The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan

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A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.

That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.

We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.

The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:

  • why people take them
  • factors affecting whether they help
  • problems that can arise
  • complicating factors

The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.

This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.

While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.

Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.

Click here to check out The Vitamin Solution, and upgrade your knowledge!

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  • Apples vs Bananas – Which is Healthier?
    Bananas triumph over apples with more Vitamins A, B, C, and essential minerals, proving to be the healthier choice in almost every category. Try sun-dried for a twist!

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  • Remember – by Dr. Lisa Genova

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    Memory is often viewed as one thing—either you have a good memory, or you don’t. At best, a lot of people have a vague idea of selective memory. But, the reality is much more complex—and much more interesting.

    Dr. Genova lays out clearly and simply the various different kinds of memory, how they work, and how they fail. Some of these kinds of memory operate on completely different principles than others, and/or in different parts of the brain. And, it’s not just “a memory for faces” or a “memory for names”, nor even “short term vs long term”. There’s working memory, explicit and implicit memory, semantic memory, episodic memory, muscle memory, and more.

    However, this is not just an interesting book—it’s also a useful one. Dr. Genova also looks at how we can guard against failing memory in later years, and how we can expand and grow the kinds of memory that are most important to us.

    The style of the book is very conversational, and not at all textbook-like. It’s certainly very accessible, and pleasant to read too.

    Bottom line: memory is a weird and wonderful thing, and this book shines a clear light on many aspects of it—including how to improve the various different kinds of memory.

    Click here to check out Remember (we recommend to do it now before you forget!

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  • Why the WHO has recommended switching to a healthier salt alternative

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    This week the World Health Organization (WHO) released new guidelines recommending people switch the regular salt they use at home for substitutes containing less sodium.

    But what exactly are these salt alternatives? And why is the WHO recommending this? Let’s take a look.

    goodbishop/Shutterstock

    A new solution to an old problem

    Advice to eat less salt (sodium chloride) is not new. It has been part of international and Australian guidelines for decades. This is because evidence clearly shows the sodium in salt can harm our health when we eat too much of it.

    Excess sodium increases the risk of high blood pressure, which affects millions of Australians (around one in three adults). High blood pressure (hypertension) in turn increases the risk of heart disease, stroke and kidney disease, among other conditions.

    The WHO estimates 1.9 million deaths globally each year can be attributed to eating too much salt.

    The WHO recommends consuming no more than 2g of sodium daily. However people eat on average more than double this, around 4.3g a day.

    In 2013, WHO member states committed to reducing population sodium intake by 30% by 2025. But cutting salt intake has proved very hard. Most countries, including Australia, will not meet the WHO’s goal for reducing sodium intake by 2025. The WHO has since set the same target for 2030.

    The difficulty is that eating less salt means accepting a less salty taste. It also requires changes to established ways of preparing food. This has proved too much to ask of people making food at home, and too much for the food industry.

    A salt shaker spilling onto a table.
    There’s been little progress on efforts to cut sodium intake. snezhana k/Shutterstock

    Enter potassium-enriched salt

    The main lower-sodium salt substitute is called potassium-enriched salt. This is salt where some of the sodium chloride has been replaced with potassium chloride.

    Potassium is an essential mineral, playing a key role in all the body’s functions. The high potassium content of fresh fruit and vegetables is one of the main reasons they’re so good for you. While people are eating more sodium than they should, many don’t get enough potassium.

    The WHO recommends a daily potassium intake of 3.5g, but on the whole, people in most countries consume significantly less than this.

    Potassium-enriched salt benefits our health by cutting the amount of sodium we consume, and increasing the amount of potassium in our diets. Both help to lower blood pressure.

    Switching regular salt for potassium-enriched salt has been shown to reduce the risk of heart disease, stroke and premature death in large trials around the world.

    Modelling studies have projected that population-wide switches to potassium-enriched salt use would prevent hundreds of thousands of deaths from cardiovascular disease (such as heart attack and stroke) each year in China and India alone.

    The key advantage of switching rather than cutting salt intake is that potassium-enriched salt can be used as a direct one-for-one swap for regular salt. It looks the same, works for seasoning and in recipes, and most people don’t notice any important difference in taste.

    In the largest trial of potassium-enriched salt to date, more than 90% of people were still using the product after five years.

    A female nurse taking a senior man's blood pressure.
    Excess sodium intake increases the risk of high blood pressure, which can cause a range of health problems. PeopleImages.com – Yuri A/Shutterstock

    Making the switch: some challenges

    If fully implemented, this could be one of the most consequential pieces of advice the WHO has ever provided.

    Millions of strokes and heart attacks could be prevented worldwide each year with a simple switch to the way we prepare foods. But there are some obstacles to overcome before we get to this point.

    First, it will be important to balance the benefits and the risks. For example, people with advanced kidney disease don’t handle potassium well and so these products are not suitable for them. This is only a small proportion of the population, but we need to ensure potassium-enriched salt products are labelled with appropriate warnings.

    A key challenge will be making potassium-enriched salt more affordable and accessible. Potassium chloride is more expensive to produce than sodium chloride, and at present, potassium-enriched salt is mostly sold as a niche health product at a premium price.

    If you’re looking for it, salt substitutes may also be called low-sodium salt, potassium salt, heart salt, mineral salt, or sodium-reduced salt.

    A review published in 2021 found low sodium salts were marketed in only 47 countries, mostly high-income ones. Prices ranged from the same as regular salt to almost 15 times higher.

    An expanded supply chain that produces much more food-grade potassium chloride will be needed to enable wider availability of the product. And we’ll need to see potassium-enriched salt on the shelves next to regular salt so it’s easy for people to find.

    In countries like Australia, about 80% of the salt we eat comes from processed foods. The WHO guideline falls short by not explicitly prioritising a switch for the salt used in food manufacturing.

    Stakeholders working with government to encourage food industry uptake will be essential for maximising the health benefits.

    Xiaoyue (Luna) Xu, Scientia Lecturer, School of Population Health, UNSW Sydney and Bruce Neal, Executive Director, George Institute Australia, George Institute for Global Health

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Get Well, Stay Well – by Dr. Gemma Newman

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Gemma Newman is a GP (British equivalent of what in America is called a “family doctor”) who realized she was functioning great as a diagnostic flowchart interpreter and pill dispensary, but not actually doing much of what she got into the job to do: helping people.

    Her patients were getting plenty of treatments, but not getting better. Often, they were getting worse. And she knew why: they come in for treatment for one medical problem, when they have six and a half medical problems probably a stack of non-medical problems that contributed to them,

    So, this book sets out to do what she tries to do in her office, but often doesn’t have the time: treat the whole person.

    In it, she details what areas of life to look at, what things are most likely to contribute to wellness/unwellness (be those things completely in your power or not), and how to—bit by bit—make all the parts better, and keep them that way.

    The writing style is conversational, and while it’s heavily informed by her professional competence, there’s no arcane science here; it’s more about the system of bringing everything together harmoniously.

    Bottom line: if you think there’s more to wellness than can be represented on an annual physicals chart, then this is the book to help you get/keep on top of things.

    Click here to check out Get Well, Stay Well, and do just that!

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Related Posts

  • Treat Your Own Back – by Robin McKenzie
  • Carrot vs Sweet Potato – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing carrot to sweet potato, we picked the sweet potato.

    Why?

    Both are great! But there’s a winner in the end:

    Looking at the macros first, sweet potato has more protein carbs, and fiber, and is thus the “more food per food” item. If they are both cooked the same, then the glycemic index is comparable, despite the carrot’s carbs having more sucrose and the sweet potato’s carbs having more starch. We’ll call this category a tie.

    In terms of vitamins, carrots have more of vitamins B9 and K, while sweet potatoes have more of vitamins B1, B2, B3, B5, B6. B7, C, E, and choline. Both are equally high in vitamin A. Thus, the vitamins category is an overwhelming win for sweet potato.

    When it comes to minerals, carrots are not higher in any minerals (unless we count that they are slightly higher in sodium, but that is not generally considered a plus for most people in most places most of the time), while sweet potato is higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Another easy win for sweet potato.

    Adding up the sections makes for a clear win for the sweet potato as the more nutritionally dense option, but as ever, enjoy either or both!

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score?

    Take care!

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  • Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight

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    Without Medicare Part B’s Shield, Patient’s Family Owes $81,000 for a Single Air-Ambulance Flight

    Debra Prichard was a retired factory worker who was careful with her money, including what she spent on medical care, said her daughter, Alicia Wieberg. “She was the kind of person who didn’t go to the doctor for anything.”

    That ended last year, when the rural Tennessee resident suffered a devastating stroke and several aneurysms. She twice was rushed from her local hospital to Vanderbilt University Medical Center in Nashville, 79 miles away, where she was treated by brain specialists. She died Oct. 31 at age 70.

    One of Prichard’s trips to the Nashville hospital was via helicopter ambulance. Wieberg said she had heard such flights could be pricey, but she didn’t realize how extraordinary the charge would be — or how her mother’s skimping on Medicare coverage could leave the family on the hook.

    Then the bill came.

    The Patient: Debra Prichard, who had Medicare Part A insurance before she died.

    Medical Service: An air-ambulance flight to Vanderbilt University Medical Center.

    Service Provider: Med-Trans Corp., a medical transportation service that is part of Global Medical Response, an industry giant backed by private equity investors. The larger company operates in all 50 states and says it has a total of 498 helicopters and airplanes.

    Total Bill: $81,739.40, none of which was covered by insurance.

    What Gives: Sky-high bills from air-ambulance providers have sparked complaints and federal action in recent years.

    For patients with private insurance coverage, the No Surprises Act, which went into effect in 2022, bars air-ambulance companies from billing people more than they would pay if the service were considered “in-network” with their health insurers. For patients with public coverage, such as Medicare or Medicaid, the government sets payment rates at much lower levels than the companies charge.

    But Prichard had opted out of the portion of Medicare that covers ambulance services.

    That meant when the bill arrived less than two weeks after her death, her estate was expected to pay the full air-ambulance fee of nearly $82,000. The main assets are 12 acres of land and her home in Decherd, Tennessee, where she lived for 48 years and raised two children. The bill for a single helicopter ride could eat up roughly a third of the estate’s value, said Wieberg, who is executor.

    The family’s predicament stems from the complicated nature of Medicare coverage.

    Prichard was enrolled only in Medicare Part A, which is free to most Americans 65 or older. That section of the federal insurance program covers inpatient care, and it paid most of her hospital bills, her daughter said.

    But Prichard declined other Medicare coverage, including Part B, which handles such things as doctor visits, outpatient treatment, and ambulance rides. Her daughter suspects she skipped that coverage to avoid the premiums most recipients pay, which currently are about $175 a month.

    Loren Adler, a health economist for the Brookings Institution who studies ambulance bills, estimated the maximum charge that Medicare would have allowed for Prichard’s flight would have been less than $10,000 if she’d signed up for Part B. The patient’s share of that would have been less than $2,000. Her estate might have owed nothing if she’d also purchased supplemental “Medigap” coverage, as many Medicare members do to cover things like coinsurance, he said.

    Nicole Michel, a spokesperson for Global Medical Response, the ambulance provider, agreed with Adler’s estimate that Medicare would have limited the charge for the flight to less than $10,000. But she said the federal program’s payment rates don’t cover the cost of providing air-ambulance services.

    “Our patient advocacy team is actively engaged with Ms. Wieberg’s attorney to determine if there was any other applicable medical coverage on the date of service that we could bill to,” Michel wrote in an email to KFF Health News. “If not, we are fully committed to working with Ms. Wieberg, as we do with all our patients, to find an equitable solution.”

    The Resolution: In mid-February, Wieberg said the company had not offered to reduce the bill.

    Wieberg said she and the attorney handling her mother’s estate both contacted the company, seeking a reduction in the bill. She said she also contacted Medicare officials, filled out a form on the No Surprises Act website, and filed a complaint with Tennessee regulators who oversee ambulance services. She said she was notified Feb. 12 that the company filed a legal claim against the estate for the entire amount.

    Wieberg said other health care providers, including ground ambulance services and the Vanderbilt hospital, wound up waiving several thousand dollars in unpaid fees for services they provided to Prichard that are normally covered by Medicare Part B.

    But as it stands, Prichard’s estate owes about $81,740 to the air-ambulance company.

    More from Bill of the Month

    The Takeaway: People who are eligible for Medicare are encouraged to sign up for Part B, unless they have private health insurance through an employer or spouse.

    “If someone with Medicare finds that they are having difficulty paying the Medicare Part B premiums, there are resources available to help compare Medicare coverage choices and learn about options to help pay for Medicare costs,” Meena Seshamani, director of the federal Center for Medicare, said in an email to KFF Health News.

    She noted that every state offers free counseling to help people navigate Medicare.

    In Tennessee, that counseling is offered by the State Health Insurance Assistance Program. Its director, Lori Galbreath, told KFF Health News she wishes more seniors would discuss their health coverage options with trained counselors like hers.

    “Every Medicare recipient’s experience is different,” she said. “We can look at their different situations and give them an unbiased view of what their next best steps could be.”

    Counselors advise that many people with modest incomes enroll in a Medicare Savings Program, which can cover their Part B premiums. In 2023, Tennessee residents could qualify for such assistance if they made less than $1,660 monthly as a single person or $2,239 as a married couple. Many people also could obtain help with other out-of-pocket expenses, such as copays for medical services.

    Wieberg, who lives in Missouri, has been preparing the family home for sale.

    She said the struggle over her mother’s air-ambulance bill makes her wonder why Medicare is split into pieces, with free coverage for inpatient care under Part A, but premiums for coverage of other crucial services under Part B.

    “Anybody past the age of 70 is likely going to need both,” she said. “And so why make it a decision of what you can afford or not afford, or what you think you’re going to use or not use?”

    Bill of the Month is a crowdsourced investigation by KFF Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!

    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.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Get Better Sleep: Beyond The Basics

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First though, for the sake of being methodical, let’s quickly note the basics:

    • Aim for 7–9 hours per night
    • Set a regular bedtime and (equally important!) regular getting-up time
    • Have a 2-hour wind-down period before bed, to decompress from any stresses of the day
    • Minimal device/screen usage before bed
    • Abstain from stimulants for as long before bed as reasonably possible (caffeine elimination halflife is 4–8 hours depending on your genes, call it 6 hours average to eliminate half (not the whole lot), and you’ll see it’s probably best to put a cap on it earlier rather than later).
    • Abstain from alcohol, ideally entirely, but allow at least 1hr/unit before bed. So for example, 1hr for a 1oz single shot of spirits, or 2–3 hours for a glass of wine (depending on size), or 3–4 hours for a martini (depending on recipe). Not that that is not the elimination time, nor even the elimination halflife of alcohol, it’s just a “give your body a chance at least” calculation. If you like to have a drink to relax before bed, then well, only you can decide what you like more: that or actually getting restorative sleep.
    • Consider a warm bath/shower before bed, if that suits your schedule.
    • Wash and change your bedsheets more often than seems necessary. Or if that’s too onerous, at least change the pillowcases more often, which makes quite a difference already.
    • Lower the temperature of your bedroom shortly before bedtime; this will help cue the body to produce melatonin
    • Make your bedroom as dark as reasonably possible. Invest in blackout blinds/curtains, and remove any pesky electronics, or at least cover their little LEDs if it’s something that reasonably needs to remain on.

    Ok, now, onwards…

    Those 7–9 hours? Yes, it goes for you too.

    A lot of people mistake getting 6 hours sleep per night for only needing 6 hours sleep per night. Sure, you may still be alive after regularly getting 6 hours, but (unless you have a rare mutation of the ADRB1 gene) it will be causing harm, and yes, that includes later in life; we don’t stop needing so much sleep, even stop getting it:

    Why You Probably Need More Sleep

    With this in mind, it becomes important to…

    Prioritize your sleep—which means planning for it!

    When does your bedtime routine start? According to sleep scientist Dr. Lisa Matricciani, it starts before breakfast. This is because the things we do earlier in the day can greatly affect the amount (and quality) of sleep we get later. For example, a morning moderate-to-intense exercise session greatly improves sleep at night:

    Planning Ahead For Better Sleep

    As for quality, that is as important as quantity, and it’s not just about “soundness” of sleep:

    The 6 Dimensions Of Sleep (And Why They Matter)

    “What gets measured, gets done” goes for sleep too

    Sleep-deprived people usually underestimate how sleep-deprived they are. This is for the same reason as why drunk people usually underestimate how drunk they are—to put it in words that go for both situations: a cognitively impaired person lacks the cognitive function to realize how cognitively impaired they are.

    Here’s the science on that, by the way:

    How Sleep-Deprived Are You, Really?

    For that reason, we recommend using sleep-tracking software (there are many apps for that) on your phone or, ideally, a wearable device (such as a smartwatch or similar).

    A benefit of doing so is that we don’t think “well, I slept from 10pm to 6am, so that’s 8 hours”, if our device tells us we slept between 10:43pm and 5:56 am with 74% sleep efficiency because we woke up many times.

    As an aside, sleep efficiency should be about 85%, by the way. Why not 100%, you ask? It’s because if your body is truly out like a light for the entire night, something is wrong (either you were very sleep-deprived, or you have been drugged, that kind of thing). See also:

    An unbroken night’s sleep is a myth. Here’s what good sleep looks like.

    So waking up during the night is normal, and nothing to worry about per se. If you do find trouble getting back to sleep, though:

    How to Fall Back Asleep After Waking Up in the Middle of the Night

    Be careful about how you try to supplement sleep

    This goes both for taking substances of various kinds, and napping. Some sleep aids can help, but many are harmful and/or do not really work as such; here’s a rundown of examples of those:

    Safe Effective Sleep Aids For Seniors?

    And when it comes to napping, timing is everything:

    How To Nap Like A Pro (No More “Sleep Hangovers”!)

    Want to know a lot more?

    This is the book on sleep:

    Why We Sleep – by Dr. Matthew Walker

    Enjoy!

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