Total Recovery – by Dr. Gary Kaplan
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First, know: Dr. Kaplan is an osteopath, and as such, will be mostly approaching things from that angle. That said, he is also board certified in other things too, including family medicine, so he’s by no means a “one-trick pony”, nor are there “when your only tool is a hammer, everything starts to look like a nail” problems to be found here. Instead, the scope of the book is quite broad.
Dr. Kaplan talks us through the diagnostic process that a doctor goes through when presented with a patient, what questions need to be asked and answered—and by this we mean the deeper technical questions, e.g. “what do these symptoms have in common”, and “what mechanism was at work when the pain become chronic”, not the very basic questions asked in the initial debriefing with the patient.
He also asks such questions (and questions like these get chapters devoted to them) as “what if physical traumas build up”, and “what if physical and emotional pain influence each other”, and then examines how to interrupt the vicious cycles that lead to deterioration of one’s condition.
The style of the book is very pop-science and often narrative in its presentation, giving lots of anecdotes to illustrate the principles. It’s a “sit down and read it cover-to-cover” book—or a chapter a day, whatever your preferred pace; the point is, it’s not a “dip directly to the part that answers your immediate question” book; it’s not a textbook or manual.
Bottom line: a lot of this work is about prompting the reader to ask the right questions to get to where we need to be, but there are many illustrative possible conclusions and practical advices to be found and given too, making this a useful read if you and/or a loved one suffers from chronic pain.
Click here to check out Total Recovery, and solve your own mysteries!
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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.
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.
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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Peanuts vs Hazelnuts – Which is Healthier?
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Our Verdict
When comparing peanuts to hazelnuts, we picked the hazelnuts.
Why?
It was close!
In terms of macros, peanuts have more protein while hazelnuts have more fiber and fat; the fat is healthy (mostly monounsaturated, some polyunsaturated, and very little saturated; less saturated fat than peanuts), so all in all, we’ll call this category a modest, subjective win for hazelnuts (since it depends on what we consider most important).
In the category of vitamins, peanuts have more of vitamins B2, B3, B5, B9, and choline, while hazelnuts have more of vitamins A, B1, B6, C, E, and K, making this one a marginal win for hazelnuts.
When it comes to minerals, peanuts have more magnesium, phosphorus, selenium, and zinc, while hazelnuts have more calcium, copper, iron, and manganese, so we’re calling it a tie on minerals.
Adding up the sections makes for a very close win for hazelnuts, but by all means enjoy both (unless you are allergic, of course)!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Enjoy!
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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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Fast Like A Girl – by Dr. Mindy Pelz
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A lot of information out there when it comes to intermittent fasting is very much centered on men in the 25–35 years age range. What about the rest of us?
Our physiological needs are not the same, and it’d be foolhardy to ignore that. But what things do still stand the same, and what things would benefit from a different approach in our cases?
Dr. Pelz has our back with this book packed with information based on the best science currently out there. She gives a general overview of fasting with full consideration to the fact that we the reader may well be female or over a certain age or both. In addition, the book offers:
- Metabolic switching (the “missing key to weight loss”)
- Building a fasting lifestyle (that works with your actual life, not just on paper)
- How to time fasting according to your menstrual cycle (if you don’t have a cycle, she has you covered too)
- How to break a fast—properly (and many other hacks/tips/tricks to make fasting so much easier)
Bottom line: if you want to do intermittent fasting and want to work with rather than against your body, then this book is a fine option.
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Watermelon vs Grapes – Which is Healthier?
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Our Verdict
When comparing watermelon to grapes, we picked the watermelon.
Why?
It was close! And certainly both are very healthy.
Both fruits are (like most fruits) good sources of water, fiber, vitamins, and minerals. Any sugar content (of which grapes are slightly higher) is offset by their fiber content and polyphenols.
See: Which Sugars Are Healthier, And Which Are Just The Same?
While both are good sources of vitamins A and C, watermelon has about 10x as much vitamin A, and about 6x as much vitamin C (give or take individual plants, how they were grown, etc, but the overall balance is clearly in watermelon’s favor).
When it comes to antioxidants, both fruits are good, but again watermelon is the more potent source. Grapes famously contain resveratrol, and they also contain quercetin, albeit you’d have to eat quite a lot of grapes to get a large portion.
Now, having to eat a lot of grapes might not sound like a terrible fate (who else finds that the grapes are gone by the time the groceries are put away?), but we are comparing the fruits here, and on a list of “100 best foods for quercetin”, for example, grapes took 99th place.
Watermelon’s main antioxidant meanwhile is lycopene, and watermelon is one of the best sources of lycopene in existence (better even than tomatoes).
We’ll have to do a main feature about lycopene sometime soon, so watch this space
Take care!
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What’s the difference between heat exhaustion and heat stroke? One’s a medical emergency
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When British TV doctor Michael Mosley died last year in Greece after walking in extreme heat, local police said “heat exhaustion” was a contributing factor.
Since than a coroner could not find a definitive cause of death but said this was most likely due to an un-identified medical reason or heat stroke.
Heat exhaustion and heat stroke are two illnesses that relate to heat.
So what’s the difference?
Studio Nut/Shutterstock A spectrum of conditions
Heat-related illnesses range from mild to severe. They’re caused by exposure to excessive heat, whether from hot conditions, physical exertion, or both. The most common ones include:
- heat oedema: swelling of the hands, feet and ankles
- heat cramps: painful, involuntary muscle spasms usually after exercise
- heat syncope: fainting due to overheating
- heat exhaustion: when the body loses water due to excessive sweating, leading to a rise in core body temperature (but still under 40°C). Symptoms include lethargy, weakness and dizziness, but there’s no change to consciousness or mental clarity
- heat stroke: a medical emergency when the core body temperature is over 40°C. This can lead to serious problems related to the nervous system, such as confusion, seizures and unconsciousness including coma, leading to death.
As you can see from the diagram below, some symptoms of heat stroke and heat exhaustion overlap. This makes it hard to recognise the difference, even for medical professionals.
CC BY-SA How does this happen?
The human body is an incredibly efficient and adaptable machine, equipped with several in-built mechanisms to keep our core temperature at an optimal 37°C.
But in healthy people, regulation of body temperature begins to break down when it’s hotter than about 31°C with 100% humidity (think Darwin or Cairns) or about 38°C with 60% humidity (typical of other parts of Australia in summer).
This is because humid air makes it harder for sweat to evaporate and take heat with it. Without that cooling effect, the body starts to overheat.
Once the core temperature rises above 37°C, heat exhaustion can set in, which can cause intense thirst, weakness, nausea and dizziness.
If the body heat continues to build and the core body temperature rises above 40°C, a much more severe heat stroke could begin. At this point, it’s a life-threatening emergency requiring immediate medical attention.
At this temperature, our proteins start to denature (like an egg on a hotplate) and blood flow to the intestines stops. This makes the gut very leaky, allowing harmful substances such as endotoxins (toxic substances in some bacteria) and pathogens (disease causing microbes) to leak into the bloodstream.
The liver can’t detoxify these fast enough, leading to the whole body becoming inflamed, organs failing, and in the worst-case scenario, death.
Who’s most at risk?
People doing strenuous exercise, especially if they’re not in great shape, are among those at risk of heat exhaustion or heat stroke. Others at risk include those exposed to high temperatures and humidity, particularly when wearing heavy clothing or protective gear.
Outdoor workers such as farmers, firefighters and construction workers are at higher risk too. Certain health conditions, such as diabetes, heart disease, or lung conditions (such as COPD or chronic obstructive pulmonary disease), and people taking blood pressure medications, can also be more vulnerable.
Adults over 65, infants and young children are especially sensitive to heat as they are less able to physically cope with fluctuations in heat and humidity.
Firefighters are among those at risk of heat-related illness. structuresxx/Shutterstock How are these conditions managed?
The risk of serious illness or death from heat-related conditions is very low if treatment starts early.
For heat exhaustion, have the individual lie down in a cool, shady area, loosen or remove excess clothing, and cool them by fanning, moistening their skin, or immersing their hands and feet in cold water.
As people with heat exhaustion almost always are dehydrated and have low electrolytes (certain minerals in the blood), they will usually need to drink fluids.
However, emergency hospital care is essential for heat stroke. In hospital, health professionals will focus on stabilising the patient’s:
- airway (ensure no obstructions, for instance, vomit)
- breathing (look for signs of respiratory distress or oxygen deprivation)
- circulation (check pulse, blood pressure and signs of shock).
Meanwhile, they will use rapid-cooling techniques including immersing the whole body in cold water, or applying wet ice packs covering the whole body.
Take home points
Heat-related illnesses, such as heat stroke and heat exhaustion, are serious health conditions that can lead to severe illness, or even death.
With climate change, heat-related illness will become more common and more severe. So recognising the early signs and responding promptly are crucial to prevent serious complications.
Matthew Barton, Senior lecturer, School of Nursing and Midwifery, Griffith University and Michael Todorovic, Associate Professor of Medicine, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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