimming.
Other hazards include cold water, high waves and deep water, all of which your body may not be capable of dealing with if you’re feeling the effects of a big night.
What can we do about it?
Authorities regularly warn about the dangers of alcohol intoxication and being near the water. Young people and men are often targeted because these are the groups more likely to drown where alcohol is involved.
Beaches may have alcohol-free zones. Rivers rarely have the same rules, despite similar dangers. https://www.youtube.com/embed/5Salt-kkGUo?wmode=transparent&start=0 Royal Life Saving urges men to ‘make the right call’ and avoid alcohol around the water.
How to stay safe around water if you’re drinking
So take care this summer and stay out of the water if you’re not feeling your best:
- do your swimming before your drinking
- look out for your mates, especially ones who may have had a few too many or are hungover
- avoid getting back into the water after you’ve drunk alcohol or if you’re not feeling your best the next day.
Amy Peden, NHMRC Research Fellow, School of Population Health & co-founder UNSW Beach Safety Research Group, UNSW Sydney; Emmanuel Kuntsche, Director of the Centre for Alcohol Policy Research, La Trobe University, and Jasmin C. Lawes, Adjunct Senior Lecturer, UNSW Beach Safety Research Group, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How to Boost Your Metabolism When Over 50
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Dr. Dawn Andalon, a physiotherapist, explains the role of certain kinds of exercise in metabolism; here’s what to keep in mind:
Work with your body
Many people make the mistake of thinking that it is a somehow a battle of wills, and they must simply will their body to pick up the pace. That’s not how it works though, and while that can occasionally get short-term results, at best it’ll quickly result in exhaustion. So, instead:
- Strength training: engage in weight training 2–3 times per week; build muscle and combat bone loss too. Proper guidance from trainers familiar with older adults is recommended. Pilates (Dr. Andalon is a Pilates instructor) can also complement strength training by enhancing core stability and preventing injuries. The “building muscle” thing is important for metabolism, because muscle increases the body’s metabolic base rate.
- Protein intake: Dr. Andalon advises to consume 25–30 grams of lean protein per meal to support muscle growth and repair (again, important for the same reason as mentioned above re exercise). Dr. Andalon’s recommendation is more protein per meal than is usually advised, as it is generally held that the body cannot use more than about 20g at once.
- Sleep quality: prioritize good quality sleep, by practising good sleep hygiene, and also addressing any potential hormonal imbalances affecting sleep. If you do not get good quality sleep, your metabolism will get sluggish in an effort to encourage you to sleep more.
- Exercise to manage stress: regular walking (such as the popular 10,000 steps daily) helps manage stress and improve metabolism. Zone two cardio (low-intensity movement) also supports joint health, blood flow, and recovery—but the main issue about stress here is that if your body experiences unmanaged stress, it will try to save you from whatever is stressing you by reducing your metabolic base rate so that you can out-survive the bad thing. Which is helpful if the stressful thing is that the fruit trees got stripped by giraffes and hunting did not yield a kill, but not so helpful if the stressful thing is the holiday season.
- Hydration: your body cannot function properly without adequate hydration; water is needed (directly or indirectly) for all bodily processes, and your metabolism will also “dry up” without it.
- Antidiabetic & anti-inflammatory diet: minimize sugar intake and reduce processed foods, especially those with inflammatory refined oils (esp. canola & sunflower) and the like. This has very directly to do with your body’s energy metabolism, and as they say in computing, “garbage in; garbage out”.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Burn! How To Boost Your Metabolism
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The High-Protein, High-Fiber Superfood Salad You’ll Want To Enjoy Daily
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This salad from Nisha Vora at Rainbow Plant Life has 30g protein and takes minutes to prepare, while being tasty enough to look forward to eating each day:
Easy preparation
Prepare the toppings first; you can do a week’s in advance at once:
- Roasted chickpeas:
- Drain, rinse, and dry two cans of chickpeas.
- Toss with olive oil, salt, and pepper.
- Roast at 425°F for 30–35 minutes.
- Roasted walnuts:
- Chop and toss with olive oil, salt, and pepper.
- Roast at 350°F for 12 minutes after chickpeas finish.
As for the salad base:
- Kale:
- Remove tough stems, slice thinly.
- Wash and massage with lemon juice and salt to soften.
- Cabbage:
- Slice thinly with a knife or mandolin.
- Store in a sealed bag in the fridge for up to a week.
Red wine vinaigrette dressing:
- Key ingredients: red wine vinegar, lemon juice, red pepper flakes, garlic, olive oil.
- Can be stored in the fridge for up to 10 days.
Putting it all together:
- Toss kale and cabbage with vinaigrette by hand.
- Add roasted chickpeas and walnuts for crunch.
- Include a protein source like tofu (store-bought curry tofu recommended).
- Mix in fresh vegetables like grated carrots, sliced bell peppers, or beets.
- Add extras like sauerkraut, avocado, pickled onions, and such.
- Top with fresh herbs (she recommends parsley, basil, or dill).
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You might also like:
21 Most Beneficial Polyphenols & What Foods Have Them
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- Roasted chickpeas:
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Food Fix – by Dr. Mark Hyman
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On a simplistic level, “eat more plants, but ideally not monocrops, and definitely fewer animals” is respectable, ecologically-aware advice that is also consistent with good health. But it is a simplification, and perhaps an oversimplification.
Is there space on a healthy, ecologically sound plate for animal products? Yes, argues Dr. Mark Hyman. It’s a small space, but it’s there.
For example, some kinds of fish are both healthier and more sustainable as a food source than others, same goes for some kinds of dairy products. Poultry, too, can be farmed sustainably in a way that promotes a small self-contained ecosystem—and in terms of health, consumption of poultry appears to be health-neutral at worst.
As this book explores:
- Oftentimes, food choices look like: healthy/sustainable/cheap (choose one).
- Dr. Hyman shows how in fact, we can have it more like: healthy/sustainable/cheap (choose two).
- He argues that if more people “vote with their fork”, production will continue to adjust accordingly, and we’ll get: healthy/sustainable/cheap (all three).
To this end, while some parts of the book can feel like they are purely academic (pertaining less to what we can do as individuals, and more on what governments, farming companies, etc can do), it’s good to know what issues we might also take to the ballot box, if we’re able.
The big picture aside, the book remains very strong even just from an individual health perspective, though.
Bottom line: if you have an interest in preserving your own health, and possibly humanity itself, this is an excellent book.
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