Uric Acid’s Extensive Health Impact (And How To Lower It)
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Uric Acid’s Extensive Health Impact (And How To Lower It)
This is Dr. David Perlmutter. He’s a medical doctor, and a Fellow of the American College of Nutrition. He’s a member of the Editorial Board for the Journal of Alzheimer’s Disease, and has been widely published in many other peer-reviewed journals.
What does he want us to know?
He wants us to know about the health risks of uric acid (not something popularly talked about so much!), and how to reduce it.
First: what is it? Uric acid is a substance we make in our own body. However, unlike most substances we make in our body, we have negligible use for it—it’s largely a waste product, usually excreted in urine.
However, if we get too much, it can build up (and crystallize), becoming such things as kidney stones, or causing painful inflammation if it shows up in the joints, as in gout.
More seriously (unpleasant as kidney stones and gout may be), this inflammation can have a knock-on effect triggering (or worsening) other inflammatory conditions, ranging from non-alcoholic fatty liver disease, to arthritis, to dementia, and even heart problems. See for example:
- David Perlmutter | Uric Acid and Cognitive Decline
- American Heart Association | Uric acid linked to later risk for irregular heart rhythm
- World Journal of Gastroenterology | The role of uric acid in non-alcoholic steatohepatitis development
How can we reduce our uric acid levels?
Uric acid is produced when we metabolize purine nucleotides, which are found in many kinds of food. We can therefore reduce our uric acid levels by reducing our purine intake, as well as things that mess up our liver’s ability to detoxify things. Offsetting the values for confounding variables (such as fiber content, or phytochemicals that mitigate the harm), the worst offenders include…
Liver-debilitating things:
- Alcohol (especially beer)
- High-fructose corn syrup (and other fructose-containing things that aren’t actual fruit)
- Other refined sugars
- Wheat / white flour products (this is why beer is worse than wine, for example; it’s a double-vector hit)
Purine-rich things:
- Red meats and game
- Organ meats
- Oily fish, and seafood (great for some things; not great for this)
Some beans and legumes are also high in purines, but much like real fruit has a neutral or positive effect on blood sugar health despite its fructose content, the beans and legumes that are high in purines, also contain phytochemicals that help lower uric acid levels, so have a beneficial effect.
Eggs (consumed in moderation) and tart cherries have a uric-acid lowering effect.
Water is important for all aspects of health, and doubly important for this.
Hydrate well!
Lifestyle matters beyond diet
The main key here is metabolic health, so Dr. Perlmutter advises the uncontroversial lifestyle choices of moderate exercise and good sleep, as well as (more critically) intermittent fasting. We wrote previously on other things that can benefit liver health:
…in this case, that means the liver gets a break to recuperate (something it’s very good at, but does need to get a chance to do), which means that while you’re not giving it something new to do, it can quickly catch up on any backlog, and then tackle any new things fresh, next time you start eating.
Want to know more about this from Dr. Perlmutter?
You might like his article:
An Integrated Plan for Lowering Uric Acid ← more than we had room for here; he also talks about extra things to include in your diet/supplementation regime for beneficial effects!
And/or his book:
…on which much of today’s main feature was based.
Take care!
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
Yesterday, we asked you for your opinions on waist trainers and posture-fixing harnesses, and got the above-depicted, below-described set of results:
- The most popular response was “Waist trainers are purely cosmetic, so useless. Posture-fixers have merit”, with a little over a quarter of the votes.
- The least popular response was “Both are great tools to help us to optimal waist size and posture, respectively!”
- The other three answers each got a little under a quarter of the vote. In terms of discrete data, these were all 7±1, so basically, there was nothing in it.
The sample size was smaller than usual—perhaps the cluster of American holiday dates yesterday and today kept people busy! But, pressing on…
What does the science say?
Waist trainers are purely cosmetic, so, useless. True or False?
True, simply. Honestly, they’re not even that great for cosmetic purposes. They will indeed cinch in your middle, and this shape will be retained for a (very) short while after uncinching, because your organs have been squished inwards and may take a short while to get back to where they are supposed to be.
The American Board of Cosmetic Surgery may not be an unbiased source, but we’re struggling to find scientists who will even touch one of these, so, let’s see what these doctors have to say:
- Waist training can damage vital organs
- You will be slowly suffocating yourself
- Waist training simply doesn’t work
- You cannot drastically change your body shape with a piece of fabric*
Read: ABCS | 4 Reasons to Throw Your Waist Trainer in the Trash
*”But what about foot-binding?”—feet have many bones, whose growth can be physically restricted. Your waist has:
- organs: necessary! (long-term damage possible, but they’re not going away)
- muscles: slightly restrictable! (temporary restriction; no permanent change)
- fat: very squeezable! (temporary muffin; no permanent change)
Posture correctors have merit: True or False?
True—probably, and as a stepping-stone measure only.
The Ergonomics Health Association (a workplace health & safety organization) says:
❝Looking at the clinical evidence of posture correctors, we can say without a doubt that they do work, just not for everyone and not in the same way for all patients.❞
Source: Do Posture Correctors Work? Here’s What Our Experts Think
That’s not very compelling, so we looked for studies, and found… Not much, actually. However, what we did find supported the idea that “they probably do help, but we seriously need better studies with less bias”:
That is also not a compelling title, but here is where it pays to look at the studies and not just the titles. Basically, they found that the results were favorable to the posture-correctors—the science itself was just trash:
❝ The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity.
The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence.❞
Since the benefit of posture correctors like this one is due to reminding the wearer to keep good posture, there is a lot more (good quality!) science for wearable biofeedback tech devices, such as this one:
Spine Cop: Posture Correction Monitor and Assistant
Take care!
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The Brain Alarm Signs That Warn Of Dementia
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When it comes to predicting age-related cognitive impairment:
First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.
When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:
Alzheimer’s Sex Differences May Not Be What They Appear
Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:
How To Reduce Your Alzheimer’s Risk
(the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)
Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.
Nipping it in the blood
In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:
- started with the premise “dementia is preceded by mild cognitive impairment”
- then, asked the question “what are the biometric signs of mild cognitive impairment?”
Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.
Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.
What they found:
- in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
- in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
- in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)
They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.
People with mild cognitive impairment had more of these brain bits in their blood than those without.
You can read the paper itself here:
What this means
The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.
And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.
As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…
Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain
Take care!
When it comes to predicting age-related cognitive impairment:
First there are genetic factors to take into account (such as the APOE4 gene for Alzheimer’s), as well as things such as age and sex.
When it comes to sex, by the way, what matters here is hormones, which is why [it seems; this as technically as yet unproven with full rigor, but the hypothesis is sound and there is a body of evidence gradually being accumulated to support it] postmenopausal women with untreated menopause get Alzheimer’s at a higher rate and deteriorate more quickly:
Alzheimer’s Sex Differences May Not Be What They Appear
Next, there are obviously modifiable lifestyle factors to take into account, things that will reduce your risk such as getting good sleep, good diet, good exercise, and abstaining from alcohol and smoking, as well as oft-forgotten things such as keeping cognitively active and, equally importantly, socially active:
How To Reduce Your Alzheimer’s Risk
(the article outlines what matters the most in each of the above areas, by the way, so that you can get the most bang-for-buck in terms of lifestyle adjustments)
Lastly (in the category of risk factors), there are things to watch out for in the blood such as hypertension and high cholesterol.
Nipping it in the blood
In new research (so new it is still ongoing, but being at year 2 of a 4-year prospective study, they have published a paper with their results so far), researchers have:
- started with the premise “dementia is preceded by mild cognitive impairment”
- then, asked the question “what are the biometric signs of mild cognitive impairment?”
Using such tools as functional near-infrared spectroscopy (fNIRS) while the participants performed cognitive tasks, they were able to record changes in plasma levels of extracellular vesicles, assessing them with small-particle flow cytometry.
Translating from sciencese: they gave the participants mental tasks, and while they completed them, the researchers scanned their brains and monitored blood flow and the brain’s ability to compensate for any lack of it.
What they found:
- in young adults, blood flow increased, facilitating neurovascular coupling (this is good)
- in older adults, blood flow did not increase as much, but they engaged other areas of the brain to compensate, by what’s called functional connectivity (this is next best)
- in those with mild cognitive impairment, blood flow was reduced, and they did not have the ability to compensate by functional connectivity (this is not good)
They also performed a liquid biopsy, which sounds alarming but it just means they took some blood, and tested this for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which—in more prosaic words—are bits from the cells lining the blood vessels in the brain.
People with mild cognitive impairment had more of these brain bits in their blood than those without.
You can read the paper itself here:
What this means
The science here is obviously still young (being as it is still in progress), but this will likely contribute greatly to early warning signs of dementia, by catching mild cognitive impairment in its early stages, by means of a simple blood test, instead of years of wondering before getting a dementia diagnosis.
And of course, forewarned is forearmed, so if this is something that could be done as a matter of routine upon hitting the age of, say, 65 and then periodically thereafter, it would catch a lot of cases while there’s still more time to turn things around.
As for how to turn things around, well, we imagine you have now read our “How To Reduce Your Alzheimer’s Risk” article linked up top (if not, we recommend checking it out), and there is also…
Do Try This At Home: The 12-Week Brain Fitness Program To Measurably Boost Your Brain
Take care!
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Walnuts vs Pecans – Which is Healthier?
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Our Verdict
When comparing walnuts to pecans, we picked the walnuts.
Why?
It was very close, though, and an argument could be made for pecans! Walnuts are nevertheless always a very good bet, and so far in our This-or-That comparisons, the only nut to beat them so far as been almonds, and that was very close too.
In terms of macros, walnuts have a lot more protein, while pecans have a little more fiber (for approximately the same carbs). Both are equally fatty (near enough; technically pecans have a little more) but where the walnuts stand out in the fat category is that while pecans have mostly healthy monounsaturated fats, walnuts have mostly healthy polyunsaturated fats, including including a good balance of omega-3 and omega-6 fatty acids. So, while we do love the extra fiber from pecans, we’re calling it for walnuts in the macros category, on account of the extra protein and the best lipids profile (not that pecans’ lipids profile is bad by any stretch; just, walnuts have it better).
In the vitamins category, walnuts have more of vitamins B2, B6, B9, and C, while pecans offer more of vitamins A, B1, B3, B5, E, K, and choline. The margins aren’t huge and walnuts are also excellent for all the vitamins that pecans narrowly beat them on, but still, the vitamins category is a win for pecans.
When it comes to minerals, walnuts take back the crown; walnuts offer more calcium, copper, iron, magnesium, phosphorus, potassium, and selenium, while pecans have a little more manganese and zinc. Once again, the margins aren’t huge and pecans are also excellent for all the minerals that walnuts narrowly beat them on, but still, the minerals category is a win for walnuts.
In short: enjoy both of these nuts for their healthy fats, vitamins, minerals, protein, and fiber, but if you’re going to pick one, walnuts come out on top.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Take care!
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Honeydew vs Cantaloupe – Which is Healthier?
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Our Verdict
When comparing honeydew to cantaloupe, we picked the cantaloupe.
Why?
In terms of macros, there’s not a lot between them—they’re both mostly water. Nominally, honeydew has more carbs while cantaloupe has more fiber and protein, but the differences are very small. So, a very slight win for cantaloupe.
Looking at vitamins: honeydew has slightly more of vitamins B5 and B6 (so, the vitamins that are in pretty much everything), while cantaloupe has a more of vitamins A, B1, B2, B3, C, and E (especially notably 67x more vitamin A, whence its color). A more convincing win for cantaloupe.
The minerals category is even more polarized: honeydew has more selenium (and for what it’s worth, more sodium too, though that’s not usually a plus for most of us in the industrialized world), while cantaloupe has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. An overwhelming win for cantaloupe.
No surprises: adding up the slight win for cantaloupe, the convincing win for cantaloupe, and the overwhelming win for cantaloupe, makes cantaloupe the overall best pick here.
Enjoy!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Shedding Some Obesity Myths
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Let’s shed some obesity myths!
There are a lot of myths and misconceptions surrounding obesity… And then there are also reactive opposite myths and misconceptions, which can sometimes be just as harmful!
To tackle them all would take a book, but in classic 10almonds style, we’re going to put a spotlight on some of the ones that might make the biggest difference:
True or False: Obesity is genetically pre-determined
False… With caveats.
Some interesting results have been found from twin studies and adoption studies, showing that genes definitely play some role, but lifestyle is—for most people—the biggest factor:
- The body-mass index of twins who have been reared apart
- An adoption study of human obesity
- Using a sibling-adoption design to parse genetic and environmental influences on children’s body mass index
In short: genes predispose; they don’t predetermine. But that predisposition alone can make quite a big difference, if it in turn leads to different lifestyle factors.
But upon seeing those papers centering BMI, let’s consider…
True or False: BMI is a good, accurate measure of health in the context of bodyweight
False… Unless you’re a very large group of thin white men of moderate height, which was the demographic the system was built around.
Bonus information: it was never intended to be used to measure the weight-related health of any individual (not even an individual thin white man of moderate height), but rather, as a tool to look at large-scale demographic trends.
Basically, as a system, it’s being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
To do a deep-dive into all the flaws of the BMI system, which are many, we’d need to devote a whole main feature just to that.
Update: we have now done so!
Here it is: When BMI Doesn’t Measure Up
True or False: Obesity does not meaningfully impact more general health
False… In more ways than one (but there are caveats)
Obesity is highly correlated with increased risk of all-cause mortality, and weight loss, correspondingly, correlates with a reduced risk. See for example:
So what are the caveats?
Let’s put it this way: owning a horse is highly correlated with increased healthy longevity. And while owning a horse may come with some exercise and relaxation (both of which are good for the health), it’s probably mostly not the horse itself that conveys the health benefits… it’s that someone who has the resources to look after a horse, probably has the resources to look after their own health too.
So sometimes there can be a reason for a correlation (it’s not a coincidence!) but the causative factor is partially (or in some cases, entirely) something else.
So how could this play out with obesity?
There’s a lot of discrimination in healthcare settings, unfortunately! In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
True or False: to reduce obesity, just eat less and move more!
False… Mostly.
Moving more is almost always good for most people. When it comes to diet, quality is much more important than quantity. But these factors alone are only part of the picture!
But beyond diet and exercise, there are many other implicated factors in weight gain, weight maintenance, and weight loss, including but not limited to:
- Disrupted sleep
- Chronic stress
- Chronic pain
- Hormonal imbalances
- Physical disabilities that preclude a lot of exercise
- Mental health issues that add (and compound) extra levels of challenge
- Medications that throw all kinds of spanners into the works with their side effects
…and even just those first two things, diet and exercise, are not always so correlated to weight as one might think—studies have found that the difference for exercise especially is often marginal:
Read: Widespread misconceptions about obesity ← academic article in the Journal of the College of Family Physicians of Canada
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Study Tips for Exam Season?
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You’ve Got Questions? We’ve Got Answers!
Q: Any study tips as we approach exam season? A lot of the productivity stuff is based on working life, but I can’t be the only student!
A: We’ve got you covered:
- Be passionate about your subject! We know of no greater study tip than that.
- Find a willing person and lecture them on your subject. When one teaches, two learn!
- Your mileage may vary depending on your subject, but, find a way of studying that’s fun to you!
- If you can get past papers, get as many as you can, and use those as your “last minute” studying in the week before your exam(s). This will prime you for answering exam-style questions (and leverage state-dependent memory). As a bonus, it’ll also help ease any anxiety, because by the time of your exam it’ll be “same old, same old”!
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