Try This At Home: ABI Test For Clogged Arteries

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Arterial plaque is a big deal, and statistically it’s more of a risk as we get older, often coming to a head around age 72 for women and 65 for men—these are the median ages at which people who are going to get heart attacks, get them. Or get it, because sometimes one is all it takes.

The Ankle-Brachial Index Test

Dr. Brewer recommends a home test for detecting arterial plaque called the Ankle-Brachial Index (ABI), which uses a blood pressure monitor. The test involves measuring blood pressure in both the arms and ankles, then calculating the ratio of these measurements:

  • A healthy ABI score is between 1.0 and 1.4; anything outside this range may indicate arterial problems.
  • Low ABI scores (below 0.8) suggest plaque is likely obstructing blood flow
  • High ABI scores (above 1.4) may indicate artery hardening

Peripheral Artery Disease (PAD), associated with poor ABI results (be they high or low), can cause a whole lot of problems that are definitely better tackled sooner rather than later—remember that atherosclerosis is a self-worsening thing once it gets going, because narrower walls means it’s even easier for more stuff to get stuck in there (and thus, the new stuff that got stuck also becomes part of the walls, and the problem gets worse).

If you need a blood pressure monitor, by the way, here’s an example product on Amazon.

Do note also that yes, if you have plaque obstructing blood flow and hardened arteries, your scores may cancel out and give you a “healthy” score, despite your arteries being very much not healthy. For this reason, this test can be used to raise the alarm, but not to give the “all clear”.

For more on all of the above, plus a demonstration and more in-depth explanation of the test, enjoy:

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Want to learn more?

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  • How does the drug abemaciclib treat breast cancer?

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    The anti-cancer drug abemaciclib (also known as Vernezio) has this month been added to the Australian Pharmaceutical Benefits Scheme (PBS) to treat certain types of breast cancer.

    This significantly reduces the cost of the drug. A patient can now expect to pay A$31.60 for a 28-day supply ($7.70 with a health care concession card). The price of abemaciclib without government subsidy is $4,250.

    So what is abemaciclib, and how did we get to this point?

    It stops cells dividing

    Researchers at the pharmaceutical company Eli Lilly developed abemaciclib and published the first study on the drug (then known as LY2835219) in 2014.

    Abemaciclib is a type of drug known as a “cyclin-dependent kinase inhibitor”. It’s taken as a pill twice a day.

    To maintain our health, many of the cells in our bodies need to grow and divide to produce new cells. Cancers develop when cells grow and divide out of control. Therefore, stopping cells from dividing into new cells is one way that cancer can be fought.

    When cells divide, they have to make a copy of their DNA to pass onto the new cell. “Cyclin-dependent kinases” (CDKs for short) are essential for this process. So, if you stop the CDKs, you stop the DNA copying, you stop cells dividing, and you fight the cancer.

    However, there are different types of CDKs, and not all cancers need them all to grow. Abemaciclib specifically targets CDK4 and CDK6. Thankfully, a lot of cancers do need these CDKs, including some breast cancers.

    Woman checks her breast
    The drug targets CDK4 and CDK6. Photoroyalty/Shutterstock

    But abemaciclib will only be effective against cancers that rely on CDK4 and CDK6 for continued growth. This specificity also means abemaciclib is fairly unique, so it can’t easily be replaced with a different drug.

    Two other CDK4/6 inhibitors were developed around the same time as abemaciclib, and are called ribociclib and palbociclib. Both of these drugs are also on the PBS for specific types of breast cancer. As the drugs differ in their chemical structures, they have slight differences in the way they are taken up and processed by the body. The preferred drug given to a breast cancer patient will depend on their unique circumstances.

    What are the side effects?

    Research is still ongoing into the differences between each of these CDK4/6 inhibitors, but it is known that the side effects are largely similar, but can differ in severity.

    The most common side effects of abemaciclib are fatigue, diarrhoea and neutropenia (reduced white blood cells). The gastrointestinal issues are generally more severe with abemaciclib.

    If these side effects are too severe, abemaciclib treatment can be stopped.

    What types of cancer has abemaciclib been approved for?

    In 2017, the United States Food and Drug Administration (FDA) approved abemaciclib for the treatment of patients with metastatic HR+/HER2- (hormone receptor-positive and human epidermal growth factor receptor 2-negative) breast cancer who did not respond to standard endocrine therapy.

    Australia’s Therapeutic Goods Administration (TGA) similarly approved abemaciclib in 2022 as an “adjuvant” therapy (after the initial surgery to remove the tumour) for patients with HR+/HER2- invasive early breast cancer which had spread to lymph nodes and was at high risk of returning.

    Doctor looks at laptop
    The drug is approved for people with early breast cancer which is at high risk of returning. PeopleImages.com – Yuri A/Shutterstock

    As of May 1 2024, the PBS covers this use of abemaciclib in combination with endocrine therapy such as fulvestrant, which is also listed on the PBS. Endocrine therapy, also known as hormonal therapy, blocks hormone receptor positive (HR+) cancers from receiving the hormones they need to survive.

    Could abemaciclib be used for other cancers in the future?

    Abemaciclib is of great interest to scientists and medical practitioners, and testing is ongoing to assess the effectiveness of abemaciclib in treating a range of other cancers, including gastrointestinal cancers and blood cancers.

    Abemaciclib may even be usable in brain cancers, as it has long been known to be capable of crossing the blood-brain barrier, a common stumbling block for potential anti-cancer drugs.

    Time will tell whether the role of abemaciclib in health care will be expanded. But for now, its inclusion on the PBS is sure to bring some relief to breast cancer patients nationwide.

    Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute

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

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  • Spoon-Fed – by Dr. Tim Spector

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    Dr. Spector looks at widespread beliefs about food, and where those often scientifically disproven beliefs come from. Hint, there’s usually some manner of “follow the money”.

    From calorie-counting to cholesterol content, from fish to bottled water, to why of all the people who self-report having an allergy, only around half turn out to actually have one when tested, Dr. Spector sets the record straight.

    The style is as very down-to-earth and not at all self-aggrandizing; the author acknowledges his own mistakes and limitations along the way. In terms of pushing any particular agenda, his only agenda is clear: inform the public about bad science, so that we demand better science going forwards. Along the way, he gives us lots of information that can inform our personal health choices based on better science than indiscriminate headlines wildly (and sometimes intentionally) misinterpreting results.

    Read this book, and you may find yourself clicking through to read the studies for yourself, next time you see a bold headline.

    Bottom line: this book looks at a lot of what’s wrong with what a lot of people believe about healthy eating. Regular 10almonds readers might not find a lot that’s new here, but it could be a great gift for a would-be health-conscious friend or relative

    Click here to check out Spoon-Fed, and bust some myths!

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  • Thinking of using an activity tracker to achieve your exercise goals? Here’s where it can help – and where it probably won’t

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    It’s that time of year when many people are getting started on their resolutions for the year ahead. Doing more physical activity is a popular and worthwhile goal.

    If you’re hoping to be more active in 2024, perhaps you’ve invested in an activity tracker, or you’re considering buying one.

    But what are the benefits of activity trackers? And will a basic tracker do the trick, or do you need a fancy one with lots of features? Let’s take a look.

    Why use an activity tracker?

    One of the most powerful predictors for being active is whether or not you are monitoring how active you are.

    Most people have a vague idea of how active they are, but this is inaccurate a lot of the time. Once people consciously start to keep track of how much activity they do, they often realise it’s less than what they thought, and this motivates them to be more active.

    You can self-monitor without an activity tracker (just by writing down what you do), but this method is hard to keep up in the long run and it’s also a lot less accurate compared to devices that track your every move 24/7.

    By tracking steps or “activity minutes” you can ascertain whether or not you are meeting the physical activity guidelines (150 minutes of moderate to vigorous physical activity per week).

    It also allows you to track how you’re progressing with any personal activity goals, and view your progress over time. All this would be difficult without an activity tracker.

    Research has shown the most popular brands of activity trackers are generally reliable when it comes to tracking basic measures such as steps and activity minutes.

    But wait, there’s more

    Many activity trackers on the market nowadays track a range of other measures which their manufacturers promote as important in monitoring health and fitness. But is this really the case? Let’s look at some of these.

    Resting heart rate

    This is your heart rate at rest, which is normally somewhere between 60 and 100 beats per minute. Your resting heart rate will gradually go down as you become fitter, especially if you’re doing a lot of high-intensity exercise. Your risk of dying of any cause (all-cause mortality) is much lower when you have a low resting heart rate.

    So, it is useful to keep an eye on your resting heart rate. Activity trackers are pretty good at tracking it, but you can also easily measure your heart rate by monitoring your pulse and using a stopwatch.

    Heart rate during exercise

    Activity trackers will also measure your heart rate when you’re active. To improve fitness efficiently, professional athletes focus on having their heart rate in certain “zones” when they’re exercising – so knowing their heart rate during exercise is important.

    But if you just want to be more active and healthier, without a specific training goal in mind, you can exercise at a level that feels good to you and not worry about your heart rate during activity. The most important thing is that you’re being active.

    Also, a dedicated heart rate monitor with a strap around your chest will do a much better job at measuring your actual heart rate compared to an activity tracker worn around your wrist.

    Maximal heart rate

    This is the hardest your heart could beat when you’re active, not something you could sustain very long. Your maximal heart rate is not influenced by how much exercise you do, or your fitness level.

    Most activity trackers don’t measure it accurately anyway, so you might as well forget about this one.

    VO₂max

    Your muscles need oxygen to work. The more oxygen your body can process, the harder you can work, and therefore the fitter you are.

    VO₂max is the volume (V) of oxygen (O₂) we could breathe maximally (max) over a one minute interval, expressed as millilitres of oxygen per kilogram of body weight per minute (ml/kg/min). Inactive women and men would have a VO₂max lower than 30 and 40 ml/kg/min, respectively. A reasonably good VO₂max would be mid thirties and higher for women and mid forties and higher for men.

    VO₂max is another measure of fitness that correlates well with all-cause mortality: the higher it is, the lower your risk of dying.

    For athletes, VO₂max is usually measured in a lab on a treadmill while wearing a mask that measures oxygen consumption. Activity trackers instead look at your running speed (using a GPS chip) and your heart rate and compare these measures to values from other people.

    If you can run fast with a low heart rate your tracker will assume you are relatively fit, resulting in a higher VO₂max. These estimates are not very accurate as they are based on lots of assumptions. However, the error of the measurement is reasonably consistent. This means if your VO₂max is gradually increasing, you are likely to be getting fitter.

    So what’s the take-home message? Focus on how many steps you take every day or the number of activity minutes you achieve. Even a basic activity tracker will measure these factors relatively accurately. There is no real need to track other measures and pay more for an activity tracker that records them, unless you are getting really serious about exercise.

    Corneel Vandelanotte, Professorial Research Fellow: Physical Activity and Health, CQUniversity Australia

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

    The Conversation

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  • Does This New Machine Cure Depression?

    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.

    Let us first talk briefly about the slightly older tech that this may replace, transcranial magnetic stimulation (TMS).

    TMS involves electromagnetic fields to stimulate the left half of the brain and inhibit the right half of the brain. It sounds like something from the late 19th century—“cure your melancholy with the mystical power of magnetism”—but the thing is, it works:

    Regulatory Clearance and Approval of Therapeutic Protocols of Transcranial Magnetic Stimulation for Psychiatric Disorders

    The main barriers to its use are that the machine itself is expensive, and it has to be done in a clinic by a trained clinician. Which, if it were treating one’s heart, say, would not be so much of an issue, but when treating depression, there is a problem that depressed people are not the most likely to commit to (and follow through with) going somewhere probably out-of-town regularly to get a treatment, when merely getting out of the door was already a challenge and motivation is thin on the ground to start with.

    Thus, antidepressant medications are more often the go-to for cost-effectiveness and adherence. Of course, some will work better than others for different people, and some may not work at all in the case of what is generally called “treatment-resistant depression”:

    Antidepressants: Personalization Is Key!

    Transcranial stimulation… At home?

    Move over transcranial magnetic stimulation; it’s time for transcranial direct-current stimulation (tDCS).

    First, what it’s not: electroconvulsive therapy (ECT). Rather, it uses a very low current.

    What it is: a small and portable headset (as opposed to the big machine to go sit in for TMS) that one can use at home. Here’s an example product on Amazon, though there are more stylish versions around, this is the same basic technology.

    In a recent study, 45% of those who received treatment with this device experienced remission in 10 weeks, significantly beating placebo (bearing in mind that placebo effect is strongest when it comes to invisible ailments such as depression).

    See also: How To Leverage Placebo Effect For Yourself ← this explains more about how the placebo effect works, to the extent that it can even be an adjuvant tool to augment “real” therapies

    And as for the study, here it is:

    Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial

    …which rather cuts through the “depressed people don’t make it to the clinic consistently, if at all” problem. Of course, it still requires adherence to its use at home, for example three 30-minute sessions per week, but honestly, “lie/sit still” is likely within the abilities of the majority of depressed people. However…

    Important note: you remember we said “in 10 weeks”? That may be critical, because shorter studies (e.g. 6 weeks) have previously returned without such glowing results:

    Home-Use Transcranial Direct Current Stimulation for the Treatment of a Major Depressive Episode

    This means that if you get this tech for yourself or a loved one, it’ll be necessary to persist for likely 10 weeks, certainly more than 6 weeks, and not abandon it after a few sessions when it hasn’t been life-changing yet. And that may be more of a challenge for a depressed person, so likely an “accountability buddy” of some kind is in order (partner, close friend, etc) to help ensure adherence and generally bug you/them into doing it consistently.

    And then, of course, you/they might still be in the 55% of people for whom it didn’t work. And that does suck, but random antidepressant medications (i.e., not personalized) don’t fare much better, statistically.

    Want something else against depression meanwhile?

    Here are some strategies that not only can significantly help, but also are tailored to be actually doable while depressed:

    The Mental Health First-Aid You’ll Hopefully Never Need ← written by your writer who has previously suffered extensively from depression and knows what it is like

    Take care!

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  • Atomic Habits – by James Clear

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    James Clear’s Atomic Habits has become “the” go-to book about the power of habit-forming. And, there’s no shortage of competition out there, so that’s quite a statement. What makes this book stand out?

    A lot of books start by assuming you want to build habits. That can seem a fair assumption; after all, we picked up the book! But an introductory chapter really hammers home the idea in a way that makes it a lot more motivational:

    • Habits are the compound interest of productivity
    • This means that progress is not linear, but exponential
    • Habits can also be stacked, and thus become synergistic
    • The more positive habits you add incrementally, the easier they become because each thing is making your life easier/better

    For example:

    • It’s easier to save money if you’re in good health
    • It’s easier to sleep better if you do not have financial worries
    • It’s easier to build your relationship with your loved ones if you’re not tired

    …and so on.

    For many people this presents a Catch-22 problem! Clear instead presents it as an opportunity… Start wherever you like, but just start small, with some two-minute thing, and build from there.

    A lot of the book is given over to:

    • how to form effective habits (using his “Four Laws”)
    • how to build them into your life
    • how to handle mishaps
    • how to make sure your habits are working for you
    • how to see habits as part of your identity, and not just a goal to be checked off

    The last one is perhaps key—goals cease to be motivating once accomplished. Habits, on the other hand, keep spiralling upwards (if you guide them appropriately).

    There’s lots more we could say, but it’s a one-minute book review, so we’ll just close by saying:

    This book can help you to become the kind of person who genuinely gets a little better each day, and reaps the benefits over time.

    Get your copy of Atomic Habits from Amazon today!

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  • Make Your Negativity Work For You

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    What’s The Right Balance?

    We’ve written before about positivity the pitfalls and perils of toxic positivity:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    …as well as the benefits that can be found from selectively opting out of complaining:

    A Bone To Pick… Up And Then Put Back Where We Found It

    So… What place, if any, does negativity usefully have in our lives?

    Carrot and Stick

    We tend to think of “carrot and stick” motivation being extrinsic, i.e. there is some authority figure offering is reward and/or punishment, in response to our reactions.

    In those cases when it really is extrinsic, the “stick” can still work for most people, by the way! At least in the short term.

    Because in the long term, people are more likely to rebel against a “stick” that they consider unjust, and/or enter a state of learned helplessness, per “I’ll never be good enough to satisfy this person” and give up trying to please them.

    But what about when you have your own carrot and stick? What about when it comes to, for example, your own management of your own healthy practices?

    Here it becomes a little different—and more effective. We’ll get to that, but first, bear with us for a touch more about extrinsic motivation, because here be science:

    We will generally be swayed more easily by negative feelings than positive ones.

    For example, a study was conducted as part of a blood donation drive, and:

    • Group A was told that their donation could save a life
    • Group B was told that their donation could prevent a death

    The negative wording given to group B boosted donations severalfold:

    Read the paper: Life or Death Decisions: Framing the Call for Help

    We have, by the way, noticed a similar trend—when it comes to subject lines in our newsletters. We continually change things up to see if trends change (and also to avoid becoming boring), but as a rule, the response we get from subscribers is typically greater when a subject line is phrased negatively, e.g. “how to avoid this bad thing” rather than “how to have this good thing”.

    How we can all apply this as individuals?

    When we want to make a health change (or keep up a healthy practice we already have)…

    • it’s good to note the benefits of that change/practice!
    • it’s even better to note the negative consequences of not doing it

    For example, if you want to overcome an addiction, you will do better for your self-reminders to be about the bad consequences of using, more than the good consequences of abstinence.

    See also: How To Reduce Or Quit Alcohol

    This goes even just for things like diet and exercise! Things like diet and exercise can seem much more low-stakes than substance abuse, but at the end of the day, they can add healthy years onto our lives, or take them off.

    Because of this, it’s good to take time to remember, when you don’t feel like exercising or do feel like ordering that triple cheeseburger with fries, the bad outcomes that you are planning to avoid with good diet and exercise.

    Imagine yourself going in for that quadruple bypass surgery, asking yourself whether the unhealthy lifestyle was worth it. Double down on the emotions; imagine your loved ones grieving your premature death.

    Oof, that was hard-hitting

    It was, but it’s effective—if you choose to do it. We’re not the boss of you! Either way, we’ll continue to send the same good health advice and tips and research and whatnot every day, with the same (usually!) cheery tone.

    One last thing…

    While it’s good to note the negative, in order to avoid the things that lead to it, it’s not so good to dwell on the negative.

    So if you get caught in negative thought spirals or the like, it’s still good to get yourself out of those.

    If you need a little help with that sometimes, check out these:

    Take care!

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