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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Entertaining Harissa Traybake
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No, it’s not entertaining in the sense that it will tell you jokes or perhaps dance for you, but rather: it can be easily prepared in advance, kept in the fridge for up to 3 days, and reheated when needed as part of a spread when entertaining, leaving you more time to spend with your houseguests.
Aside from its convenience, it is of course nutritious and delicious:
You will need
- 14 oz cherry tomatoes
- 2 cans chickpeas, drained and rinsed (or 2 cups cooked chickpeas, drained and rinsed)
- 2 eggplants, cut into ¾” cubes
- 1 red onion, roughly chopped
- 1 bulb garlic
- 2 tbsp extra virgin olive oil
- 1 tbsp harissa paste
- 1 tbsp ras el-hanout
- 1 tsp MSG or 2 tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400℉ / 200℃
2) Mix the onion, eggplant, and garlic (whole cloves; just peel them and put them in) with the olive oil in a mixing bowl, ensuring everything is coated evenly.
3) Add in 1 tbsp of the harissa paste, 1 tbsp of the ras-el hanout, and half of the MSG/salt, and again mix thoroughly to coat evenly.
4) Bake in the oven, in a walled tray, for about 30 minutes, giving things a stir/jiggle halfway through to ensure they cook evenly.
5) Add the cherry tomatoes to the tray, and return to the oven for another 10 minutes.
6) Mix the chickpeas with the other 1 tbsp of the harissa paste, the other 1 tbsp of the ras-el hanout, and the other half of the MSG/salt, and add to the tray, returning it to the oven for a final 10 minutes.
7) Serve hot, or set aside for later, refrigerating once cool enough to do so. When you do serve, we recommend serving with a yogurt, cucumber, and mint dip, and perhaps flatbreads (you can use our Healthy Homemade Flatbreads recipe):
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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How To Reduce Knee Pain After Sitting
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Sitting is bad for the health, and doubly so if you have arthritis, as a lack of regular movement can cause joints to “seize up”. So, what to do about it if you have to sit for an extended time?
Dr. Alyssa Kuhn, arthritis specialist, explains:
Movement remains key
The trick is to continue periodically moving, notwithstanding that you may need to remain seated. So…
- Heel slides
- Straighten and bend your leg by sliding or lifting your heel.
- Promotes blood flow and reduces fluid buildup in the knee.
- Helps lubricate the joint, making standing up easier.
- Heel lifts
- Lift your heels up and down while keeping feet on the ground.
- This one’s ideal for tight spaces, such as when riding in a car or airplane.
- Improves blood circulation and can reduce ankle swelling and leg heaviness.
Do 20–30 repetitions every now and again, to keep your joints moving.
Note: if you are a wheelchair user whose legs lack the strength and/or motor function to do this, in this case it’s the movement of the leg that counts, not where that movement originated from. So, if you use one hand to lift your leg slightly and the other to push it like a swing, that will also be sufficient to give the joint the periodic movement it needs.
For more on all of this plus visual demonstrations, enjoy:
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You might also like to read:
Stand Up For Your Health (Or Don’t) ← our main feature on this also includes more things you can do if you must sit, to make sitting less bad!
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- Heel slides
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Watch Out For Lipedema
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Lipedema occurs mostly in women, mostly in times of hormonal change, with increasing risk as time goes by (so for example, puberty yields a lower risk than pregnancy, which yields a lower risk than menopause).
Its name literally means “fat swelling”, and can easily be mistaken for obesity or, in its earlier stages, just pain old cellulite.
Cellulite, by the way, is completely harmless and is also not, per se, an indicator of bad health. But if you have it and don’t like it, you can reduce it:
Obesity is more of a complex matter, and one that we’ve covered here:
Lipedema is actively harmful
Lipedema can become a big problem, because lifestyle change does not reduce lipedema fat, the fat is painful, can lead to obesity if one was not already obese, causes gait and joint abnormalities, causes fatigue, can lead to lymphedema (beyond the scope of today’s article—perhaps another time!) and very much psychosocial distress.
Like many conditions that mostly affect women, the science is… Well, here’s a recent example review that was conducted and published:
Fun fact: in Romanian there is an expression “one eye is laughing; the other is crying”, and it seems appropriate here.
Spot the signs
Because it’s most readily mistaken for cellulite in first presentation, let’s look at the differences between them:
- Cellulite is characterized by dimpled, bumpy, or even skin; lipedema is the same but with swelling too.
- Cellulite is a connective tissue condition; lipedema is too (at least in part), but also involves the abnormal accumulation and deposition of fat cells, rather than just pulling some down a bit.
- Cellulite has no additional symptoms; lipedema soon also brings swollen limbs, joint pain, and/or skin that’s “spongy” and easily bruised.
What to do about it
First, get it checked out by a doctor.
If the doctor says it is just cellulite or obesity, ask them what difference(s) they are basing that on, and ask that they confirm in writing having dismissed your concerns (having this will be handy later if it turns out to be lipedema after all).
If it is lipedema, you will want to catch it early; there is no known cure, but advanced symptoms are a lot easier to keep at bay than they are to reverse once they’ve shown up.
Weight maintenance, skin care (including good hydration), and compression therapy have all been shown to help slow the progression.
If it is allowed to progress unhindered, that’s when a lot more fat accumulation and joint pain is likely to occur. Liposuction and surgery are options, but even they are only a temporary solution, and are obviously not fun things to have to go through.
Prevention is, as ever, much better than
curetreatment ← because there is no known cureOne last thing
Lipedema’s main risk factor is genetic. The bad news is, there’s not much that can be done about that for now, but the good news is, you can at least get the heads-up about whether you are at increased risk or not, and be especially vigilant if you’re in the increased risk group. See also:
One Test, Many Warnings: The Real Benefit Of Genetic Testing
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Do We Need Supplements, And Do They Work?
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Does our diet need a little help?
We asked you for your take on supplements, and got the above-illustrated, below-described set of results.
- The largest minority of respondents (a little over a third) voted for “I just take something very specific”
- The next most respondents voted for “I take so many supplements; every little helps!”
- Almost as many voted for “I just take a vitamin or two / a multivitamin”
- Fewest, about 8%, voted for “I get everything I need from my diet”
But what does the science say?
Food is less nutritious now than it used to be: True or False?
True or False depending on how you measure it.
An apple today and an apple from a hundred years ago are likely to contain the same amounts of micronutrients per apple, but a lower percentage of micronutrients per 100g of apple.
The reason for this is that apples (and many other food products; apples are just an arbitrary example) have been selectively bred (and in some cases, modified) for size, and because the soil mineral density has remained the same, the micronutrients per apple have not increased commensurate to the increase in carbohydrate weight and/or water weight. Thus, the resultant percentage will be lower, despite the quantity remaining the same.
We’re going to share some science on this, and/but would like to forewarn readers that the language of this paper is a bit biased, as it looks to “debunk” claims of nutritional values dropping while skimming over “yes, they really have dropped percentage-wise” in favor of “but look, the discrete mass values are still the same, so that’s just a mathematical illusion”.
The reality is, it’s no more a mathematical illusion than is the converse standpoint of saying the nutritional value is the same, despite the per-100g values dropping. After all, sometimes we eat an apple as-is; sometimes we buy a bag of frozen chopped fruit. That 500g bag of chopped fruit is going to contain less copper (for example) than one from decades past.
Here’s the paper, and you’ll see what we mean:
Supplements aren’t absorbed properly and thus are a waste of money: True or False?
True or False depending on the supplement (and your body, and the rest of your diet)
Many people are suffering from dietary deficiencies of vitamins and minerals, that could be easily correctable by supplementation:
However, as this study by Dr. Fang Fang Zhang shows, a lot of vitamin and mineral supplementation does not appear to have much of an effect on actual health outcomes, vis-à-vis specific diseases. She looks at:
- Cardiovascular disease
- Cancer
- Type 2 diabetes
- Osteoporosis
Her key take-aways from this study were:
- Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases
- People using supplements tend to be older, female, and have higher education, income, and healthier lifestyles than people who do not use them
- Use of supplements appreciably reduces the prevalence of inadequate intake for most nutrients but also increases the prevalence of excess intake for some nutrients
- Further research is needed to assess the long term effects of supplements on the health of the general population and in individuals with specific nutritional needs, including those from low and middle income countries
Read her damning report: Health effects of vitamin and mineral supplements
On the other hand…
This is almost entirely about blanket vitamin-and-mineral supplementation. With regard to fish oil supplementation, many commercial fish oil supplements break down in the stomach rather than the intestines, and don’t get absorbed well. Additionally, many people take them in forms that aren’t pleasant, and thus result in low adherence (i.e., they nominally take them, but in fact they just sit on the kitchen counter for a year).
One thing we can conclude from this is that it’s good to check the science for any given supplement before taking it, and know what it will and won’t help for. Our “Monday Research Review” editions of 10almonds do this a lot, although we tend to focus on herbal supplements rather than vitamins and minerals.
We can get everything we need from our diet: True or False?
Contingently True (but here be caveats)
In principle, if we eat the recommended guideline amounts of various macro- and micro-nutrients, we will indeed get all that we are generally considered to need. Obviously.
However, this may come with:
- Make sure to get enough protein… Without too much meat, and also without too much carbohydrate, such as from most plant sources of protein
- Make sure to get enough carbohydrates… But only the right kinds, and not too much, nor at the wrong time, and without eating things in the wrong order
- Make sure to get enough healthy fats… Without too much of the unhealthy fats that often exist in the same foods
- Make sure to get the right amount of vitamins and minerals… We hope you have your calculators out to get the delicate balance of calcium, magnesium, potassium, phosphorus, and vitamin D right.
That last one’s a real pain, by the way. Too much or too little of one or another and the whole set start causing problems, and several of them interact with several others, and/or compete for resources, and/or are needed for the others to do their job.
And, that’s hard enough to balance when you’re taking supplements with the mg/µg amount written on them, never mind when you’re juggling cabbages and sardines.
On the topic of those sardines, don’t forget to carefully balance your omega-3, -6, and -9, and even within omega-3, balancing ALA, EPA, and DHA, and we hope you’re juggling those HDL and LDL levels too.
So, when it comes to getting everything we need from our diet, for most of us (who aren’t living in food deserts and/or experiencing food poverty, or having a medical condition that restricts our diet), the biggest task is not “getting enough”, it’s “getting enough of the right things without simultaneously overdoing it on the others”.
With supplements, it’s a lot easier to control what we’re putting in our bodies.
And of course, unless our diet includes things that usually can’t be bought in supermarkets, we’re not going to get the benefits of taking, as a supplement, such things as:
Etc.
So, there definitely are supplements with strong science-backed benefits, that probably can’t be found on your plate!
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How to Read a Book – by Mortimer J. Adler and Charles Van Doren
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Are you a cover-to-cover person, or a dip-in-and-out person?
Mortimer Adler and Charles van Doren have made a science out of getting the most from reading books.
They help you find what you’re looking for (Maybe you want to find a better understanding of PCOS… maybe you want to find the definition of “heuristics”… maybe you want to find a new business strategy… maybe you want to find a romantic escape… maybe you want to find a deeper appreciation of 19th century poetry, maybe you want to find… etc).
They then help you retain what you read, and make sure that you don’t miss a trick.
Whether you read books so often that optimizing this is of huge value for you, or so rarely that when you do, you want to make it count, this book could make a real difference to your reading experience forever after.
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Severe Complications for Pregnant Veterans Nearly Doubled in the Last Decade, a GAO Report Finds
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ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.
Series: Post-Roe America:Abortion Access Divides the Nation
After the Supreme Court overturned Roe v. Wade, ending nearly 50 years of federal protection for abortion, some states began enforcing strict abortion bans while others became new havens for the procedure. ProPublica is investigating how sweeping changes to reproductive health care access in America are affecting people, institutions and governments.
Over the past decade, the rate of veterans suffering severe pregnancy complications has risen dramatically, a new federal report found.
Veterans have raced to the hospital with dangerous infections, kidney failure, aneurysms or blood loss. They’ve required hysterectomies, breathing machines and blood transfusions to save their lives. Between 2011 and 2020, 13 veterans died after such complications.
The report found that among people getting health care benefits through the Department of Veterans Affairs, the rate of severe complications nearly doubled during that time, from about 93 per 10,000 hospitalizations in 2011 to just over 184 per 10,000 hospitalizations in 2020. Black veterans had the highest rates.
The report, which was put together by the Government Accountability Office, also made recommendations for reducing the problem, which focus on conducting more routine screenings throughout pregnancy and in the postpartum period.
“It is imperative that the VA help ensure veterans have the healthiest pregnancy outcomes possible,” the report said, highlighting the increasing number of veterans using the agency’s maternity benefits as well as the troublesome complication rates faced by Black women.
The report’s findings are an unfortunate trend, said Alyssa Hundrup, director of health care at the GAO. The office analyzed data on 40,000 hospitalizations related to deliveries paid for by the VA. It captures a time period before 21 states banned or greatly restricted abortion and the military was thrust into a political battle over whether it would pay for active service members to travel for abortion care if a pregnancy was a risk to their health.
Hundrup, who led the review, said the analysis included hospital records from days after delivery to a year postpartum. The report was mandated after Congress passed a law in 2021 that aimed to address the maternal health crisis among veterans. The law led to a $15 million investment in maternity care coordination programs for veterans.
The report recommended that the VA analyze and collect more data on severe complications as well as data on the mental health, race and ethnicity of veterans who experience complications to understand the causes behind the increase and the reasons for the disparity. The report also states that oversight is needed to ensure screenings are being completed.
Studies show there’s a connection between mental health conditions and pregnancy-related complications, VA officials said.
The report recommended expanding the screening questions that providers ask patients at appointments to glean more information about their mental health, including anxiety and PTSD symptoms. It urged the VA to review the data more regularly.
“You don’t know what you don’t measure,” Hundrup said in an interview with ProPublica.
The VA health system, which historically served a male population, does not provide maternity care at its facilities. Instead, the agency has outsourced maternity care. But when patients were treated by those providers, the VA failed to track whether they were getting screened for other health issues and mental health problems.
Officials hope the improved data collection will help the VA study underlying issues that may lead to complications. For example, do higher rates of anxiety have a connection to rates of high blood pressure in pregnant people?
VA officials are working with a maternal health review committee to monitor the data as it is gathered. The agency recently conducted its first review of data going back five years about pregnancy-related complications, said Dr. Amanda Johnson, acting head of the VA’s Office of Women’s Health, who is overseeing the implementation of the report’s recommendations.
The VA has created a dashboard to monitor pregnant veterans’ health outcomes. The VA’s data analysis team will also examine the impact of veterans’ ages on complications and whether they differ for people who live in urban and rural areas.
VA officials will begin to review mental health screenings conducted by maternal care coordinators in March. The coordinators advocate for veterans, helping them between health care visits, whether their providers are inside or outside the VA.
Johnson said that reducing racial and ethnic disparities is a priority for the agency. In 2018, ProPublica published “Lost Mothers,” a series that shed light on the country’s maternal health crisis. Studies have shown that in the general population, Black women are three times more likely than white women to die from pregnancy-related complications. While deaths made up only a small portion of the bad outcomes for Black veterans cited in the report, VA care could not spare them from elevated rates of severe complications. Johnson said the maternal health crisis also persists within the VA.
“There is a disparity,” Johnson said. “We are not immune to that.”
Research shows pregnant people who have used the VA’s coverage have higher rates of trauma and mental conditions that can increase their risks of complications and bad outcomes.
This may be because many people who join the military enter it having already faced trauma, said Dr. Laura Miller, a psychiatrist and the medical director of reproductive mental health at the VA.
She said veterans with PTSD have higher rates of complications such as preeclampsia, a potentially fatal condition related to high blood pressure, gestational diabetes and postpartum depression. If untreated during pregnancy, depression also increases the likelihood of preterm birth and lingering problems for babies.
Hundrup said she hopes this proactive work will improve maternal health.
“We want these numbers trending in the other direction,” Hundrup said.
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