‘Disease X’: What it is (and isn’t)

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What you need to know

  • In January 2024, the World Economic Forum hosted an event called Preparing for Disease X to discuss strategies to improve international pandemic response.
  • Disease X is a term used in epidemiology to refer to potential disease threats. It is not a real disease or a global conspiracy.
  • Preparation to prevent and respond to future pandemics is a necessary part of global health to keep us all safer.

During the World Economic Forum’s 54th annual meeting in Davos, Switzerland, global health experts discussed ways to strengthen health care systems in preparation for future pandemics. Conspiracy theories quickly began circulating posts about the event and the fictional disease at its center, so-called Disease X. 

What is Disease X?

In 2018, the World Health Organization added Disease X to its list of Blueprint Priority Diseases that are public health risks. But, unlike the other diseases on the list, Disease X doesn’t exist. The term represents a hypothetical human disease capable of causing a pandemic. Although experts don’t know what the next Disease X will be, they can make educated guesses about where and how it may emerge—and how we can prepare for it.

Why are we hearing about Disease X now?

COVID-19 has been the deadliest infectious disease outbreak of the 21st century. It’s also an example of a Disease X: a previously unknown pathogen that spreads rapidly around the world, claiming millions of lives. 

When the WEF hosted a panel of experts to discuss Disease X, it was the first exposure that many people had to a concept that global health experts have been discussing since 2018.

Even before the routine pandemic preparedness event took place, online conspiracy theorists began circulating false claims that those discussing and preparing for Disease X had sinister motives, underscoring how widespread distrust of global health entities has become in the wake of the COVID-19 pandemic. 

Why does Disease X matter?

Epidemiologists use concepts like Disease X to plan for future outbreaks and avoid the mistakes of past outbreaks. The COVID-19 pandemic and the recent non-endemic outbreak of mpox highlight the importance of global coordination to efficiently prevent and respond to disease outbreaks.

Pandemics are inevitable, but the scale of their destruction doesn’t have to be. Major disease outbreaks are likely to become more frequent due to the impacts of climate change. Preparing for a pandemic now helps ensure that the world is better equipped to handle the next one.

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

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  • Elderberries vs Cranberries – Which is Healthier?

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    Our Verdict

    When comparing elderberries to cranberries, we picked the elderberries.

    Why?

    In terms of macros, elderberry has slightly more carbs and 2x the fiber, the ratio of which gives elderberries the lower glycemic index also. A win for elderberries, then.

    Looking at the vitamins, elderberries have more of vitamins A, B1, B2, B3, B6, B9, and C, while cranberries have more vitamin B5. An easy win for elderberries in this category.

    In the category of minerals, we see a similar story: elderberries have more calcium, copper, iron, phosphorus, potassium, selenium, and zinc, while cranberries have (barely) more magnesium. Another clear win for elderberries.

    Both of these fruits have additional “special” properties, and it’s worth noting that:

    • elderberries’ bonus properties include that they significantly hasten recovery from upper respiratory tract viral infections.
    • cranberries’ bonus properties (including: famously very good at reducing UTI risk) come with some warnings, including that they may increase the risk of kidney stones if you are prone to such, and also that cranberries have anti-clotting effects, which are great for heart health but can be a risk of you’re on blood thinners or have a bleeding disorder.

    You can read about both of these fruits’ special properties in more detail below:

    Want to learn more?

    You might like to read:

    Enjoy!

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  • Heart Health vs Systemic Stress

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    At The Heart Of Good Health

    This is Dr. Michelle Albert. She’s a cardiologist with a decades-long impressive career, recently including a term as the president of the American Heart Association. She’s the current Admissions Dean at UCSF Medical School. She’s accumulated enough awards and honors that if we list them, this email will not fit in your inbox without getting clipped.

    What does she want us to know?

    First, lifestyle

    Although Dr. Albert is also known for her work with statins (which found that pravastatin may have anti-inflammatory effects in addition to lipid-lowering effects, which is especially good news for women, for whom the lipid-lowering effects may be less useful than for men), she is keen to emphasize that they should not be anyone’s first port-of-call unless “first” here means “didn’t see the risk until it was too late and now LDL levels are already ≥190 mg/dL”.

    Instead, she recommends taking seriously the guidelines on:

    • getting plenty of fruit, vegetables, whole grains, lean protein
    • avoiding red meat, processed meats, refined carbohydrates, and sweetened beverages
    • getting your 150 minutes per week of moderate exercise
    • avoiding alcohol, and definitely abstaining from smoking

    See also: These Top Five Things Make The Biggest Difference To Health

    Next, get your house in order

    No, not your home gym—though sure, that too!

    But rather: after the “Top Five Things” we linked just above, the sixth on the list would be “reduce stress”. Indeed, as Dr. Albert says:

    ❝Heart health is not just about the physical heart but also about emotional well-being. Stress management is crucial for a healthy heart❞

    ~ Dr. Michelle Albert

    This is where a lot of people would advise mindfulness meditation, CBT, somatic therapies, and the like. And these things are useful! See for example:

    No-Frills, Evidence-Based Mindfulness

    …and:

    How To Manage Chronic Stress

    However, Dr. Albert also advocates for awareness of what some professionals have called “Shit Life Syndrome”.

    This is more about socioeconomic factors. There are many of those that can’t be controlled by the individual, for example:

    Adverse maternal experiences such as depression, economic issues and low social status can lead to poor cognitive outcomes as well as cardiovascular disease.

    Many jarring statistics illuminate a marked wealth gap by race and ethnicity… You might be thinking education could help bridge that gap. But it is not that simple.

    While education does increase wealth, the returns are not the same for everyone. Black persons need a post-graduate degree just to attain similar wealth as white individuals with a high school degree.

    ~ Dr. Michelle Albert

    Read in full: AHA president: The connection between economic adversity and cardiovascular health

    What this means in practical terms (besides advocating for structural change to tackle the things such as the racism that has been baked into a lot of systems for generations) is:

    Be aware not just of your obvious health risk factors, but also your socioeconomic risk factors, if you want to have good general health outcomes.

    So for example, let’s say that you, dear reader, are wealthy and white, in which case you have some very big things in your favor, but are you also a woman? Because if so…

    Women and Minorities Bear the Brunt of Medical Misdiagnosis

    See also, relevant for some: Obesity Discrimination In Healthcare Settings ← you’ll need to scroll to the penultimate section for this one.

    In other words… If you are one of the majority of people who is a woman and/or some kind of minority, things are already stacked against you, and not only will this have its own direct harmful effect, but also, it’s going to make your life harder and that stress increases CVD risk more than salt.

    In short…

    This means: tackle not just your stress, but also the things that cause that. Look after your finances, gather social support, know your rights and be prepared to self-advocate / have someone advocate for you, and go into medical appointments with calm well-prepared confidence.

    Take care!

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  • Could Just Two Hours Sleep Per Day Be Enough?

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    Polyphasic Sleep… Super-Schedule Or An Idea Best Put To Rest?

    What is it?

    Let’s start by defining some terms:

    • Monophasic sleep—sleeping in one “chunk” per day. For example, a good night’s “normal” sleep.
    • Biphasic sleep—sleeping in two “chunks” per day. Typically, a shorter night’s sleep, with a nap usually around the middle of the day / early afternoon.
    • Polyphasic sleep—sleeping in two or more “chunks per day”. Some people do this in order to have more hours awake per day, to do things. The idea is that sleeping this way is more efficient, and one can get enough rest in less time. The most popular schedules used are:
      • The Überman schedule—six evenly-spaced 20-minute naps, one every four hours, throughout the 24-hour day. The name is a semi-anglicized version of the German word Übermensch, “Superman”.
      • The Everyman schedule—a less extreme schedule, that has a three-hours “long sleep” during the night, and three evenly-spaced 20-minute naps during the day, for a total of 4 hours sleep.

    There are other schedules, but we’ll focus on the most popular ones here.

    Want to learn about the others? Visit: Polyphasic.Net (a website by and for polyphasic sleep enthusiasts)

    Some people have pointed to evidence that suggests humans are naturally polyphasic sleepers, and that it is only modern lifestyles that have forced us to be (mostly) monophasic.

    There is at least some evidence to suggest that when environmental light/dark conditions are changed (because of extreme seasonal variation at the poles, or, as in this case, because of artificial changes as part of a sleep science experiment), we adjust our sleeping patterns accordingly.

    The counterpoint, of course, is that perhaps when at the mercy of long days/nights at the poles, or no air-conditioning to deal with the heat of the day in the tropics, that perhaps we were forced to be polyphasic, and now, with modern technology and greater control, we are free to be monophasic.

    Either way, there are plenty of people who take up the practice of polyphasic sleep.

    Ok, But… Why?

    The main motivation for trying polyphasic sleep is simply to have more hours in the day! It’s exciting, the prospect of having 22 hours per day to be so productive and still have time over for leisure.

    A secondary motivation for trying polyphasic sleep is that when the brain is sleep-deprived, it will prioritize REM sleep. Here’s where the Überman schedule becomes perhaps most interesting:

    The six evenly-spaced naps of the Überman schedule are each 20 minutes long. This corresponds to the approximate length of a normal REM cycle.

    Consequently, when your head hits the pillow, you’ll immediately begin dreaming, and at the end of your dream, the alarm will go off.

    Waking up at the end of a dream, when one hasn’t yet entered a non-REM phase of sleep, will make you more likely to remember it. Similarly, going straight into REM sleep will make you more likely to be aware of it, thus, lucid dreaming.

    Read: Sleep fragmentation and lucid dreaming (actually a very interesting and informative lucid dreaming study even if you don’t want to take up polyphasic sleep)

    Six 20-minute lucid-dreaming sessions per day?! While awake for the other 22 hours?! That’s… 24 hours per day of wakefulness to use as you please! What sorcery is this?

    Hence, it has quite an understandable appeal.

    Next Question: Does it work?

    Can we get by without the other (non-REM) kinds of sleep?

    According to Überman cycle enthusiasts: Yes! The body and brain will adapt.

    According to sleep scientists: No! The non-REM slow-wave phases of sleep are essential

    Read: Adverse impact of polyphasic sleep patterns in humans—Report of the National Sleep Foundation sleep timing and variability consensus panel

    (if you want to know just how bad it is… the top-listed “similar article” is entitled “Suicidal Ideation”)

    But what about, for example, the Everman schedule? Three hours at night is enough for some non-REM sleep, right?

    It is, and so it’s not as quickly deleterious to the health as the Überman schedule. But, unless you are blessed with rare genes that allow you to operate comfortably on 4 hours per day (you’ll know already if that describes you, without having to run any experiment), it’s still bad.

    Adults typically need 7–9 hours of sleep per night, and if you don’t get it, you’ll accumulate a sleep debt. And, importantly:

    When you accumulate sleep debt, you are borrowing time at a very high rate of interest!

    And, at risk of laboring the metaphor, but this is important too:

    Not only will you have to pay it back soon (with interest), you will be hounded by the debt collection agents—decreased cognitive ability and decreased physical ability—until you pay up.

    In summary:

    • Polyphasic sleep is really very tempting
    • It will give you more hours per day (for a while)
    • It will give the promised lucid dreaming benefits (which is great until you start micronapping between naps, this is effectively a mini psychotic break from reality lasting split seconds each—can be deadly if behind the wheel of a car, for instance!)
    • It is unequivocally bad for the health and we do not recommend it

    Bottom line:

    Some of the claimed benefits are real, but are incredibly short-term, unsustainable, and come at a cost that’s far too high. We get why it’s tempting, but ultimately, it’s self-sabotage.

    (Sadly! We really wanted it to work, too…)

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  • You, Happier – by Dr. Daniel Amen

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    The implicit question “what’s your brain type?” makes this book sound a little like a horoscope for science-enjoyers, but really, the “brain type” in question is simply a way of expressing which neurochemicals one’s brain makes most and/or least easily.

    That’s something that a) really does differ from one person to another b) isn’t necessarily fixed forever, but will tend to remain mostly the same most of the time for most people.

    And yes, the book does cover figuring out which neurotransmitter(s) it might be for you. On a secondary level, it also talks about more/less active parts of the brain for each of us, but the primary focus is on neurotransmitters.

    It’s easy to assume “everyone wants more [your favorite neurotransmitter here]” but in fact, most people most of the time have most of what they need.

    For those of us who don’t, those of us who perhaps have to work more to keep our level(s) of one or more neurotransmitters where they should be, this book is a great guide to optimizing aspects of our diet and lifestyle to compensate for what our brains might lack—potentially reducing the need to go for pharmaceutical approaches.

    The style of the book is very much pop-science, but it is all well-informed and well-referenced.

    Bottom line: if you sometimes (or often!) think “if only my brain would just make/acknowledge more [neurotransmitter], this book is for you.

    Click here to check out You, Happier, and discover a happier you!

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  • Fasting Without Crashing?

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    Intermittent Fasting: What’s the truth?

    Before we get to facts and fictions, let’s quickly cover:

    What is Intermittent Fasting?

    Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:

    Time-restricted IF, for example:

    • 16:8—Fast for 16 hours, eat during an 8-hour window
    • 18:6–Fast for 18 hours, eat during a 6-hour window
    • 20:4—Fast for 20 hours, eat during a 4-hour window

    24hr fasting, including:

    • Eat Stop Eat—basically, take a day off from eating once a week
    • Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat

    Non-fast fasting, e.g:

    • 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
    • Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
    • The Warrior Diet—as above, but include a small amount of non-starchy vegetables

    Why IF?

    While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.

    But… Does it work?

    Here we get into the myth-busting bit!

    “IF promotes weight loss”

    Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.

    “IF promotes fat loss, without eating less”

    Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.

    “IF provides metabolic benefits for general health”

    Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)

    However, results vary according to which protocol you’re observing…

    For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.

    “Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”

    Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!

    However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.

    On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.

    The American Journal of Clinical Nutrition wrote:

    ❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞

    American Journal of Clinical Nutrition

    “IF improves mood and cognition”

    Mix of True and False (plus an honest “We Don’t Know” from researchers).

    Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.

    Basically this is one where researchers typically append the words “more research is needed” to their summaries.

    “Anyone can do IF”

    Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.

    For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.

    (On the other hand, IF may help achieve remission of type 2 diabetes)

    Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).

    WHICH APP?

    Choosing a fasting app

    Thinking of giving IF a try and would like a little extra help? We’ve got you covered!

    Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023

    Prefer to just trust us with a recommendation?

    We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.

    Both are available on both iOS and Android:

    See the BodyFast App / See the Zero App

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  • New News From The Centenarian Blue Zones

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    From Blue To Green…

    We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

    This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

    In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

    • Lifespan: how long we live
    • Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

    Most of our readers don’t live in a Blue Zone (in fact, many live in the US, which is a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

    You may be wondering… How much good will this do me? And, we do have an answer for that:

    When All’s Said And Done, How Likely Are You To Live To 100?

    Now that we’re all caught-up…

    The news from the Blues

    A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

    Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

    1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
    2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
    3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
    4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

    See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

    And showing that yes, even parks in cities make a significant difference:

    The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

    Want to know more?

    You can read the study in full here:

    A systematic review of diet and medication use among centenarians and near-centenarians worldwide

    Take care!

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