Two Awesome Hours – by Dr. Josh Davis
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The brain is an amazing and powerful organ, with theoretically unlimited potential in some respects. So why doesn’t it feel that way a lot of the time?
The truth is that not only are we often tired, dehydrated, or facing other obvious physiological challenges to peak brain health, but also… We’re simply not making the best use of it!
What Dr. Davis does is outline for us how we can create the conditions for “two awesome hours” of effective mental performance by:
- Recognizing when to most effectively flip the switch on our automatic thinking
- Scheduling tasks based on their “processing demand” and recovery time
- Learning how to direct attention, rather than avoid distractions
- Feeding and moving our bodies in ways that prep us for success
- Identifying what matters in our environment to be at the top of our mental game
Why only two hours? Why not four, or eight, or more?
Well, our brains need recovery time too, so we can’t be “always on” and operating and peak efficiency. But, what we can do is optimize a couple of hours for absolute peak efficiency, and then enjoy the rest of time with lower cognitive-load activities.
Bottom line: if the idea of what you could accomplish if you could just be guaranteed two schedulable hours (your preference when!) of peak cognitive performance per day, then this is a great book for you.
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Test For Whether You Will Be Able To Achieve The Splits
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Some people stretch for years without being able to do the splits; others do it easily after a short while. Are there people for whom it is impossible, and is there a way to know in advance whether our efforts will be fruitful? Liv (of “LivInLeggings” fame) has the answer:
One side of the story
There are several factors that affect whether we can do the splits, including:
- arrangement of the joint itself
- length of tendons and muscles
- “stretchiness” of tendons and muscles
The latter two things, we can readily train to improve. Yes, even the basic length can be changed over time, because the body adapts.
The former thing, however (arrangement of the joint itself) is near-impossible, because skeletal changes happen more slowly than any other changes in the body. In a battle of muscle vs bone, muscle will always win eventually, and even the bone itself can be rebuilt (as the body fixes itself, or in the case of some diseases, messes itself up). However, changing the arrangement of your joint itself is far beyond the auspices of “do some stretches each day”. So, for practical purposes, without making it the single most important thing in your life, it’s impossible.
How do we know if the arrangement of our hip joint will accommodate the splits? We can test it, one side at a time. Liv uses the middle splits, also called the side splits or box splits, as an example, but the same science and the same method goes for the front splits.
Stand next to a stable elevated-to-hip-height surface. You want to be able to raise your near-side leg laterally, and rest it on the surface, such that your raised leg is now perfectly perpendicular to your body.
There’s a catch: not only do you need to still be stood straight while your leg is elevated 90° to the side, but also, your hips still need to remain parallel to the floor—not tilted up to one side.
If you can do this (on both sides, even if not both simultaneously right now), then your hip joint itself definitely has the range of motion to allow you to do the side splits; you just need to work up to it. Technically, you could do it right now: if you can do this on both sides, then since there’s no tendon or similar running between your two legs to make it impossible to do both at once, you could do that. But, without training, your nerves will stop you; it’s an in-built self-defense mechanism that’s just firing unnecessarily in this case, and needs training to get past.
If you can’t do this, then there are two main possibilities:
- Your joint is not arranged in a way that facilitates this range of motion, and you will not achieve this without devoting your life to it and still taking a very long time.
- Your tendons and muscles are simply too tight at the moment to allow you even the half-split, so you are getting a false negative.
This means that, despite the slightly clickbaity title on YouTube, this test cannot actually confirm that you can never do the middle splits; it can only confirm that you can. In other words, this test gives two possible results:
- “Yes, you can do it!”
- “We don’t know whether you can do it”
For more on the anatomy of this plus a visual demonstration of the test, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Stretching Scientifically – by Thomas Kurz ← this is our review of the book she’s working from in this video; this book has this test!
Take care!
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Evidence doesn’t support spinal cord stimulators for chronic back pain – and they could cause harm
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In an episode of ABC’s Four Corners this week, the use of spinal cord stimulators for chronic back pain was brought into question.
Spinal cord stimulators are devices implanted surgically which deliver electric impulses directly to the spinal cord. They’ve been used to treat people with chronic pain since the 1960s.
Their design has changed significantly over time. Early models required an external generator and invasive surgery to implant them. Current devices are fully implantable, rechargeable and can deliver a variety of electrical signals.
However, despite their long history, rigorous experimental research to test the effectiveness of spinal cord stimulators has only been conducted this century. The findings don’t support their use for treating chronic pain. In fact, data points to a significant risk of harm.
What does the evidence say?
One of the first studies used to support the effectiveness of spinal cord stimulators was published in 2005. This study looked at patients who didn’t get relief from initial spinal surgery and compared implantation of a spinal cord stimulator to a repeat of the spinal surgery.
Although it found spinal cord stimulation was the more effective intervention for chronic back pain, the fact this study compared the device to something that had already failed once is an obvious limitation.
Later studies provided more useful evidence. They compared spinal cord stimulation to non-surgical treatments or placebo devices (for example, deactivated spinal cord stimulators).
A 2023 Cochrane review of the published comparative studies found nearly all studies were restricted to short-term outcomes (weeks). And while some studies appeared to show better pain relief with active spinal cord stimulation, the benefits were small, and the evidence was uncertain.
Only one high-quality study compared spinal cord stimulation to placebo up to six months, and it showed no benefit. The review concluded the data doesn’t support the use of spinal cord stimulation for people with back pain.
What about the harms?
The experimental studies often had small numbers of participants, making any estimate of the harms of spinal cord stimulation difficult. So we need to look to other sources.
A review of adverse events reported to Australia’s Therapeutic Goods Administration found the harms can be serious. Of the 520 events reported between 2012 and 2019, 79% were considered “severe” and 13% were “life threatening”.
We don’t know exactly how many spinal cord stimulators were implanted during this period, however this surgery is done reasonably widely in Australia, particularly in the private and workers compensation sectors. In 2023, health insurance data showed more than 1,300 spinal cord stimulator procedures were carried out around the country.
In the review, around half the reported harms were due to a malfunction of the device itself (for example, fracture of the electrical lead, or the lead moved to the wrong spot in the body). The other half involved declines in people’s health such as unexplained increased pain, infection, and tears in the lining around the spinal cord.
More than 80% of the harms required at least one surgery to correct the problem. The same study reported four out of every ten spinal cord stimulators implanted were being removed.
Chronic back pain can be debilitating. CGN089/Shutterstock High costs
The cost here is considerable, with the devices alone costing tens of thousands of dollars. Adding associated hospital and medical costs, the total cost for a single procedure averages more than $A50,000. With many patients undergoing multiple repeat procedures, it’s not unusual for costs to be measured in hundreds of thousands of dollars.
Rebates from Medicare, private health funds and other insurance schemes may go towards this total, along with out-of-pocket contributions.
Insurers are uncertain of the effectiveness of spinal cord stimulators, but because their implantation is listed on the Medicare Benefits Schedule and the devices are approved for reimbursement by the government, insurers are forced to fund their use.
Industry influence
If the evidence suggests no sustained benefit over placebo, the harms are significant and the cost is high, why are spinal cord stimulators being used so commonly in Australia? In New Zealand, for example, the devices are rarely used.
Doctors who implant spinal cord stimulators in Australia are well remunerated and funding arrangements are different in New Zealand. But the main reason behind the lack of use in New Zealand is because pain specialists there are not convinced of their effectiveness.
In Australia and elsewhere, the use of spinal cord stimulators is heavily promoted by the pain specialists who implant them, and the device manufacturers, often in unison. The tactics used by the spinal cord stimulator device industry to protect profits have been compared to tactics used by the tobacco industry.
A 2023 paper describes these tactics which include flooding the scientific literature with industry-funded research, undermining unfavourable independent research, and attacking the credibility of those who raise concerns about the devices.
It’s not all bad news
Many who suffer from chronic pain may feel disillusioned after watching the Four Corners report. But it’s not all bad news. Australia happens to be home to some of the world’s top back pain researchers who are working on safe, effective therapies.
New approaches such as sensorimotor retraining, which includes reassurance and encouragement to increase patients’ activity levels, cognitive functional therapy, which targets unhelpful pain-related thinking and behaviour, and old approaches such as exercise, have recently shown benefits in robust clinical research.
If we were to remove funding for expensive, harmful and ineffective treatments, more funding could be directed towards effective ones.
Ian Harris, Professor of Orthopaedic Surgery, UNSW Sydney; Adrian C Traeger, Research Fellow, Institute for Musculoskeletal Health, University of Sydney, and Caitlin Jones, Postdoctoral Research Associate in Musculoskeletal Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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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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Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
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The Healthiest Bread Recipe You’ll Probably Find
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝[About accidental scalding with water] Is cold water actually the best immediate treatment for a burn? Maybe there is something better, or something I should apply after the cold water.❞
If this is a case of spilled tea or similar—as in your story, which (apologies) we clipped for brevity—indeed, cold running water is best, and nothing else should be needed. It’s up to you whether you want to invest the time based on the extent of the scalding, but 10 minutes is recommended to minimize tissue damage.
If it’s a more severe scalding or burning, seek medical attention immediately. If it’s a burn to anywhere other than the airway, cold running water is still best for 10 minutes, but if you have to choose between that and professional medical attention, don’t delay the help.
If it’s a burn you’ve given 10 minutes of cold running water and it still hurts and/or has blistered, cover it in a sterile, non-adhesive dressing that extends well beyond the visible burn (because the actual damage probably extends further, and you don’t want to find this out the hard way later). If the burn is to the face, do still irrigate but not cover it; wait for help.
Do not apply any kind of cream, lotion, oil, etc. No matter how tempting, no matter where the burn is.
All of the above also goes for splashed oil, chemical burns, and electrical burns too (but obviously, make sure to get away from the electricity first).
Source: this ex-military writer was trained for this sort of thing and, suffice it to say, has dealt with more serious things than spilled tea before now.
Legal note: notwithstanding the above, we are a health science newsletter, not paramedics. Also, circumstances may differ, and best practices may change. In the case of serious injury, call emergency services first, and follow their instructions over ours.
Take care!
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Plum vs Persimmon – Which is Healthier?
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Our Verdict
When comparing plum to persimmon, we picked the plum.
Why?
Looking at the macros first, persimmon has 3x the carbs for only the same amount of fiber, on account of which plum has the lower glycemic index, so we’ll go with plum here, though your opinion could vary.
In terms of vitamins, it’s much less subjective: plums have more of vitamins A, B1, B2, B3, B5, B6, B7, B9, E, K, and choline, while persimmon has more vitamin C. So, unless you have scurvy, plums will be the best choice for most people.
In the category of minerals, plums have more copper, magnesium, manganese, and zinc, while persimmon has more calcium, iron, phosphorus, and potassium—thus, a 4:4 tie on minerals.
Adding up the sections gives an overall win for plums, but of course, enjoy either or both; diversity is good!
PS: plums have an extra bonus too; check out the link below…
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← plums kill cancer cells while sparing healthy ones
Enjoy!
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