The Truth About Statins – by Barbara H. Roberts, M.D.
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All too often, doctors looking to dispense a “quick fix” will prescribe from their playbook of a dozen or so “this will get you out of my office” drugs. Most commonly, things that treat symptoms rather than the cause. Sometimes, this can be fine! For example, in some cases, painkillers and antidepressants can make a big improvement to people’s lives. What about statins, though?
Prescribed to lower cholesterol, they broadly do exactly that. However…
Dr. Roberts wants us to know that we could be missing the big picture of heart health, and making a potentially fatal mistake.
This is not to say that the book argues that statins are necessarily terrible, or that they don’t have their place. Just, we need to understand what they will and won’t do, and make an informed choice.
To which end, she does advise regards when statins can help the most, and when they may not help at all. She also covers the questions to ask if your doctor wants to prescribe them. And—all so frequently overlooked—the important differences between men’s and women’s heart health, and the implications these have for the efficacy (or not) of statins.
With regard to the “alternatives to cholesterol-lowering drugs” promised in the subtitle… we won’t keep any secrets here:
Dr. Roberts (uncontroversially) recommends the Mediterranean diet. She also provides two weeks’ worth of recipes for such, in the final part of the book.
All in all, an important book to read if you or a loved one are taking, or thinking of taking, statins.
Pick up your copy of The Truth About Statins on Amazon today!
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Voluntary assisted dying is different to suicide. But federal laws conflate them and restrict access to telehealth
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Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.
However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.
A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?
What’s wrong with the current laws?
Voluntary assisted dying doesn’t meet the definition of suicide under state laws.
But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.
This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.
Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.
This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.
In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.
Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.
Not all patients can physically see a doctor
Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.
Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.
The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.
Some people aren’t able to attend doctors’ appointments in person.
Jeffrey M Levine/ShutterstockDoctors don’t want to be involved in ‘suicide’
Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.
Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.
The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.
It misclassifies deaths
In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.
In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.
In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.
The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.
There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.
So what is the solution?
The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.
Chaney’s private member’s bill is yet to be debated in federal parliament.
If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.
A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.
Failure to change this will cause unnecessary suffering for patients and doctors alike.
Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Aspirin vs Cancer Metastasis
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Aspirin is a bit of a mixed bag.
In the category of things in its favor, it’s a modest analgesic with few side effects from occasional use, so it’s a good option if you have a headache, for example.
Unless you’re already on blood thinners or having a bleeding disorder, in which case, aspirin is not the thing to reach for.
About aspirin and heart disease
This is actually a complicated one, and we covered it at length in a dedicated main feature. If you want a one-line summary, it’s “chronic low-dose aspirin use can lower overall CVD risk, but does not reduce CVD mortality or all-cause mortality, and you may pay for it with gastrointestinal bleeding, and increased risk of ulcers“.
For a more nuanced explanation, see: Aspirin, CVD Risk, & Potential Counter-Risks
On the other hand, if you are having a heart attack and are waiting for the ambulance that you already called, and have aspirin to hand that you don’t have to go looking for, then it can be good to take a dose then.
For more on that, see: How To Survive A Heart Attack When You’re Alone
There are more problems
In the case of chronic use of low-dose aspirin, not only does it increase the risks of bleeding, especially gastrointestinal bleeding, and ulcers, but also it increases the risk of anemia. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
For the science about this, see: Low-Dose Aspirin & Anemia
Now, about aspirin and cancer metastasis
This one’s a point in aspirin’s favor.
Cancer is, in and of itself, obviously a big problem. In terms of when it’s most likely to kill someone, that is usually when the cancer becomes metastatic, that is to say, it has spread.
So, while preventing cancer and, failing that, killing cancer are very important goals, there is a third axis to cancer care, which is preventing metastasis in someone who has cancer.
And that’s what aspirin does. How, you ask?
Scientists found this one out by accident!
They were doing genetic research in mice, to find genes that had an effect on metastasis. In the process, they found a certain gene that instructs the creation of a certain protein, and mice that lacked that gene (and thus its associated protein) had less metastasis.
The protein in question suppresses T-cells, which are programmed to recognize and kill metastatic cancer cells (amongst having other great jobs; they are an important part of the immune system in general, and one that declines with aging; most people in their 60s or older are producing very few T-cells).
About that, see: Focusing On Health In Our Sixties
Tracing the cell signaling, the researchers found that the protein is activated when T-cells are exposed to thromboxane A2 (or TXA2 to its friends).
And TXA2? That’s produced by platelets, and aspirin works by inhibiting TXA2 production, effectively making platelets (and thus the blood as a whole) less sticky.
So, that’s quite a few steps in the process, but ultimately:
- Aspirin inhibits TXA2 production
- Lower TXA2 levels mean ARHGEF1 (that’s the protein) isn’t activated
- ARHGEF1 not being activated means T-cells are free to do their thing
- T-cells are now free to kill metastatic cancer cells
You can read the paper here:
Aspirin prevents metastasis by limiting platelet TXA2 suppression of T cell immunity
Take care!
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The Path to Longevity – by Dr. Luigi Fontana
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We’ve reviewed other “expand your healthspan” books, and while they’re good (or else we wouldn’t include them), this is top-tier, up there with Dr. Greger’s books while being more accessible (more on this later).
This book is far more informational than opinionated, and while some reviewers have described the book as motivating them, that’s not at all the tone, and it’s clear that (beyond hoping for the reader to have to information to promote a long healthy life), the author has no particular agenda to push.
One example: while he gives a whole-foods, plant-based diet a “A+” rating, he puts the (often meat/fish-heavy) paleo diet at a close “A-“, depending on the animal products chosen (which can swing it a lot, and he discusses this in some detail).
In the category of criticism… This reviewer has none. Sometimes it seemed something was going unaddressed, but it would be addressed later.
Stylistically, the text is easy-reading and/but has a lot of references to hard science, complete with charts, diagrams, and so forth. The impression that this reviewer got is that Dr. Fontana took pains to convey as much science as possible, with (unlike Dr. Greger) as little jargon as possible. And that goes a long way.
Bottom line: if you’re looking for a “healthy aging” book that has a lot more science than “copy the Blue Zone supercentenarians and hope” without being so scientifically dense as “How Not To Die” or “How Not To Age“, then this is the book for you.
Click here to check out The Path to Longevity, and optimize the path you take!
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The Hidden Risk of Stretching: Avoiding Hamstring Injuries in Yoga
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What is Yoga Butt
Have you ever experienced a mysterious pain while stretching, or perhaps during yoga? You might be dealing with “yoga butt,” a common—although rarely discussed—injury. In the below video, the Lovely Liv from Livinleggings shares her journey of discovering, and overcoming, “yoga butt”.
Dealing With Yoga Butt
Yoga butt, or proximal hamstring tendinopathy, occurs when the hamstrings are overstretched without adequate strengthening. Many yoga poses help stretch the hamstrings, but often don’t focus on strengthening said hamstrings; this imbalance is what can lead to damage over time.
To help prevent Yoga butt, it’s essential to balance stretching with strengthening. You can look into incorporating hamstring-strengthening exercises like Romanian deadlifts, hamstring curls, and modified yoga poses into your routine.
(If you’re new to strengthening exercises, we recommend reading Women’s Strength Training Anatomy Workouts or Strength Training for Seniors).
Watch the full video to learn more and hopefully protect yourself from long-term injuries:
Let us know your thoughts, and whether you have any other topics you’d like us to cover.
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The End of Stress – by Don Joseph Goewey
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So, we probably know to remember to take a deep breath once in a while, and adopt a “focus on what you can control, rather than what you can’t” attitude. In this book, Goewey covers a lot more.
After an overview of how we have a brain wired for stress, what it does to us, and why we should rewire that, he dives straight into such topics as:
- Letting go of fear—safely!
- Number-crunching the real risks
- Leading with good decisions, and trusting the process
- Actively practicing a peaceful mindset (some very good tips here)
- Transcending shame (and thus sidestepping the stress that it may otherwise bring)
The book brings together a lot of ideas and factors, seamlessly. From scientific data to case studies, to “try this and see”, encouraging us to try certain exercises for ourselves and be surprised at the results.
All in all, this is a great book on not just managing stress, but—as the title suggests—ending it in all and any cases it’s not useful to us. In other words, this book? It is useful to us.
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Cashew & Chickpea Balti
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When it comes to curries, the humble balti is perhaps the best when you don’t have all day to let something simmer. Filled with healthful spices, this one also comes complete with lots of fiber as well as healthy proteins and fats, with most of its calories coming from the nuts themselves, and the haricot paste base makes for a deliciously creamy curry without having to add anything unhealthy.
You will need
- 1 cup cashews, soaked in warm water for at least 5 minutes, and drained (if allergic, omit)
- 1 can chickpeas (keep the water)
- 1 can haricot beans (keep the water)
- 1 can crushed tomatoes
- 2 medium (or 3 small) red onions, sliced
- red or green chilis, quantity per your preference re heat, chopped
- ½ bulb garlic, crushed
- ½ oz fresh ginger, peeled and finely chopped
- 1 tbsp tomato paste
- 1 tbsp garam masala
- 1 tbsp ground coriander
- 1 tbsp black pepper, coarse ground
- 2 tsp turmeric
- 1 tsp mustard seeds (if allergic, omit)
- 1 tsp sweet cinnamon
- 1 tsp coriander seeds
- ½ tsp MSG or 1 tsp low-sodium salt
- Avocado oil, for frying (extra virgin olive-oil, or cold-pressed coconut oil, are fine alternatives)
- Garnish: handful fresh cilantro, chopped (or parsley, if you have the “cilantro tastes like soap” gene)
Method
(we suggest you read everything at least once before doing anything)
1) Heat a little oil in a large sauté pan (we’re going to need space to work; a large wok is traditional but a sauté pan is convenient), and add the garlic, ginger, mustard seeds, and coriander seeds, stirring for about 2 minutes, then add the onions and chilis, stirring for another 3 minutes. The onions and chilis won’t be fully cooked yet, but that’s fine, we just needed to get them started.
2) Add the crushed tomatoes, stirring them in, and when they get to temperature, turn the heat down to a simmer.
3) Add the chickpeas to the pan, but separately put the chickpea water into a high-speed blender.
4) Add the haricot beans, including the water they came in, to the high-speed blender, as well as the tomato paste and the remaining spices (including the MSG or salt), and blend on high until smooth. Add the curry paste (that’s what you’ve just made in the blender) to the pan, and stir in well.
5) Add the cashews, stirring in well. Taste, and adjust any spices if necessary for your liking. If the onions still aren’t fully cooked, let them simmer until they are, but it shouldn’t take long.
10almonds tip: if perchance you made it too spicy, you can add a little lime juice and the acidity will counteract the heat. Adding lemon juice, lime juice, or some kind of vinegar (depending on what works with the flavor profile of your recipe) is a good last resort to have up your sleeve for fixing a dish that got too spicy.
6) Add the garnish, and serve—we recommend serving it with our Tasty Versatile Rice, but any carb is fine.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Three Daily Servings of Beans?
- Cashew Nuts vs Coconut – Which is Healthier?
- What Matters Most For Your Heart?
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we hit 5/5 again today!
Take care!
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