What Nobody Teaches You About Strengthening Your Knees

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Strengthening unhappy knees can seem difficult, because many obvious exercises like squats may hurt, and can feel like they are doing harm (and if your knees are bad enough, maybe they are; it depends on many factors). Here’s a way to improve things:

The muscle nobody talks about

Well, not nobody. But, it’s a muscle that’s rarely talked about; namely, the tibialis anterior.

It plays a key role in decelerating knee motionโ€”in other words, the movement that hurts if you have bad knees. It’s essential for absorbing shock during activities like walking, climbing stairs, and stepping off curbs

So, of course, strengthening this muscle supports knee health.

The exercise this video recommends for strengthening it involves leaning against a wall with feet about a foot away (closer feet make it easier, further makes it harder). Note, this is a lean, not a “Roman chair”.

The exercise involves squeezing the quadriceps, lifting toes toward the nose, and engaging the tibialis anterior muscle. If you’re wondering what to do with your hands, they can be held out with palms open to work on posture, or hanging by the sides. Do this for about 1ยฝโ€“2 minutes.

For more on all this, plus a visual demonstration, enjoy:

Click Here If The Embedded Video Doesnโ€™t Load Automatically!

Want to learn more?

You might also like to read:

When Bad Joints Stop You From Exercising (5 Things To Change)

Take care!

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  • Reversing Alzheimer’s โ€“ by Dr. Heather Sandison

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    The title here is bold, isnโ€™t it? But, if the studies so far are anything to go by, she is, indeed, reversing Alzheimerโ€™s. By this we mean: her Alzheimerโ€™s patients have enjoyed a measurable reversal of the symptoms of cognitive decline (this is not something that usually happens).

    The science here is actually new, and/but references are given aplenty, including Dr. Sandisonโ€™s own research and othersโ€”thereโ€™s a bibliography of several hundred papers, which we love to see.

    Dr. Sandisonโ€™s approach is of course multivector, but is far more lifestyle medicine than pills, with diet in particular playing a critical role. Indeed, it’s worth mentioning that she is a naturopathic doctor (not an MD), so that is her focusโ€”though she’s had a lot of MDs looking in on her work too, as you may see in the book. She has found best results in a diet low in carbs, high in healthy fatsโ€”and it bears emphasizing, healthy ones. Many other factors are also built in, but this is a book review, not a book summary.

    Nor does the book look at diet in isolation; other aspects of lifestyle are also taken into account, as well as various medical pathways, and how to draw up a personalized plan to deal with those.

    The book is written with the general assumption that the reader is someone with increased Alzheimerโ€™s risk wishing to reduce that risk, or the relative of someone with Alzheimerโ€™s disease already. However, the information within is beneficial to all.

    The style is on the hard end of pop-science; itโ€™s written for the lay reader, but will (appropriately enough) require active engagement to read effectively.

    Bottom line: if Alzheimerโ€™s is something that affects or is likely to affect you (directly, or per a loved one), then this is a very good book to have read

    Click here top check out Reversing Alzheimerโ€™s, and learn how to do it!

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  • Vitamin D2 vs Vitamin D3: What You Would Benefit From Knowing

    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.

    Itโ€™s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where weโ€™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 tooโ€”thereโ€™s always more to say!

    As ever: if the question/request can be answered briefly, weโ€™ll do it here in our Q&A Thursday edition. If not, weโ€™ll make a main feature of it shortly afterwards!

    So, no question/request too big or small ๐Ÿ˜Ž

    โHi, is there any important difference between vitamin d2 and vitamin d3? Is one better than the other?โž

    There is indeed! And one is better than the other!

    Where they come from

    You’ll find a lot of sources that will tell you “Vitamin D2 is from plants, D3 is from animals”, and in fact only the second half of that is true.

    In nature, there are no plants that are known to produce vitamin D.

    Vitamin D2, however, is produced by many fungi, as well as algae, neither of which are part of the Kingdom Plantae.

    Vitamin D3, meanwhile, is produced by many animals (including humans).

    When “the sun” is sometimes considered a source of vitamin D, that’s true only insofar as the sun is also a source of tomatoes, for example, which required the sun to grow. While we humans (and other animals) cannot photosynthesize in general, producing vitamin D is something we can do if exposed to UV light (such as from the sun).

    However, of course exposure to UV light (such as from the sun) comes with other problems, so… Should we get sun exposure or not?

    We weighed up the balance of evidence, here: The Sun Exposure Dilemma

    If, like this writer, you are a mostly crepuscular being who avoids the sun, we have good news: mushrooms can do the sunbathing for us!

    โExposing mushrooms to UV (from sunlight or in a laboratory) increases the amount of vitamin D in mushrooms by nearly eightfold. Putting five store-bought button mushrooms in the sun, or just one portobello mushroom, produces 24 ยตg of vitamin D, which translates to nearly 1000 international units, providing the amount of vitamin D one needs in an entire day, and the equivalent found in most vitamin D supplements.

    If youโ€™re wondering if the vitamin D from mushrooms actually makes it into your bloodstream, it does. A recent meta-analysis of randomized controlled trials showed that tanned (UV-exposed) mushrooms may be effective in increasing active vitamin D levels in adults with low levels of vitamin D, and studies (randomised controlled trials) have shown that it may be just as effective as supplements at increasing vitamin D levels in the blood (here, and here).

    Some research is very positive, saying that putting your mushrooms in direct sunlight for 10โ€“15 minutes may provide you with 100% of your daily vitamin D needs, and the vitamin D content in sunlight-exposed mushrooms may be retained with refrigeration for up to 8 days.

    The production of vitamin D may be increased by a further 30% by placing them in the sun with the underside, or gills, facing up, or by 60% if you slice them.โž

    Read all about it: Tan your mushrooms, not your skin

    Which is better?

    In few words: D3 is better.

    They both do the exact same job, but with D3, you simply get more bang-for-buck:

    โThe WMD in change in total 25(OH)D based on 12 daily dosed vitamin D2-vitamin D3 comparisons, analyzed using liquid chromatography-tandem mass spectrometry, was 10.39 nmol/L (40%) lower for the vitamin D2 group compared with the vitamin D3 group.

    Vitamin D3 leads to a greater increase of 25(OH)D than vitamin D2, even if limited to daily dose studies, but vitamin D2 and vitamin D3 had similar positive impacts on their corresponding 25(OH)D hydroxylated forms.โž

    Note: “WMD” here means “weighted mean difference”, not “weapons of mass destruction”

    Read in full: Comparison of the Effect of Daily Vitamin D2 and Vitamin D3 Supplementation on Serum 25-Hydroxyvitamin D Concentration (Total 25(OH)D, 25(OH)D2, and 25(OH)D3) and Importance of Body Mass Index: A Systematic Review and Meta-Analysis

    About that “and importance of BMI”, by the way: in persons with a BMI >25, there was no longer a difference between the two forms. Literally, no difference at all; the difference was reduced to 0%.

    Another study found similarly, but with different numbers (finding a greater difference), and without recording BMI as a factor:

    โD3 is approximately 87% more potent in raising and maintaining serum 25(OH)D concentrations and produces 2- to 3-fold greater storage of vitamin D than does equimolar D2.โž

    See the paper: Vitamin D3 Is More Potent Than Vitamin D2 in Humans

    “Well that sucks, because I’m vegan”

    Fear not, you can get vegan D3 too.

    Much like “you can’t get vegan B12” (but you can; it’s made by yeast), there are vegan D3 supplements, made by lichen.

    The trouble with lichen, when it comes to classifying it, it that itโ€™s actually a hybrid colony of many small, strange things (beyond the scope of this article, but they are fascinating, so this writer is holding herself back by the scruff of the neck from explaining in detail), some of which are technically part of Kingdom Animalia, but it is hard to find even the most ardent vegan who will object to consuming bacteria, for example.

    Want to try some?

    We don’t sell it, but here for your convenience is an example product on Amazon ๐Ÿ˜Ž

    But watch out with the doses, if supplementing vitamin D in either form, because…

    Vit D + Calcium: Too Much Of A Good Thing? โ† this also talks about safe and effective doses, and what goes wrong if you take too much

    Take care!

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  • The Most Annoying Nutrition Tips (7 Things That Actually Work)

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    You can’t out-exercise a bad diet, and getting a good diet can be a challenge depending on your starting point. Here’s Cori Lefkowith’s unglamorous seven-point plan:

    Step by step

    Seven things to do:

    1. Start tracking first: track your food intake (as it is, without changing anything) without judgment to identify realistic areas for improvement.
    2. Add protein: add 10g of protein to three meals daily to improve satiety, aid fat loss, and retain muscle.
    3. Fiber swaps: swap foods for higher-fiber options where possible to improve gut health, improve heart health, support fat loss, and promote satiety.
    4. Hydration: take your body weight in kilograms (or half your body weight in pounds), then get that many ounces of water daily to support metabolism and reduce cravings. 
    5. Calorie swaps: replace or reduce calorie-dense foods to create a small, modestly sustainable calorie deficit. Your body will still adjust to this after a while; thatโ€™s fine; itโ€™s about a gradual reduction.
    6. Tweak and adjust: regularly reassess and adjust your diet and habits to fit your lifestyle and progress.
    7. Guard against complacency: track consistently, and stay on course.

    For more on all of these, enjoy:

    Click Here If The Embedded Video Doesnโ€™t Load Automatically!

    Want to learn more?

    You might also like:

    The Smartest Way To Get To 20% Body Fat (Or 10% For Men)

    Take care!

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  • Human, Bird, or Dog Waste? Scientists Parsing Poop To Aid DCโ€™s Forgotten River

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    KFF Health News Peggy Girshman reporting fellow Jackie Fortiรฉr joined a boat tour to spotlight a review of microbes in the Anacostia River, a step toward making the river healthier and swimmable. The story was featured on WAMUโ€™s โ€œHealth Hubโ€ on Feb. 26.

    On a bright October day, high schoolers from Francis L. Cardozo Education Campus piled into a boat on the Anacostia River in Washington, D.C. Most had never been on the water before.

    Their guide, Trey Sherard of the Anacostia Riverkeeper, started the tour with a well-rehearsed safety talk. The nonprofit advocates for the protection of the river.

    A boy with tousled black hair casually dipped his fingers in the water.

    โ€œDonโ€™t touch it!โ€ Sherard yelled.

    Why was Sherard being so stern? Was it dangerously cold? Were there biting fish?

    Because of the sewage.

    โ€œWe get less sewage than we used to. Sewage is a code word for what?โ€ Sherard asked the teenagers.

    โ€œPoop!โ€ one student piped up.

    โ€œHuman poop,โ€ Sherard said. โ€œNotice I didnโ€™t say we get none. I said we get what? Less.โ€

    Tours like this are designed to get young people interested in the riverโ€™s ecology, but itโ€™s a fine line to tread โ€” interacting with the water can make people sick. Because of the health risks, swimming hasnโ€™t been legal in the Anacostia for more than half a century. The polluted water can cause gastrointestinal and respiratory illnesses, as well as eye, nose, and skin infections.

    The river is the cleanest itโ€™s been in years, according to environmental experts, but they still advise you not to take a dip in the Anacostia โ€” not yet, at least.

    About 40 million people in the U.S. live in a community with a combined sewer system, where wastewater and stormwater flow through the same pipes. When pipe capacities are reached after heavy rains, the overflow sends raw wastewater into the rivers instead of to a treatment plant.

    Federal regulations, including sections of the Clean Water Act, require municipalities such as Washington to reduce at least 85% of this pollution or face steep fines.

    To achieve compliance, Washington launched a $2.6 billion infrastructure project in 2011. DC Waterโ€™s Clean Rivers Project will eventually build multiple miles-long underground storage basins to capture stormwater and wastewater and pump it to treatment plants once heavy rains have subsided.

    The Anacostia tunnel is the first of these storage basins to be completed. It can collect 190 million gallons of bacteria-laden wastewater for later treatment, said Moussa Wone, vice president of the Clean Rivers Project.

    Climate change is causing more intense rainstorms in Washington, so even after construction is complete in 2030, Wone said, untreated stormwater will be discharged into the river, though much less frequently.

    โ€œOn the Anacostia, weโ€™re going to be reducing the frequency of overflows from 82 to two in an average year,โ€ Wone said.

    But while the Anacostia sewershed covers 176 square miles, he noted, only 17% is in Washington.

    โ€œThe other 83% is outside the district,โ€ Wone said. โ€œWe can do our part, but everybody else has to do their part also.โ€

    Upstream in Marylandโ€™s Montgomery and Prince Georgeโ€™s counties, miles of sewer lines are in the process of being upgraded to divert raw sewage to a treatment plant instead of the river.

    The data shows that poop is a problem for river health โ€” but knowing what kind of poop it is matters. Scientists monitor E. coli to indicate the presence of feces in river water, but since the bacteria live in the guts of most warm-blooded animals, the source is difficult to determine.

    โ€œIs it human feces? Or is it deer? Is it gullsโ€™? Is it dogsโ€™?โ€ said Amy Sapkota, a professor of environmental and occupational health at the University of Maryland.

    Bacterial levels can fluctuate across the river even without rainstorms. An Anacostia Riverkeeper report found that in 2023 just three of nine sites sampled along the Washington portion of the watershed had consistently low E. coli levels throughout the summer season.

    Sapkota is heading a new bacterial monitoring program measuring the amount of E. coli that different animal species deposit along the river.

    The team uses microbial source tracking to analyze samples of river water taken from different locations each month by volunteers. The molecular approach enables scientists to target specific gene sequences associated with fecal bacteria and determine whether the bacteria come from humans or wildlife. Microbial source tracking also measures fecal pollution levels by source.

    โ€œWe can quantify the levels of different bacterial targets that may be coming from a human fecal source or an animal fecal source,โ€ Sapkota said.

    Her team expects to have preliminary results this year.

    The health risk to humans from river water will never be zero, Sapkota said, but based on her teamโ€™s research, smart city planning and retooled infrastructure could lessen the level of harmful bacteria in the water.

    โ€œLetโ€™s say that weโ€™re finding that actually thereโ€™s a lot of deer fecal signatures in our results,โ€ Sapkota said. โ€œMaybe this points to the fact that we need more green buffers along the river that can help prevent fecal contaminants from wildlife from entering the river during stormwater events.โ€

    Washington is hoping to recoup some of the cost of building green spaces and other river cleanup. In January, the office of D.C. Attorney General Brian Schwalb filed a lawsuit seeking unspecified damages from the federal government over decades of alleged pollution of the Anacostia River.

    Brenda Lee Richardson, coordinator of the Anacostia Parks & Community Collaborative, said the efforts to cut down on trash and sewage are paying off. She sees a river on the mend, with more plant and animal life sprouting up.

    โ€œThe ecosystem seems a lot greener,โ€ she said. โ€œThereโ€™s stuff in the river now that wasnโ€™t there before.โ€

    But any changes to the waterfront need to be done with residents of both sides of the river in mind, she said.

    โ€œWe want there to be some sense of equity as it relates to who has access,โ€ she said. โ€œWhen I look at who is recreating, itโ€™s not people who look like me.โ€

    Richardson has lived for 40 years in Ward 8 โ€” a predominantly Black area on the east side of the river whose residents are generally less affluent than those on the west side. She and her neighbors donโ€™t consider the Anacostia a place to get out and play, she said.

    As the water quality slowly improves, Richardson said, she hopes the Anacostiaโ€™s reputation is also rehabilitated. Even if itโ€™s not safe to swim in, Richardson enjoys boating trips like the one with the Anacostia Riverkeeper.

    โ€œTo see all those creatures along the way and the greenery. It was comforting,โ€ she said. โ€œSo rather than take a pill to settle my nerves, I can just go down the river.โ€

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFFโ€”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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  • Fitness Freedom for Seniors โ€“ by Jackie Jacobs

    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.

    Exercise books often assume that either we are training for the Olympics, and most likely also that we are 20 years old. This one doesn’t.

    Instead, we see a well-researched, well-organized, clearly-illustrated fitness plan with age in mind. Author Jackie Jacobs offers tips and advice for all levels, and a progressive week-by-week plan of 15-minute sessions. This way, we’re neither overdoing it nor slacking off; it’s a perfect balance.

    The exercises are aimed at “all areas”, that is to say, improving cardiovascular fitness, balance, flexibility, and strength. It also gives some supplementary advice with regard to diet and suchlike, but the workouts are the real meat of the book.

    Bottom line: if you’d like a robust, science-based exercise regime that’s tailored to seniors, this is the book for you.

    Click here to check out Fitness Freedom for Seniors, and get yours!

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  • Hospitals worldwide are short of saline. We canโ€™t just switch to other IV fluids โ€“ย hereโ€™sย why

    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.

    Last week, the Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of medicines in short supply. The shortage is due to higher-than-expected demand and manufacturing issues.

    Two particular IV fluids are affected: saline and compound sodium lactate (also called Hartmannโ€™s solution). Both fluids are made with salts.

    There are IV fluids that use other components, such as sugar, rather than salt. But instead of switching patients to those fluids, the government has chosen to approve salt-based solutions by other overseas brands.

    So why do IV fluids contain different chemicals? And why canโ€™t they just be interchanged when one runs low?

    Pavel Kosolapov/Shutterstock

    We canโ€™t just inject water into a vein

    Drugs are always injected into veins in a water-based solution. But we canโ€™t do this with pure water, we need to add other chemicals. Thatโ€™s because of a scientific principle called osmosis.

    Osmosis occurs when water moves rapidly in and out of the cells in the blood stream, in response to changes to the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs and proteins.

    Too high a concentration of chemicals and protein in your blood stream leads it to being in a โ€œhypertonicโ€ state, which causes your blood cells to shrink. Not enough chemicals and proteins in your blood stream causes your blood cells to expand. Just the right amount is called โ€œisotonicโ€.

    Mixing the drug with the right amount of chemicals, via an injection or infusion, ensures the concentration inside the syringe or IV bag remains close to isotonic.

    A woman connected to an IV drip looks out a hospital window.
    Australia is currently short on two salt-based IV fluids. sirnength88/Shutterstock

    What are the different types of IV fluids?

    There are a range of IV fluids available to administer drugs. The two most popular are:

    • 0.9% saline, which is an isotonic solution of table salt. This is one of the IV fluids in short supply
    • a 5% solution of the sugar glucose/dextrose. This fluid is not in short supply.

    There are also IV fluids that combine both saline and glucose, and IV fluids that have other salts:

    • Ringerโ€™s solution is an IV fluid which has sodium, potassium and calcium salts
    • Plasma-Lyte has different sodium salts, as well as magnesium
    • Hartmannโ€™s solution (compound sodium lactate) contains a range of different salts. It is generally used to treat a condition called metabolic acidosis, where patients have increased acid in their blood stream. This is in short supply.

    What if you use the wrong solution?

    Some drugs are only stable in specific IV fluids, for instance, only in salt-based IV fluids or only in glucose.

    Putting a drug into the wrong IV fluid can potentially cause the drug to โ€œcrash outโ€ of the solution, meaning patients wonโ€™t get the full dose.

    Or it could cause the drug to decompose: not only will it not work, but it could also cause serious side effects.

    An example of where a drug can be transformed into something toxic is the cancer chemotherapy drug cisplatin. When administered in saline it is safe, but administration in pure glucose can cause life-threatening damage to a patientsโ€™ kidneys.

    What can hospitals use instead?

    The IV fluids in short supply are saline and Hartmannโ€™s solution. They are provided by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.

    The governmentโ€™s solution to this is to approve multiple overseas-registered alternative saline brands, which they are allowed to do under current legislation without it going through the normal Australian quality checks and approval process. They will have received approval in their country of manufacture.

    The government is taking this approach because it may not be effective or safe to formulate medicines that are meant to be in saline into different IV fluids. And we donโ€™t have sufficient capacity to manufacture saline IV fluids here in Australia.

    The Australian Society of Hospital Pharmacists provides guidance to other health staff about what drugs have to go with which IV fluids in their Australian Injectable Drugs Handbook. If there is a shortage of saline or Hartmannโ€™s solution, and shipments of other overseas brands have not arrived, this guidance can be used to select another appropriate IV fluid.

    Why donโ€™t we make it locally?

    The current shortage of IV fluids is just another example of the problems Australia faces when it is almost completely reliant on its critical medicines from overseas manufacturers.

    Fortunately, we have workarounds to address the current shortage. But Australia is likely to face ongoing shortages, not only for IV fluids but for any medicines that we rely on overseas manufacturers to produce. Shortages like this put Australian lives at risk.

    In the past both myself, and others, have called for the federal government to develop or back the development of medicines manufacturing in Australia. This could involve manufacturing off-patent medicines with an emphasis on those medicines most used in Australia.

    Not only would this create stable, high technology jobs in Australia, it would also contribute to our economy and make us less susceptible to future global drug supply problems.

    Nial Wheate, Professor and Director Academic Excellence, Macquarie University and Shoohb Alassadi, Casual academic, pharmaceutical sciences, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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