The SharpBrains Guide to Brain Fitness – by Alvaro Fernandez et al.
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We say “et al.” in the by-line, because this one has a flock of authors, including Dr. Pascale Michelon, Dr. Sandra Bond Chapman, Dr. Elkehon Goldberg, and various others if we include the foreword, introduction, etc.
This is relevant, because those who contributed to the meat of the book (i.e., those listed above), it makes the work a lot more scientifically reliable; one skilled science writer might make a mistake; it’s much less likely to make it through to publication when there are a bevy of doctors in the mix, each staking their reputation on the book’s content, and thus having a vested interest in checking each other’s work as well as their own.
As for what this multidisciplinary team have to offer? The book covers such things as:
- how the brain works (especially the possibilities of neuroplasticity), and what that means for such things as memory and attention
- being “a coach not a patient”; i.e., being active rather than passive in one’s approach to brain health
- the relevance of physical exercise, how much, and what kind
- the relevance (and limitations) of diet choices for brain health
- the relevance of such things as learning new languages and musical training
- the relevance of social engagement, and how some (but not all) social engagement can boost cognition
- methods for managing stress and building resilience to same (critical for maintaining a healthy brain)
- “cross-fit for your brain”, that is to say, a multi-vector collection of tools to explore, ranging from meditation to CBT to biofeedback and more.
The style is pop-science without being sensationalist, just communicating ideas clearly, with enough padding to feel casual, and not like a dense read. Importantly, it’s also practical and applicable too, which is something we always look for here.
Bottom line: if you’d like to be given a good overview of what things work (and how much they can be expected to work), along with a good framework to put that knowledge into practice, then this is a great book for you.
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Falling: Is It Due To Age Or Health Issues?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝What are the signs that a senior is falling due to health issues rather than just aging?❞
Superficial answer: having an ear infection can result in a loss of balance, and is not particularly tied to age as a risk factor
More useful answer: first, let’s consider these two true statements:
- The risks of falling (both the probability and the severity of consequences) increase with age
- Health issues (in general) tend to increase with age
With this in mind, it’s difficult to disconnect the two, as neither exist in a vacuum, and each is strongly associated with the other.
So the question is easier to answer by first flipping it, to ask:
❝What are the health issues that typically increase with age, that increase the chances of falling?❞
A non-exhaustive list includes:
- Loss of strength due to sarcopenia (reduced muscle mass)
- Loss of mobility due to increased stiffness (many causes, most of which worsen with age)
- Loss of risk-awareness due to diminished senses (for example, not seeing an obstacle until too late)
- Loss of risk-awareness due to reduced mental focus (cognitive decline producing absent-mindedness)
Note that in the last example there, and to a lesser extent the third one, reminds us that falls also often do not happen in a vacuum. There is (despite how it may sometimes feel!) no actual change in our physical relationship with gravity as we get older; most falls are about falling over things, even if it’s just one’s own feet:
The 4 Bad Habits That Cause The Most Falls While Walking
Disclaimer: sometimes a person may just fall down for no external reason. An example of why this may happen is if a person’s joint (for example an ankle or a knee) has a particular weakness that means it’ll occasionally just buckle and collapse under one’s own weight. This doesn’t even have to be a lot of weight! The weakness could be due to an old injury, or Ehlers-Danlos Syndrome (with its characteristic joint hypermobility symptoms), or something else entirely.
Now, notice how:
- all of these things can happen at any age
- all of these things are more likely to happen the older we get
- none of these things have to happen at any age
That last one’s important to remember! Aging is often viewed as an implacable Behemoth, but the truth is that it is many-faceted and every single one of those facets can be countered, to a greater or lesser degree.
Think of a room full of 80-year-olds, and now imagine that…
- One has the hearing of a 20-year-old
- One has the eyesight of a 20-year-old
- One has the sharp quick mind of a 20-year-old
- One has the cardiovascular fitness of a 20-year-old
…etc. Now, none of those things in isolation is unthinkable, so remember, there is no magic law of the universe saying we can’t have each of them:
Age & Aging: What Can (And Can’t) We Do About It?
Which means: that goes for the things that increase the risk of falling, too. In other words, we can combat sarcopenia with protein and resistance training, maintain our mobility, look after our sensory organs as best we can, nourish our brain and keep it sharp, etc etc etc:
Train For The Event Of Your Life! (Mobility As A Long-Term “Athletic” Goal For Personal Safety)
Which doesn’t mean: that we will necessarily succeed in all areas. Your writer here, broadly in excellent health, and whose lower body is still a veritable powerhouse in athletic terms, has a right ankle and left knee that will sometimes just buckle (yay, the aforementioned hypermobility).
So, it becomes a priority to pre-empt the consequences of that, for example:
- being able to fall with minimal impact (this is a matter of knowing how, and can be learned from “soft” martial arts such as aikido), and
- ensuring the skeleton can take a knock if necessary (keeping a good balance of vitamins, minerals, protein, etc; keeping an eye on bone density).
See also:
Fall Special ← appropriate for the coming season, but it’s about avoiding falling, and reducing the damage of falling if one does fall, including some exercises to try at home.
Take care!
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Signs That Are Present When Someone Is Dying
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You’ve probably been there a few times, although given the emotional nature of the thing, it’s likely that you weren’t taking notes. Hospice workers, on the other hand, do take notes, so here are some things you might want to know, and if anything makes the next time even a little easier, that’ll be good:
Last stages
Here are the discussed signs of the “active dying” phase:
- Increasing unconsciousness:
- The person will be mostly unresponsive most of the time.
- Eyes may be open or partially open but not making eye contact.
- Mouth will likely remain open due to muscle relaxation.
- Cessation of food and water intake
- The person will likely not eat or drink for several days.
- This is a natural process and does not cause suffering per se (e.g. thirst, hunger).
- Dryness of mouth, however, can be treated with a little moistening, for comfort.
- Changes in breathing
- Breathing patterns will change and may be irregular.
- This is a natural metabolic response, and is not a sign of distress.
- Terminal secretions (“death rattle”) may occur:
- A gurgling sound caused by saliva buildup due to loss of swallowing reflex.
- Not painful or distressing for the person.
- Can be managed by repositioning or using medication to dry secretions.
- Skin color changes / mottling:
- First appears on fingers and toes (purple or gray discoloration).
- May spread to knees, nose, or other extremities.
- Temperature fluctuations:
- The body loses its ability to regulate temperature.
- Person may feel hot but be cold (or vice versa).
- Fevers are common—cooling measures and/or Tylenol can help.
A person in discomfort may appear restless, have a furrowed brow, or show physical agitation. If on the other hand they appear peaceful and unresponsive, they are almost certainly not in distress. At such times, it’s best to focus on just keeping them clean and comfortable.
For more on all of these, see:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Managing Mortality: When Planning Is a Matter of Life and Death
Take care!
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- Increasing unconsciousness:
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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:
Click Here If The Embedded Video Doesn’t Load Automatically!
Take care!
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The Good, The Bad, & The Vigorously Debated
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This week in health news sees some pretty varied topics:
One more reason to care about the gut-brain axis
Stroke is a top killer in much of the industrialized world, usually making it into the top-few list on a per-country basis. And, it’s rising in prevalence, too. This is partly because our longevity is increasing so age-related things kill us more often, statistically, than age-unrelated things. But that’s only part of the reason; another is that our lifestyle (on the national level) is becoming more conducive to stroke. Diet is a large contributor to that, and gut health has now been identified as a key factor.
What recent research has shown is that minutes after a stroke occurs, normal gut anatomy is disrupted, and cells responsible for gut barrier integrity are eroded, and bugs from the gut get into the blood, and arrive at the (newly damaged) brain vasculature, where the blood-brain barrier is often also compromised on account of the stroke.
Because of this, critical to reducing post-stroke neuroinflammation (something that makes stroke damage more severe and recovery a lot harder) is improving the gut’s ability to heal itself quickly.
This can be helped with a dose of Insulin-like Growth Factor (IGF-1), but there are other things that can help or hinder, and those other things are modifiable by us as individuals in our lifestyle choices (e.g. a gut-healthy diet with plenty of fiber, and avoiding gut-unhealthy things like sugar and alcohol that feed C. albicans growths that will put roots through your intestines and make holes as they do), because the better/worse your gut barrier integrity is to start with, the easier/harder it will be for your gut to repair itself quickly:
Read in full: Healing the gut can reduce long-term impact of stroke
Related: Stop Sabotaging Your Gut
How about that seasonal lead-spiced hot drink?
Lead contamination in ground spices has become a bit of an issue, ground turmeric has had quite some flak in this regard, and now the spotlight is on cinnamon.
These reports, by the way, do not specify what kind of cinnamon (i.e. cassia vs Ceylon), however, clicking through to assorted sources and then doing our own digging finds that all cinnamon products we found listed as contaminated, were cassia cinnamon. This is unsurprising, as a) it’s cheaper b) it’s the kind most readily found on shelves in the US. That said, when it comes to Ceylon (sweet) cinnamon, absence of evidence is not evidence of absence, so that doesn’t mean they got the all-clear on lead contamination, but rather, that they haven’t received the same scrutiny as yet.
It’s worth noting that cinnamon sticks have been found to have less contamination than ground cinnamon, though.
It’s also worth noting that since some adulterated products have had lead added deliberately in increase the weight and darken the color, this is more likely to happen to cassia cinnamon than sweet cinnamon because cassia cinnamon is visibly darker, so adding a darkening agent to sweet cinnamon would just make it look like cassia (which no seller would want to do since cassia is the cheaper of the two).
Read in full: Why lead-tainted cinnamon products have turned up on shelves, and what questions consumers should ask
Related: Sweet Cinnamon vs Regular Cinnamon – Which is Healthier? ← this also covers toxicity issues, by the way
A matter of life and death
Assisted dying is currently legal in 10/40 US states, and Canada. Over in the UK, it’s being debated (and voted on) in Parliament today, at time of writing.
While bodily autonomy discussions are usually quite straightforward arguments between the very separate camps of
- “my body, my choice” vs
- “they shouldn’t be allowed to do that”,
…this one comes with a considerable middleground, because
- “people should have to right to end things without extra suffering and on their own terms”, and
- “many disabled people fear being placed in a position of having justify why they are not exercising their right to die when it might be cheaper and easier for others if they did”
…are positions with a lot of potential overlap.
In any case, we know most of our readers are in the US, but with a 10/40 split in US states (and some recent controversies in Canada), it’s likely a topic that’ll come up for most people at some point, so it’s good to understand it, and this is as good an opportunity as any:
Read in full: How would the assisted dying bill work and what issues might it create?
Related: Managing Your Mortality ← this talks about psychological/social considerations, as well as end-of-life care, palliative care (which is not quite the same thing!) and euthanasia in various forms, including the unofficial kind that you might want to be aware of if you want to avoid that happening.
Take care!
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Get The Right Help For Your Pain
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How Much Does It Hurt?
Sometimes, a medical professional will ask us to “rate your pain on a scale of 1–10”.
It can be tempting to avoid rating one’s pain too highly, because if we say “10” then where can we go from there? There is always a way to make pain worse, after all.
But that kind of thinking, however logical, is folly—from a practical point of view. Instead of risking having to give an 11 later, you have now understated your level-10 pain as a “7” and the doctor thinks “ok, I’ll give Tylenol instead of morphine”.
A more useful scale
First, know this:
Zero is not “this is the lowest level of pain I get to”.
Zero is “no pain”.
As for the rest…
- My pain is hardly noticeable.
- I have a low level of pain; I am aware of my pain only when I pay attention to it.
- My pain bothers me, but I can ignore it most of the time.
- I am constantly aware of my pain, but can continue most activities.
- I think about my pain most of the time; I cannot do some of the activities I need to do each day because of the pain.
- I think about my pain all of the time; I give up many activities because of my pain.
- I am in pain all of the time; It keeps me from doing most activities.
- My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.
- My pain is all that I can think about; I can barely move or talk because of my pain.
- I am in bed and I can’t move due to my pain; I need someone to take me to the emergency room because of my pain.
10almonds tip: are you reading this on your phone? Screenshot the above, and keep it for when you need it!
One extra thing to bear in mind…
Medical staff will be more likely to believe a pain is being overstated, on a like-for-like basis, if you are a woman, or not white, or both.
There are some efforts to compensate for this:
A new government inquiry will examine women’s pain and treatment. How and why is it different?
Some other resources of ours:
- The 7 Approaches To Pain Management ← a pain specialist discusses the options available
- Managing Chronic Pain (Realistically!) ← when there’s no quick fix, but these things can buy you some hours’ relief at least / stop the pain from getting worse in the moment
- Science-Based Alternative Pain Relief ← for when you’re maxxed out on painkillers, and need something more/different, these are the things the science says will work
Take care!
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The FDA Just Redefined “Healthy”—But How?
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In the ongoing war of labelling regulations (usually with advertisers on one side and regulators on the other), the FDA has updated what’s required in order to label a food as “healthy”.
Here’s what they’re now* requiring:
To bear the “healthy” claim, a food product needs to:
- Contain a certain amount of food (food group equivalent) from at least one of the food groups or subgroups (such as fruits, vegetables, fat-free and low-fat dairy etc.) recommended by the Dietary Guidelines.
- Adhere to specified limits for the following nutrients: saturated fat, sodium, and added sugars.
Source: FDA | Press Releases | FDA Finalizes Updated “Healthy” Nutrient Content Claim
*however, manufacturers have 3 years to conform, which if we’re being cynical about it, looks suspiciously like just short of a US presidential election cycle so that actual enforcement will be someone else’s problem.
Will it help?
Maybe! It’s not too dissimilar to the “traffic light system” already in use in Europe, although that currently emphasizes the absence/presence of “bad things” e.g. saturated fat, sodium, and added sugars.
It has its faults, because for example…
- not all saturated fat is bad, and a jar of coconut oil is now definitely going to get labelled as very unhealthy
- low-sodium salt is, ironically, going to to get flagged as being very high in sodium and therefore unhealthy
This latter is because on a g/100g basis, a product that’s ⅓ sodium chloride is going to have a lot of sodium, even if it’s approaching ⅔ less sodium than the product it’s (healthily!) replacing.
However, on a large scale, these kinds of problems are surely going to be small next to (hopefully) manufacturers scrambling to find ways to cut down on the saturated fats, sodium, and added sugars.
You may be wondering…
What will they replace them with?
Sometimes, companies trying to make something healthier will mess up, like when the health risks of smoking hit public consciousness, one cigarette company had the bright idea of putting asbestos in their filter tips, to market them as healthier. So, could something similar happen here?
- Saturated fat: definitely could; because the health benefits/risks of different kinds of fats and their constituent fatty acids are a lot more nuanced than just “saturated” vs “mono-/polyunsaturated”, it is definitely possible that companies may replace healthier saturated-heavy fats with less healthy unsaturated fats, depending on what is cheaper.
- See also: Can Saturated Fats Be Healthy?
- Sodium: probably not; likely go-to replacements for sodium chloride will be potassium chloride (healthier than sodium chloride) and MSG (has an unearned bad reputation in the US, but is healthier than sodium chloride).
- Added sugars: probably—things get very complicated very quickly when it comes to artificial sweeteners, and also the crux will definitely lie in what gets defined as an “added sugar”; watch out for a rise in the use of things that slide by the definition of added sugar while still being chemically (and, which is important, metabolically) the same thing.
Well that doesn’t sound great
It doesn’t, but on the flipside, the positive inclusions will probably be mostly good.
For example, the only way to get a “healthy” labelling in including fiber is to include more fiber, same with vitamins and minerals.
The low-fat dairy thing could possibly get abused (much like with the general “low-fat” trend of the 80s).
The “portion of fruit” thing will need to be carefully defined to avoid running straight back into the “this is just added sugar by another name” problem; mostly that it’ll need to still include the same amount of fiber as was in the whole fruit, gram for gram.
See also: What Matters Most For Your Heart? ← it’s about fiber, not salt or saturated fats!
Take care!
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