Waist Size Worries: Age-Appropriate Solutions
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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
❝My BMI is fine, but my waist is too big. What do I do about that? I am 5′ 5″ tall and 128 pounds and 72 years old.❞
It’s hard to say without knowing about your lifestyle (and hormones, for that matter)! But, extra weight around the middle in particular is often correlated with high levels of cortisol, so you might find this of benefit:
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What’s Your Ikigai?
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Ikigai: A Closer Look
We’ve mentioned ikigai from time to time, usually when discussing the characteristics associated with Blue Zone centenarians, for example as number 5 of…
It’s about finding one’s “purpose”. Not merely a function, but what actually drives you in life. And, if Japanese studies can be extrapolated to the rest of the world, it has a significant and large impact on mortality (other factors being controlled for); not having a sense of ikigai is associated with an approximately 47%* increase in 7-year mortality risk in the categories of cardiovascular disease and external cause mortality:
Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study
*we did a lot of averaging and fuzzy math to get this figure; the link will show you the full stats though!
In case that huge (n=43,391) study didn’t convince you, here’s another comparably-sized (n=43,117) one that found similarly, albeit framing the numbers the other way around, i.e. a comparable decrease in mortality risk for having a sense of ikigai:
This study was even longer (12 years rather than 7), so the fact that it found pretty much the same results the 7-year study we cited just before is quite compelling evidence. Again, multivariate hazard ratios were adjusted for age, BMI, drinking and smoking status, physical activity, sleep duration, education, occupation, marital status, perceived mental stress, and medical history—so all these things were effectively controlled for statistically.
Three kinds of ikigai
There are three principal kinds of ikigai:
- Social ikigai: for example, a caring role in the family or community, volunteer work, teaching
- Asocial ikigai: for example, a solitary practice of self-discipline, spirituality, or study without any particular intent to teach others
- Antisocial ikigai: for example, a strong desire to outlive an enemy, or to harm a person or group that one hates
You may be thinking: wait, aren’t those last things bad?
And… Maybe! But ikigai is not a matter of morality or even about “warm fuzzy feelings”. The fact is, having a sense of purpose increases longevity regardless of moral implications or niceness.
Nevertheless, for obvious reasons there is a lot more focus on the first two categories (social and asocial), and of those, especially the first category (social), because on a social level, “we all do well when we all do well”.
We exemplified them above, but they can be defined:
- Social: working for the betterment of society
- Asocial: working for the betterment of oneself
Of course, for many people, the same ikigai may cover both of those—often somebody who excels at something for its own sake and/but shares it with others to enrich their lives also, for example a teacher, an artist, a scientist, etc.
For it to cover both, however, requires that both parts of it are genuinely part of their feeling of ikigai, and not merely unintended consequences.
For example, a piano teacher who loves music in general and the piano in particular, and would gladly spend every waking moment studying/practising/performing, but hates having to teach it, but needs to pay the bills so teaches it anyway, cannot be said to be living any kind of social ikigai there, just asocial. And in fact, if teaching the piano is causing them to not have the time or energy to pursue it for its own sake, they might not even be living any ikigai at all.
One other thing to watch out for
There is one last stumbling block, which is that while we can find ikigai, we can also lose it! Examples of this may include:
- A professional whose job is their ikigai, until they face mandatory retirement or are otherwise unable to continue their work (perhaps due to disability, for example)
- A parent whose full-time-parent role is their ikigai, until their children leave for school, university, life in general
- A married person whose “devoted spouse” role is their ikigai, until their partner dies
For this reason, people of any age can have a “crisis of identity” that’s actually more of a “crisis of purpose”.
There are two ways of handling this:
- Have a back-up ikigai ready! For example, if your profession is your ikigai, maybe you have a hobby waiting in the wings, that you can smoothly jump ship to upon retirement.
- Embrace the fluidity of life! Sometimes, things don’t happen the way we expect. Sometimes life’s surprises can trip us up; sometimes they can leave us a sobbing wreck. But so long as life continues, there is an opportunity to pick ourselves up and decide where to go from that point. Note that this is not fatalism, by the way, it doesn’t have to be “this bad thing happened so that we could find this good thing, so really it was a good thing all along”. Rather, it can equally readily be “well, we absolutely did not want that bad thing to happen, but since it did, now we shall take it this way from here”.
For more on developing/maintaining psychological resilience in the face of life’s less welcome adversities, see:
Psychological Resilience Training
…and:
Putting The Abs Into Absurdity ← do not underestimate the power of this one
Take care!
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ADHD medication – can you take it long term? What are the risks and do benefits continue?
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Attention deficit hyperactivity disorder (ADHD) is a condition that can affect all stages of life. Medication is not the only treatment, but it is often the treatment that can make the most obvious difference to a person who has difficulties focusing attention, sitting still or not acting on impulse.
But what happens once you’ve found the medication that works for you or your child? Do you just keep taking it forever? Here’s what to consider.
What are ADHD medications?
The mainstay of medication for ADHD is stimulants. These include methylphenidate (with brand names Ritalin, Concerta) and dexamfetamine. There is also lisdexamfetamine (branded Vyvanse), a “prodrug” of dexamfetamine (it has a protein molecule attached, which is removed in the body to release dexamfetamine).
There are also non-stimulants, in particular atomoxetine and guanfacine, which are used less often but can also be highly effective. Non-stimulants can be prescribed by GPs but this may not always be covered by the Pharmaceutical Benefits Scheme and could cost more.
How stimulants work
Some stimulants prescribed for ADHD are “short acting”. This means the effect comes on after around 20 minutes and lasts around four hours.
Longer-acting stimulants give a longer-lasting effect, usually by releasing medication more slowly. The choice between the two will be guided by whether the person wants to take medication once a day or prefers to target the medication effect to specific times or tasks.
For the stimulants (with the possible exception of lisdexamfetamine) there is very little carry-over effect to the next day. This means the symptoms of ADHD may be very obvious until the first dose of the morning takes effect.
One of the main aims of treatment is the person with ADHD should live their best life and achieve their goals. In young children it is the parents who have to consider the risks and benefits on behalf of the child. As children mature, their role in decision making increases.
What about side effects?
The most consistent side effects of the stimulants are they suppress appetite, resulting in weight loss. In children this is associated with temporary slowing of the growth rate and perhaps a slight delay in pubertal development. They can also increase the heart rate and may cause a rise in blood pressure. Stimulants often cause insomnia.
These changes are largely reversible on stopping medication. However, there is concern the small rises in blood pressure could accelerate the rate of heart disease, so people who take medication over a number of years might have heart attacks or strokes slightly sooner than would have happened otherwise.
This does not mean older adults should not have their ADHD treated. Rather, they should be aware of the potential risks so they can make an informed decision. They should also make sure high blood pressure and attacks of chest pain are taken seriously.
Stimulants can be associated with stomach ache or headache. These effects may lessen over time or with a reduction in dose. While there have been reports about stimulants being misused by students, research on the risks of long-term prescription stimulant dependence is lacking.
Will medication be needed long term?
Although ADHD can affect a person’s functioning at all stages of their life, most people stop medication within the first two years.
People may stop taking it because they don’t like the way it makes them feel, or don’t like taking medication at all. Their short period on medication may have helped them develop a better understanding of themselves and how best to manage their ADHD.
In teenagers the medication may lose its effectiveness as they outgrow their dose and so they stop taking it. But this should be differentiated from tolerance, when the dose becomes less effective and there are only temporary improvements with dose increases.
Tolerance may be managed by taking short breaks from medication, switching from one stimulant to another or using a non-stimulant.
Too many prescriptions?
ADHD is becoming increasingly recognised, with more people – 2–5% of adults and 5–10% of children – being diagnosed. In Australia stimulants are highly regulated and mainly prescribed by specialists (paediatricians or psychiatrists), though this differs from state to state. As case loads grow for this lifelong diagnosis, there just aren’t enough specialists to fit everyone in.
In November, a Senate inquiry report into ADHD assessment and support services highlighted the desperation experienced by people seeking treatment.
There have already been changes to the legislation in New South Wales that may lead to more GPs being able to treat ADHD. Further training could help GPs feel more confident to manage ADHD. This could be in a shared-care arrangement or independent management of ADHD by GPs like a model being piloted at Nepean Blue Mountains Local Health District, with GPs training within an ADHD clinic (where I am a specialist clinician).
Not every person with ADHD will need or want to take medication. However, it should be more easily available for those who could find it helpful.
Alison Poulton, Senior Lecturer, Brain Mind Centre Nepean, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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28-Day FAST Start Day-by-Day – by Gin Stephens
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We have previously reviewed Gin Stephens’ other book, “Fast. Feast. Repeat.”, so what’s so special about this one that it deserves reviewing too?
This one is all about troubleshooting the pitfalls that many people find when taking up intermittent fasting.
To be clear: the goal here is not a “28 days and yay you did it, put that behind you now”, but rather “28 days and you are now intermittently fasting easily each day and can keep it up without difficulty”. As for the difficulties that may arise early in the 28 days…
Not just issues of willpower, but also the accidental breaks. For example, some artificial sweeteners, while zero-calorie, trigger an insulin response, which breaks the fast on the metabolic level (avoiding that is the whole point of IF). Lots of little tips like that peppered through the book help the reader to stop accidentally self-sabotaging their progress.
The author does talk about psychological issues too, and also how it will feel different at first while the liver is adapting, than later when it has already depleted its glycogen reserves and the body must burn body fat instead. Information like that makes it easier to understand that some initial problems (hunger, getting “hangry”, feeling twitchy, or feeling light-headed) will last only a few weeks and then disappear.
So, understanding things like that makes a big difference too.
The style of the book is simple and clear pop-science, with lots of charts and bullet points and callout-boxes and the like; it makes for very easy reading, and very quick learning of all the salient points, of which there are many.
Bottom line: if you’ve tried intermittent fasting but struggled to make it stick, this book can help you get to where you want to be.
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Forever Strong – by Dr. Gabrielle Lyon
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Obesity kills a lot of people (as does medical neglect and malpractice when it comes to obese patients, but that is another matter), but often the biggest problem is not “too much fat” but rather “too little muscle”. This gets disguised a bit, because these factors often appear in the same people, but it’s a distinction that’s worthy of note.
Dr. Lyon lays out a lot of good hard science in this work, generally in the field of protein metabolism, but also with a keen eye on all manner of blood metrics (triglycerides, LDL/HDL, fasting blood sugars, assorted other biomarkers of metabolic health).
The style of this book is two books in one. It’s a very accessible pop-science book in its primary tone, with an extra layer of precise science and lots of references, for those who wish to dive into that.
In the category of criticism, the diet plan section of the book is rather meat-centric, but the goal of this is protein content, not meat per se, so substitutions can easily be made. That’s just one small section of the book, though, and it’s little enough a downside that even Dr. Mark Hyman (a popular proponent of plant-based nutrition) highly recommends the book.
Bottom line: if you’d like to be less merely fighting decline and more actually becoming healthier as you age, then this book will help you do just that.
Click here to check out Forever Strong, and level up your wellness as you age!
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These Signs Often Mean These Nutrient Deficiencies (Do You Have Any?)
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These are not a necessary “if this then this” equation, but rather a “if this, then probably this”, and it’s a cue to try upping that thing in your diet, and if that doesn’t quickly fix it, get some tests done:
- White bumps on the skin: vitamin A, omega 3
- Craving sour foods: vitamin C
- Restless leg syndrome: iron, magnesium
- Cracked lips: vitamin B2
- Tingling hands and feet: vitamin B12
- Easy bruising: vitamin K and vitamin C
- Canker sores: vitamin B9 (folate), vitamin B12, iron
- Brittle or misshapen nails: vitamin B7 (biotin)
- Craving salty foods: sodium, potassium
- Prematurely gray hair: copper, vitamin B9 (folate), vitamin B12
- Dandruff: omega 3, zinc, vitamin B6
- Craving ice: iron
Dr. LeGrand Peterson has more to say about these though, as well as a visual guide to symptoms, so do check out the video:
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Want to know more?
You might like this previous main feature about supplements vs nutrients from food
Do We Need Supplements, And Do They Work?
Enjoy!
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Walk Like You’re 20 Years Younger Again
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How fit, healthy, strong, and mobile were you 20 years ago? For most people, the answer is “better than now”. Physiotherapist Dr. Doug Weiss has advice on turning back the clock:
The exercises
If you already have no problems walking, this one is probably not for you. However, if you’re not so able to comfortably walk as you used to be, then Dr. Weiss recommends:
- Pillow squat: putting pillow on a chair, crossing hands on chest, standing up and sitting down. Similar to the very important “getting up off the floor without using your hands” exercise, but easier.
- Wall leaning: standing against a wall with heels 4″ away from it, crossing arms over chest again, and pulling the body off the wall using the muscles in the front of the shin. Note, this means not cheating by using other muscles, leveraging the upper body, pushing off with the buttocks, or anything else like that.
- Stepping forward: well, this certainly is making good on the promise of walking like we did 20 years ago; there sure was a lot of stepping forward involved. More seriously, this is actually about stepping over some object, first with support, and then without.
- Heel raise: is what it sounds like, raising up on toes and back down again; first with support, then without.
- Side stepping: step sideways 2–3 steps in each direction. First with support, then without. Bonus: if your support is your partner, then congratulations, you are now dancing bachata.
For more details (and visual demonstration) of these exercises and more, enjoy:
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Want to learn more?
You might also like:
4 Tips To Stand Without Using Hands
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
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