Walking… Better.
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Walking… Better.
We recently reviewed “52 Ways To Walk” by Annabel Streets. You asked us to share some more of our learnings from that book, and… Obviously we can’t do all 52, nor go into such detail, but here are three top tips inspired by that book…
Walk in the cold!
While cold weather is often seen as a reason to not walk, in fact, it has numerous health benefits, the most exciting of which might be:
Walking in the cold causes us to convert white and yellow fat into the healthier brown fat. If you didn’t know about this, neither did scientists until about 15 years ago.
In fact, scientists didn’t even know that adult humans could even have brown adipose tissue! It was really quite groundbreaking.
In case you missed it: The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
Work while you walk!
Obviously this is only appropriate for some kinds of work… but if in your life you have any kind of work that is chiefly thinking, a bunch of it can be done while walking.
Open your phone’s note-taking app, lock the screen and pocket your phone, and think on some problem that you need to solve. Whenever you have an “aha” moment, take out your phone and make a quick note on the go.
For that matter, if you have the money and space (or are fortunate to have an employer disposed towards facilitating such), you could even set up a treadmill desk… At worst, it wouldn’t harm your work (and it’ll be a LOT better than sitting for so long).
Walk within an hour of waking!
No, this doesn’t mean that if you don’t get out of the house within 60 minutes you say “Oh no, missed the window, guess it’s a day in today”
But it does mean: in the evening, make preparations to head out first thing in the morning. Set out your clothes and appropriate footwear, find your flask to fill with the beverage of your choice in the morning and set that with them.
Then, when morning arrives… do your morning necessaries (e.g. some manner of morning ablutions and perhaps a light breakfast), make that drink for your flask, and hit the road.
Why? We’ll tell you a secret:
You ever wondered why some people seem to be more able to keep a daylight-regulated circadian rhythm than others? It’s not just about smartphones and coffees…
This study found that getting sunlight (not electric light, not artificial sunlight, but actual sunlight, from the sun, even if filtered through partial cloud) between 08:30—09:00 resulted in higher levels of a protein called PER2. PER2 is critical for setting circadian rhythms, improving metabolism, and fortifying blood vessels.
Besides, on a more simplistic level, it’s also a wonderful and energizing start to a healthy and productive day!
Read: Beneficial effects of daytime light exposure on daily rhythms, metabolic state and affect
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How we diagnose and define obesity is set to change – here’s why, and what it means for treatment
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Obesity is linked to many common diseases, such as type 2 diabetes, heart disease, fatty liver disease and knee osteoarthritis.
Obesity is currently defined using a person’s body mass index, or BMI. This is calculated as weight (in kilograms) divided by the square of height (in metres). In people of European descent, the BMI for obesity is 30 kg/m² and over.
But the risk to health and wellbeing is not determined by weight – and therefore BMI – alone. We’ve been part of a global collaboration that has spent the past two years discussing how this should change. Today we publish how we think obesity should be defined and why.
As we outline in The Lancet, having a larger body shouldn’t mean you’re diagnosed with “clinical obesity”. Such a diagnosis should depend on the level and location of body fat – and whether there are associated health problems.
World Obesity Federation What’s wrong with BMI?
The risk of ill health depends on the relative percentage of fat, bone and muscle making up a person’s body weight, as well as where the fat is distributed.
Athletes with a relatively high muscle mass, for example, may have a higher BMI. Even when that athlete has a BMI over 30 kg/m², their higher weight is due to excess muscle rather than excess fatty tissue.
Some athletes have a BMI in the obesity category. Tima Miroshnichenko/Pexels People who carry their excess fatty tissue around their waist are at greatest risk of the health problems associated with obesity.
Fat stored deep in the abdomen and around the internal organs can release damaging molecules into the blood. These can then cause problems in other parts of the body.
But BMI alone does not tell us whether a person has health problems related to excess body fat. People with excess body fat don’t always have a BMI over 30, meaning they are not investigated for health problems associated with excess body fat. This might occur in a very tall person or in someone who tends to store body fat in the abdomen but who is of a “healthy” weight.
On the other hand, others who aren’t athletes but have excess fat may have a high BMI but no associated health problems.
BMI is therefore an imperfect tool to help us diagnose obesity.
What is the new definition?
The goal of the Lancet Diabetes & Endocrinology Commission on the Definition and Diagnosis of Clinical Obesity was to develop an approach to this definition and diagnosis. The commission, established in 2022 and led from King’s College London, has brought together 56 experts on aspects of obesity, including people with lived experience.
The commission’s definition and new diagnostic criteria shifts the focus from BMI alone. It incorporates other measurements, such as waist circumference, to confirm an excess or unhealthy distribution of body fat.
We define two categories of obesity based on objective signs and symptoms of poor health due to excess body fat.
1. Clinical obesity
A person with clinical obesity has signs and symptoms of ongoing organ dysfunction and/or difficulty with day-to-day activities of daily living (such as bathing, going to the toilet or dressing).
There are 18 diagnostic criteria for clinical obesity in adults and 13 in children and adolescents. These include:
- breathlessness caused by the effect of obesity on the lungs
- obesity-induced heart failure
- raised blood pressure
- fatty liver disease
- abnormalities in bones and joints that limit movement in children.
2. Pre-clinical obesity
A person with pre-clinical obesity has high levels of body fat that are not causing any illness.
People with pre-clinical obesity do not have any evidence of reduced tissue or organ function due to obesity and can complete day-to-day activities unhindered.
However, people with pre-clinical obesity are generally at higher risk of developing diseases such as heart disease, some cancers and type 2 diabetes.
What does this mean for obesity treatment?
Clinical obesity is a disease requiring access to effective health care.
For those with clinical obesity, the focus of health care should be on improving the health problems caused by obesity. People should be offered evidence-based treatment options after discussion with their health-care practitioner.
Treatment will include management of obesity-associated complications and may include specific obesity treatment aiming at decreasing fat mass, such as:
- support for behaviour change around diet, physical activity, sleep and screen use
- obesity-management medications to reduce appetite, lower weight and improve health outcomes such as blood glucose (sugar) and blood pressure
- metabolic bariatric surgery to treat obesity or reduce weight-related health complications.
Treatment for clinical obesity may include support for behaviour change. Shutterstock/shurkin_son Should pre-clinical obesity be treated?
For those with pre-clinical obesity, health care should be about risk-reduction and prevention of health problems related to obesity.
This may require health counselling, including support for health behaviour change, and monitoring over time.
Depending on the person’s individual risk – such as a family history of disease, level of body fat and changes over time – they may opt for one of the obesity treatments above.
Distinguishing people who don’t have illness from those who already have ongoing illness will enable personalised approaches to obesity prevention, management and treatment with more appropriate and cost-effective allocation of resources.
What happens next?
These new criteria for the diagnosis of clinical obesity will need to be adopted into national and international clinical practice guidelines and a range of obesity strategies.
Once adopted, training health professionals and health service managers, and educating the general public, will be vital.
Reframing the narrative of obesity may help eradicate misconceptions that contribute to stigma, including making false assumptions about the health status of people in larger bodies. A better understanding of the biology and health effects of obesity should also mean people in larger bodies are not blamed for their condition.
People with obesity or who have larger bodies should expect personalised, evidence-based assessments and advice, free of stigma and blame.
Louise Baur, Professor, Discipline of Child and Adolescent Health, University of Sydney; John B. Dixon, Adjunct Professor, Iverson Health Innovation Research Institute, Swinburne University of Technology; Priya Sumithran, Head of the Obesity and Metabolic Medicine Group in the Department of Surgery, School of Translational Medicine, Monash University, and Wendy A. Brown, Professor and Chair, Monash University Department of Surgery, School of Translational Medicine, Alfred Health, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Stop The World…
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Some news highlights from this week:
“US vs Them”?
With the US now set to lose its WHO membership, what does that mean for Americans? For most, the consequences will be indirect:
- the nation’s scientists and institutions will be somewhat “left out in the cold” when it comes to international scientific collaboration in the field of health
- the US will no longer enjoy a position of influence and power within the WHO, which organization’s reports and position statements have a lot of sway over the world’s health practices
Are there any benefits (of leaving the WHO) for Americans? Yes, there is one: the US will no longer be paying into the WHO’s budget, which means:
- the US will save the 0.006% of the Federal budget that it was paying into the WHO annually
- for the average American’s monthly budget, that means (if the saving is passed on) you’ll have an extra dime
However, since US scientific institutions will still need access to international data, likely that access will need to be paid separately, at a higher rate than US membership in WHO cost.
In short: it seems likely to go the way that Brexit did: “saving” on membership fees and then paying more for access to less.
Why is the US leaving again? The stated reasons were mainly twofold:
- the cost of US membership (the US’s contribution constituted 15% of the the overall WHO budget)
- holding the US’s disproportionately high COVID death rate (especially compared to countries such as China) to be a case of WHO mismanagement
Read in full: What losing WHO membership means for the U.S.
Related: What Would a Second Trump Presidency Look Like for Health Care? ← this was a speculative post by KFF Health News, last year
Halt, You’re Under A Breast
More seriously, this is about halting the metastasis of cancerous tumors in the breast. It is reasonable to expect the same principle and thus treatment may apply to other cancers too, but this is where the research is at for now (breast cancer research gets a lot of funding).
And, what principle and treatment is this, you ask? It’s about the foxglove-derived drug digoxin, and how it stops cancerous cells from forming clusters, and even actively dissolves clusters that have already formed. No clusters means no new tumors, which means no metastasis. No metastasis, in turn, means the cancer becomes much more treatable because it’s no longer a game of whack-a-mole; instead of spreading to other places, it’s a much more manageable case of “here’s the tumor, now let’s kill it with something”.
Note: yes, that does mean the tumor still needs killing by some other means—digoxin won’t do that, it “just” stops it from spreading while treatment is undertaken.
Read in full: Proof-of-concept study dissolves clusters of breast cancer cells to prevent metastases
Related: The Hormone Therapy That Reduces Breast Cancer Risk & More
Force Of Habit
“It takes 21 days to make a habit”, says popular lore. Popular is not, however, evidence-based:
❝This systematic review of 20 studies involving 2601 participants challenges the prevailing notion of rapid habit formation, revealing that health-related habits typically require 2–5 months to develop, with substantial individual variability ranging from 4 to 335 days. The meta-analysis demonstrated significant improvements in habit scores across various health behaviours, with key determinants including morning practices, personal choice, and behavioural characteristics❞
So, this is not a lottery, “maybe it will take until Tuesday, maybe it will take nearly a year”, so much as “there are important factors that seriously change how long a habit takes to become engrained, and here is what those factors are”.
Read in full: Study reveals healthy habits take longer than 21 days to set in
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No, your aches and pains don’t get worse in the cold. So why do we think they do?
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It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather.
It’s a common idea, but a myth.
When we looked at the evidence, we found no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains.
So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on.
fongbeerredhot/Shutterstock Weather can be linked to your health
The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures may worsen asthma symptoms. Hot temperatures increase the risk of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease.
Many people are also convinced the weather is linked to their aches and pains. For example, two in every three people with knee, hip or hand osteoarthritis say cold temperatures trigger their symptoms.
Musculoskeletal conditions affect more than seven million Australians. So we set out to find out whether weather is really the culprit behind winter flare-ups.
What we did
Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies.
We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included.
We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry).
Bad back on a cold day? We wanted to know if the weather was really to blame. Pearl PhotoPix/Shutterstock What we found
We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis.
The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain.
In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis.
It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather.
The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions.
Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up.
Why do people blame the weather?
The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain.
For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know prolonged sitting, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your back and knee pain.
Likewise, changes in mood, often experienced in cold weather, trigger increases in both back and knee pain.
So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself.
Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the nocebo effect.
When it’s cold outside, we may be less active. Anna Nass/Shutterstock What to do about winter aches and pains?
It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather).
You can:
- become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool
- lose weight if obese or overweight, as this is linked to lower levels of joint pain and better physical function
- keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep less well in cold rooms
- maintain a healthy diet and avoid smoking or drinking high levels of alcohol. These are among key lifestyle recommendations to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with higher levels of physical function.
Manuela Ferreira, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, George Institute for Global Health and Leticia Deveza, Rheumatologist and Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Calm For Surgery – by Dr Chris Bonney
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As a general rule of thumb, nobody likes having surgery. We may like the results of the surgery, we may like having the surgery done and behind us, but surgery itself is not most people’s idea of fun, and honestly, the recovery period afterwards can be a pain in every sense of the word.
Dr. Chris Bonney, an anesthesiologist, gives us the industry-secrets low-down, and is the voice of experience when it comes to the things to know about and/or prepare in advance—the little things that make a world of difference to your in-hospital experience and afterwards.
Think of it like “frequent flyer traveller tips” but for surgeries, whereupon knowing a given tip can mean the difference between deeply traumatic suffering and merely not being at your usual best. We think that’s worth it.
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Infrared-Reflecting Patches For Health?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Hi! I’ve been reading about LifeWave patches, would you recommend them?❞
For reference first, this is talking about these: LifeWave.com
Short answer: no
Longer answer: their main premise seems to be that the patches (subscription prices seem to start from about $100–$300 per month) reflect infrared energy back into your body, making you more energized and healthy.
Fun fact: aluminum foil reflects infrared energy (which we feel as heat), by the way, and that is why space blankets (of the kind used in emergencies and by some athletes) are made shiny like that, often with aluminized mylar.
We cannot comment too closely on the rest of the presented science of their products, as it seems quite unlike anything we’re accustomed to reading, and we were not able to make a lot of sense of it.
They do cite research papers to back their claims, including research conducted by the company’s founder and published via an open journal.
Many others are independent studies conducted by often the same researchers as each other, mostly experts in acupuncture and acupressure.
For the papers we looked at, the sample sizes were very small, but the conclusions were very positive.
They were published in a variety of journals, of which we cannot claim any prior knowledge (i.e:, they were not the peer-reviewed journals from which we cite most of our sources).
Also, none were registered with ClinicalTrials.gov.
To be on the safe side, their disclaimer does advise:
❝LifeWave products are only intended to maintain or encourage a general state of health or healthy activity and are not intended to diagnose, treat, cure, mitigate, or prevent any disease or medical condition of the body❞
They do have a Frequently Asked Questions page, which tells about ancient Egyptian use of colored glass, as well as more modern considerations including joining, ordering, their commissions system, binary commissions and matching bonuses, and “how to rank up in LifeWave” as well as a lot of information about subscribing as a preferred customer or a brand partner, opting in to their multi-level marketing opportunities.
Here’s what “Honest Brand Reviews” had to say:
Honest Brand Reviews | LifeWave Review
Our position:
We cannot honestly claim to understand their science, and thus naturally won’t actively recommend what we can’t speak for.
An expert’s position:
Since we couldn’t understand how this would work, here’s what Dr. Paul Knoepfler has to say about their flagship product, the LifeWave X39 patch:
LifeWave X39 stem cell patch story has holes
Take care!
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Coach’s Plan – by Mike Kavanagh
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A sports coach’s job is to prepare a plan, give it to the player(s), and hold them accountable to it. Change the strategy if needs be, call the shots. The job of the player(s) is then to follow those instructions.
If you have trouble keeping yourself accountable, Kavanagh argues that it can be good to separate how you approach things.
Not just “coach yourself”, but put yourself entirely in the coach’s shoes, as though you were a separate person, then switch back, and follow those instructions, trusting in your coach’s guidance.
The book also provides illustrative examples and guides the reader through some potential pitfalls—for example, what happens when morning you doesn’t want to do the things that evening you decided would be best?
The absolute backbone of this method is that it takes away the paralysing self-doubt that can occur when we second-guess ourselves mid-task.
In short, this book will fire up your enthusiasm and give you a reliable fall-back for when your motivation’s flagging.
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