Water Water Everywhere, But Which Is Best To Drink?

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Well Well Well…

In Tuesday’s newsletter, we asked you for your (health-related) opinion on drinking water—with the understanding that this may vary from place to place. We got the above-depicted, below-described, set of responses:

  • About 65% said “Filtered is best”
  • About 20% said “From the mains is best”
  • About 8% said “Bottled is best”
  • About 3% said “Distilled is best”
  • About 3% said “Some other source is best”

Of those who said “some other source is best”, one clarified that their preferred source was well water.

So what does the science say?

Fluoridated water is bad for you: True or False?

False, assuming a normal level of consumption. Rather than take up more space today though, we’ll link to what we previously wrote on this topic:

Q&A: Water Fluoridation

You may be wondering: but what if my level of consumption is higher than normal?

Let’s quickly look at some stats:

  • The maximum permitted safety level varies from place to place, but is (for example) 2mg/l in the US, 1.5mg/l in Canada & the UK.
  • The minimum recommended amount also varies from place to place, but is (for example) 0.7mg/l in Canada and the US, and 1mg/l in the UK.

It doesn’t take grabbing a calculator to realize that if you drink twice as much water as someone else, then depending on where you are, water fluoridated to the minimum may give you more than the recommended maximum.

However… Those safety margins are set so much lower than the actual toxicity levels of fluoride, that it doesn’t make a difference.

For example: your writer here takes a medication that has the side effect of causing dryness of the mouth, and consequently she drinks at least 3l of water per day in a climate that could not be described as hot (except perhaps for about 2 weeks of the year). She weighs 72kg (that’s about 158 pounds), and the toxicity of fluoride (for ill symptoms, not death) is 0.2mg/kg. So, she’d need 14.4mg of fluoride, which even if the water fluoridation here were 2mg/l (it’s not; it’s lower here, but let’s go with the highest figure to make a point), would require drinking more than 7l of water faster than the body can process it.

For more about the numbers, check out:

Acute Fluoride Poisoning from a Public Water System

Bottled water is the best: True or False?

False, if we consider “best” to be “healthiest”, which in turn we consider to be “most nutrients, with highest safety”.

Bottled water generally does have higher levels of minerals than most local mains supply water does. That’s good!

But you know what else is generally has? Microplastics and nanoplastics. That’s bad!

We don’t like to be alarmist in tone; it’s not what we’re about here, but the stats on bottled water are simply not good; see:

We Are Such Stuff As Bottles Are Made Of

You may be wondering: “but what about bottled water that comes in glass bottles?”

Indeed, water that comes in glass bottles can be expected to have lower levels of plastic than water that comes in plastic bottles, for obvious reasons.

However, we invite you to consider how likely you believe it to be that the water wasn’t stored in plastic while being processed, shipped and stored, before being portioned into its final store-ready glass bottles for end-consumer use.

Distilled water is the best: True or False?

False, generally, with caveats:

Distilled water is surely the safest water anywhere, because you know that you’ve removed any nasties.

However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals).

Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.

Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.

Here’s an example product on Amazon if you’d like to invest in a water still for such cases.

PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee. So we really don’t recommend distilling your water unless you have a good reason to do so.

Filtered water is the best: True or False?

True for most people in most places.

Let’s put it this way: it can’t logically be worse than whatever source of water you put into it…

Provided you change the filter regularly, of course.

Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.

You may be wondering: can water filters remove microplastics, and can they remove minerals?

The answer in both cases is: sometimes.

  • For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
  • For minerals, it depends on the filter type. Check out:

The H2O Chronicles | 5 Water Filters That Remove Minerals

One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like

Take care!

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  • 10,000 Steps, 30 Days, 4 Changes

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    Ariel wasn’t the most active person, and took on a “30 day challenge” to do the commonly-prescribed 10,000 steps per day—without adjusting her diet or doing any other exercise. How much of a difference does it make, really?

    Stepping onwards

    The 4 main things that she found changed for her weren’t all what she expected:

    • Weight loss yes, but only marginally: she lost 3 lbs in a month, which did nevertheless make a visible difference. We might hypothesize that part of the reason for the small weight loss and yet visible difference is that she gained a little muscle, and the weight loss was specifically shifting away from a cortisol-based fat distribution, to a more healthy fat distribution.
    • Different eating habits: she felt less hungry and craved less sugar. This likely has less to do with calorie consumption, and more to do with better insulin signalling.
    • Increased energy and improved mood: these are going together in one item, because she said “4 things”, but really they are two related things. So, consider one of them a bonus item! In any case, she felt more energized and productive, and less reliant on caffeine.
    • Improved sleep: or rather, at first, disrupted sleep, and then slept better and stayed better. A good reminder that changes for the better don’t always feel better in the first instance!

    To hear about it in her own words, and see the before and after pictures, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Gut Health for Women – by Aurora Bloom

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    First things first: though the title says “For Women”, almost all of it applies to men too—and the things that don’t apply, don’t cause a problem. So if you’re cooking for your family that contains one or more men, this is still great.

    Bloom gives us a good, simple, practical introduction to gut health. Her overview also covers gut-related ailments beyond the obvious “tummy hurts”. On which note:

    A very valuable section of this book covers dealing with any stomach-upsets that do occur… without harming your trillions of tiny friends (friendly gut microbiota). This alone can make a big difference!

    The book does of course also cover the things you’d most expect: things to eat or avoid. But it goes beyond that, looking at optimizing and maintaining your gut health. It’s not just dietary advice here, because the gut affects—and is affected by—other lifestyle factors too. Ranges from mindful eating, to a synchronous sleep schedule, to what kinds of exercise are best to keep your gut ticking over nicely.

    There’s also a two-week meal plan, and an extensive appendix of resources, not to mention a lengthy bibliography for sourcing health claims (and suggesting further reading).

    In short, a fine and well-written guide to optimizing your gut health and enjoying the benefits.

    Get your copy of Gut Health For Women from Amazon today!

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  • Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When Michael Adams was researching health insurance options in 2023, he had one very specific requirement: coverage for prosthetic limbs.

    Adams, 51, lost his right leg to cancer 40 years ago, and he has worn out more legs than he can count. He picked a gold plan on the Colorado health insurance marketplace that covered prosthetics, including microprocessor-controlled knees like the one he has used for many years. That function adds stability and helps prevent falls.

    But when his leg needed replacing last January after about five years of everyday use, his new marketplace health plan wouldn’t authorize it. The roughly $50,000 leg with the electronically controlled knee wasn’t medically necessary, the insurer said, even though Colorado law leaves that determination up to the patient’s doctor, and his has prescribed a version of that leg for many years, starting when he had employer-sponsored coverage.

    “The electronic prosthetic knee is life-changing,” said Adams, who lives in Lafayette, Colorado, with his wife and two kids. Without it, “it would be like going back to having a wooden leg like I did when I was a kid.” The microprocessor in the knee responds to different surfaces and inclines, stiffening up if it detects movement that indicates its user is falling.

    People who need surgery to replace a joint typically don’t encounter similar coverage roadblocks. In 2021, 1.5 million knee or hip joint replacements were performed in United States hospitals and hospital-owned ambulatory facilities, according to the federal Agency for Healthcare Research and Quality, or AHRQ. The median price for a total hip or knee replacement without complications at top orthopedic hospitals was just over $68,000 in 2020, according to one analysis, though health plans often negotiate lower rates.

    To people in the amputee community, the coverage disparity amounts to discrimination.

    “Insurance covers a knee replacement if it’s covered with skin, but if it’s covered with plastic, it’s not going to cover it,” said Jeffrey Cain, a family physician and former chair of the board of the Amputee Coalition, an advocacy group. Cain wears two prosthetic legs, having lost his after an airplane accident nearly 30 years ago.

    AHIP, a trade group for health plans, said health plans generally provide coverage when the prosthetic is determined to be medically necessary, such as to replace a body part or function for walking and day-to-day activity. In practice, though, prosthetic coverage by private health plans varies tremendously, said Ashlie White, chief strategy and programs officer at the Amputee Coalition. Even though coverage for basic prostheses may be included in a plan, “often insurance companies will put caps on the devices and restrictions on the types of devices approved,” White said.

    An estimated 2.3 million people are living with limb loss in the U.S., according to an analysis by Avalere, a health care consulting company. That number is expected to as much as double in coming years as people age and a growing number lose limbs to diabetes, trauma, and other medical problems.

    Fewer than half of people with limb loss have been prescribed a prosthesis, according to a report by the AHRQ. Plans may deny coverage for prosthetic limbs by claiming they aren’t medically necessary or are experimental devices, even though microprocessor-controlled knees like Adams’ have been in use for decades.

    Cain was instrumental in getting passed a 2000 Colorado law that requires insurers to cover prosthetic arms and legs at parity with Medicare, which requires coverage with a 20% coinsurance payment. Since that measure was enacted, about half of states have passed “insurance fairness” laws that require prosthetic coverage on par with other covered medical services in a plan or laws that require coverage of prostheses that enable people to do sports. But these laws apply only to plans regulated by the state. Over half of people with private coverage are in plans not governed by state law.

    The Medicare program’s 80% coverage of prosthetic limbs mirrors its coverage for other services. Still, an October report by the Government Accountability Office found that only 30% of beneficiaries who lost a limb in 2016 received a prosthesis in the following three years.

    Cost is a factor for many people.

    “No matter your coverage, most people have to pay something on that device,” White said. As a result, “many people will be on a payment plan for their device,” she said. Some may take out loans.

    The federal Consumer Financial Protection Bureau has proposed a rule that would prohibit lenders from repossessing medical devices such as wheelchairs and prosthetic limbs if people can’t repay their loans.

    “It is a replacement limb,” said White, whose organization has heard of several cases in which lenders have repossessed wheelchairs or prostheses. Repossession is “literally a punishment to the individual.”

    Adams ultimately owed a coinsurance payment of about $4,000 for his new leg, which reflected his portion of the insurer’s negotiated rate for the knee and foot portion of the leg but did not include the costly part that fits around his stump, which didn’t need replacing. The insurer approved the prosthetic leg on appeal, claiming it had made an administrative error, Adams said.

    “We’re fortunate that we’re able to afford that 20%,” said Adams, who is a self-employed leadership consultant.

    Leah Kaplan doesn’t have that financial flexibility. Born without a left hand, she did not have a prosthetic limb until a few years ago.

    Growing up, “I didn’t want more reasons to be stared at,” said Kaplan, 32, of her decision not to use a prosthesis. A few years ago, the cycling enthusiast got a prosthetic hand specially designed for use with her bike. That device was covered under the health plan she has through her county government job in Spokane, Washington, helping developmentally disabled people transition from school to work.

    But when she tried to get approval for a prosthetic hand to use for everyday activities, her health plan turned her down. The myoelectric hand she requested would respond to electrical impulses in her arm that would move the hand to perform certain actions. Without insurance coverage, the hand would cost her just over $46,000, which she said she can’t afford.

    Working with her doctor, she has appealed the decision to her insurer and been denied three times. Kaplan said she’s still not sure exactly what the rationale is, except that the insurer has questioned the medical necessity of the prosthetic hand. The next step is to file an appeal with an independent review organization certified by the state insurance commissioner’s office.

    A prosthetic hand is not a luxury device, Kaplan said. The prosthetic clinic has ordered the hand and made the customized socket that will fit around the end of her arm. But until insurance coverage is sorted out, she can’t use it.

    At this point she feels defeated. “I’ve been waiting for this for so long,” Kaplan said.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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Related Posts

  • Mythbusting The Big O
  • When Age Is A Flexible Number

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Aging, Counterclockwise!

    In the late 1970s, Dr. Ellen Langer hypothesized that physical markers of aging could be affected by psychosomatic means.

    Note: psychosomatic does not mean “it’s all in your head”.

    Psychosomatic means “your body does what your brain tells it to do, for better or for worse”

    She set about testing that, in what has been referred to since as…

    The Counterclockwise Study

    A small (n=16) sample of men in their late 70s and early 80s were recruited in what they were told was a study about reminiscing.

    Back in the 1970s, it was still standard practice in the field of psychology to outright lie to participants (who in those days were called “subjects”), so this slight obfuscation was a much smaller ethical aberration than in some famous studies of the same era and earlier (cough cough Zimbardo cough Milgram cough).

    Anyway, the participants were treated to a week in a 1950s-themed retreat, specifically 1959, a date twenty years prior to the experiment’s date in 1979. The environment was decorated and furnished authentically to the date, down to the food and the available magazines and TV/radio shows; period-typical clothing was also provided, and so forth.

    • The control group were told to spend the time reminiscing about 1959
    • The experimental group were told to pretend (and maintain the pretense, for the duration) that it really was 1959

    The results? On many measures of aging, the experimental group participants became quantifiably younger:

    ❝The experimental group showed greater improvement in joint flexibility, finger length (their arthritis diminished and they were able to straighten their fingers more), and manual dexterity.

    On intelligence tests, 63 percent of the experimental group improved their scores, compared with only 44 percent of the control group. There were also improvements in height, weight, gait, and posture.

    Finally, we asked people unaware of the study’s purpose to compare photos taken of the participants at the end of the week with those submitted at the beginning of the study. These objective observers judged that all of the experimental participants looked noticeably younger at the end of the study.❞

    ~ Dr. Ellen Langer

    Remember, this was after one week.

    Her famous study was completed in 1979, and/but not published until eleven years later in 1990, with the innocuous title:

    Higher stages of human development: Perspectives on adult growth

    You can read about it much more accessibly, and in much more detail, in her book:

    Counterclockwise: A Proven Way to Think Yourself Younger and Healthier – by Dr. Ellen Langer

    We haven’t reviewed that particular book yet, so here’s Linda Graham’s review, that noted:

    ❝Langer cites other research that has made similar findings.

    In one study, for instance, 650 people were surveyed about their attitudes on aging. Twenty years later, those with a positive attitude with regard to aging had lived seven years longer on average than those with a negative attitude to aging.

    (By comparison, researchers estimate that we extend our lives by four years if we lower our blood pressure and reduce our cholesterol.)

    In another study, participants read a list of negative words about aging; within 15 minutes, they were walking more slowly than they had before.❞

    ~ Linda Graham

    Read the review in full:

    Aging in Reverse: A Review of Counterclockwise

    The Counterclockwise study has been repeated since, and/but we are still waiting for the latest (exciting, much larger sample, 90 participants this time) study to be published. The research proposal describes the method in great detail, and you can read that with one click over on PubMed:

    PubMed | Ageing as a mindset: a study protocol to rejuvenate older adults with a counterclockwise psychological intervention

    It was approved, and has now been completed (as of 2020), but the results have not been published yet; you can see the timeline of how that’s progressing over on ClinicalTrials.gov:

    Clinical Trials | Ageing as a Mindset: A Counterclockwise Experiment to Rejuvenate Older Adults

    Hopefully it’ll take less time than the eleven years it took for the original study, but in the meantime, there seems to be nothing to lose in doing a little “Citizen Science” for ourselves.

    Maybe a week in a 20 years-ago themed resort (writer’s note: wow, that would only be 2004; that doesn’t feel right; it should surely be at least the 90s!) isn’t a viable option for you, but we’re willing to bet it’s possible to “microdose” on this method. Given that the original study lasted only a week, even just a themed date-night on a regular recurring basis seems like a great option to explore (if you’re not partnered then well, indulge yourself how best you see fit, in accord with the same premise; a date-night can be with yourself too!).

    Just remember the most important take-away though:

    Don’t accidentally put yourself in your own control group!

    In other words, it’s critically important that for the duration of the exercise, you act and even think as though it is the appropriate date.

    If you instead spend your time thinking “wow, I miss the [decade that does it for you]”, you will dodge the benefits, and potentially even make yourself feel (and thus, potentially, if the inverse hypothesis holds true, become) older.

    This latter is not just our hypothesis by the way, there is an established potential for nocebo effect.

    For example, the following study looked at how instructions given in clinical tests can be worded in a way that make people feel differently about their age, and impact the results of the mental and/or physical tests then administered:

    ❝Our results seem to suggest how manipulations by instructions appeared to be more largely used and capable of producing more clear performance variations on cognitive, memory, and physical tasks.

    Age-related stereotypes showed potentially stronger effects when they are negative, implicit, and temporally closer to the test of performance. ❞

    ~ Dr. Francesco Pagnini

    Read more: Age-based stereotype threat: a scoping review of stereotype priming techniques and their effects on the aging process

    (and yes, that’s the same Dr. Francesco Pagnini whose name you saw atop the other study we cited above, with the 90 participants recreating the Counterclockwise study)

    Want to know more about [the hard science of] psychosomatic health?

    Check out Dr. Langer’s other book, which we reviewed recently:

    The Mindful Body: Thinking Our Way to Chronic Health – by Dr. Ellen Langer

    Enjoy!

    Don’t Forget…

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    Learn to Age Gracefully

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  • How To Rebuild Your Neurons’ Myelin Sheaths

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    PS: We Love You

    Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.

    In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).

    For an overview that’s more comprehensive than we have room for here, check out:

    Phosphatidylserine and the human brain

    Many people take it as a supplement.

    Does taking it as a supplement work?

    This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:

    ❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞

    ~ Glade & Smith.

    (“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)

    Why do people take it?

    The health claims for phosphatidylserine fall into two main categories:

    1. Neuroprotection (helping your brain to avoid age-related decline in the long term)
    2. Cognitive enhancement (helping your brain work better in the short term)

    What does the science say?

    There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:

    Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.

    There is no established difference in the efficacy of these.

    There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.

    There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:

    The effects of [phosphatidylserine supplementation] on cognitive function, mood and endocrine response before and following acute exercise

    (as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)

    PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.

    Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.

    Where can we get it?

    We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.

    Enjoy!

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  • The Comfort Zone – by Kristen Butler

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Are you sitting comfortably? Then we’ll begin. Funny, how being comfortable can be a good starting point, then we are advised “You have to get out of your comfort zone”.

    And yet, when we think of our personal greatest moments in life, they were rarely uncomfortable moments. Why is that?

    Kristen Butler wants us to resolve this paradox, with a reframe:

    The comfort zone? That’s actually the “flow” zone.

    Just as “slow and steady wins the race”, we can—like the proverbial tortoise—take our comfort with us as we go.

    The discomfort zone? That’s the stress zone, the survival zone, the “putting out fires” zone. From the outside, it looks like we’re making a Herculean effort, and perhaps we are, but is it actually so much better than peaceful consistent productivity?

    Butler writes in a way that will be relatable for many, and may be a welcome life-ring if you feel like you’ve been playing catch-up for a while.

    Is she advocating for complacency, then? No, and she discusses this too. That “complacency zone” is really the “burnout zone” after being in the “survival zone” for too long.

    She lays out for us, therefore, a guide for growing in comfort, expanding the comfort zone yes, but by securely pushing it from the inside, not by making a mad dash out and hoping it follows us.

    Bottom line: if you’ve been (perhaps quietly) uncomfortable for a little too long for comfort, this book can reframe your approach to get you to a position of sustainable, stress-free growth.

    Click here to check out The Comfort Zone, and start building yours!

    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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