Women Rowing North – by Dr. Mary Pipher
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Ageism is rife, as is misogyny. And those can be internalized too, and compounded as they intersect.
Clinical psychologist Dr. Mary Pipher, herself 75, writes for us a guidebook of, as the subtitle goes, “navigating life’s currents and flourishing as we age”.
The book does assume, by the way, that the reader is…
- a woman, and
- getting old (if not already old)
However, the lessons the book imparts are vital for women of any age, and valuable as a matter of insight and perspective for any reader.
Dr. Pipher takes us on a tour of aging as a woman, and what parts of it we can make our own, do things our way, and take what joy we can from it.
Nor is the book given to “toxic positivity” though—it also deals with themes of hardship, frustration, and loss.
When it comes to those elements, the book is… honest, human, and raw. But also, an exhortation to hope, beauty, and a carpe diem attitude.
Bottom line: this book is highly recommendable to anyone of any age; life is precious and can be short. And be we blessed with many long years, this book serves as a guide to making each one of them count.
Click here to check out Women Rowing North—it really is worth it
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Early Dementia Screening From Your Blood & More
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Dementia is, statistically speaking, the most feared disease in the US. Notwithstanding…
- heart disease killing more
- COVID being more of a lottery
- cancer being the “yes you can modify risk factors but it can come for anyone” life-changing (and often life-ending) disease,
…it’s still dementia that Americans report fearing the most.
And yet… Early dementia screening is seriously underused
It may be a case of a head-in-sand approach to avoid unwanted news, or it could be a case of not knowing what’s available.
So, with that in mind…
How to watch out: first line warning signs
You walk into a room of your house, and suddenly stop: “what did I come in here for?”, you wonder.
A moment later, you’re worrying whether this is a sign of age-related cognitive decline.
The good news: it usually isn’t. In fact, you did that when you were younger, too, you just didn’t pay enough attention at the time to remember it now.
Dementia-related memory loss is less “where did I put my car keys?”, and more “what is this thing for?” (it’s your car keys). Or at a less advanced stage: “whose are these car keys?” (they are yours).
You can read about some of the nuances here:
Is It Dementia? Spot The Signs (Because None Of Us Are Immune) ← If you’d like an objective test of memory and other cognitive impairments, this article also has a link to the industry’s gold standard test (it’s free)
(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)
Tests you can’t do at home
We wrote a little while back about how one kind of blood testing for Alzheimer’s disease works:
The Brain Alarm Signs That Warn Of Dementia
Why “Brain Alarm Signs” if it’s a blood test? Because the blood gets (in very lay terms) bits of broken brain in it. Or more specifically, they tested the blood for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which are bits of the cells from the lining of blood vessels in the brain. These cerebrovascular endothelial extracellular vesicles should not, ideally, be falling off and riding around your bloodstream, and the greater the density of them, the greater likelihood of mild cognitive impairment now, and by extension, dementia later.
It’s not the only blood test available though, see:
Highly accurate blood test for Alzheimer’s disease is similar or superior to clinical cerebrospinal fluid (CSF) tests ← this one checks the ratio of phosporylated-tau217 to non-phosphorylated tau (which is a protein antibody), which equalled or outperformed FDA-approved CSF tests in classifying amyloid-β positron emission topography (PET, as in a PET scan) status, with a confidence interval as high as, or better than, industry standards.
If you don’t like having your blood taken, trust us that you’d find having your cerebrospinal fluid taken even less enjoyable, so this is a very welcome improvement!
In case you’re curious about how the CSF test works, here you go: NPTX2 in Cerebrospinal Fluid Predicts the Progression From Normal Cognition to Mild Cognitive Impairment ← NPTX2 is a protein biomarker of Alzheimer’s risk
…but again, we really think the blood test is preferable.
Tests beyond the physiological
There are, of course, psychological tests that can be done, including a linguistic analysis of your conversation, compared with a vast database of other people’s conversations, with and without various degrees of cognitive impairment
As Dr. Ioannis Paschalidis explains:
❝We wanted to predict what would happen in the next six years—and we found we can reasonably make that prediction with relatively good confidence and accuracy.
Rather than using acoustic features of speech, like enunciation or speed, the model is just pulling from the content of the interview—the words spoken, how they’re structured.
You can think of the score as the likelihood, the probability, that someone will remain stable or transition to dementia. It had significant predictive ability.
Digital is the new blood. You can collect it, analyze it for what is known today, store it, and reanalyze it for whatever new emerges tomorrow.❞
You can read the full paper here: Prediction of Alzheimer’s disease progression within 6 years using speech: A novel approach leveraging language models
See also: AI: The Doctor That Never Tires?
What if the news isn’t good?
While bad news is never welcome per se, it is preferable to not knowing, insofar as we can then take steps to manage the situation.
You may be wondering: what can be done that I wouldn’t already be doing to minimize my dementia risk in the first place?
And the answer is: yes, do continue those things of course, but there is more to do:
See: Beyond Guarding Against Dementia: When Age’s Brain-Changes Come Knocking
Take care!
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Should You Shower Daily?
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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
❝I read an article that daily showering is “performative” and doesn’t really give any health benefits, what do you say?❞
We looked to find the article you might be referring to, and this seems to be about a BBC article that was then picked up, rehashed in fewer (but more sensational) words, and widely popularized by the New York Post (not the most scholarly of publications, but it seems to have “done numbers”).
Here’s the BBC article:
BBC | There’s no need to shower every day—here’s why
Looking for the science behind the “Experts say…” claims, none of the articles we found linked to any new research. One of them did link to some old (2005) research:
We also see (in the dearth of scholarly research to cite), a Harvard Health article being cited quite a bit, and this is more helpful and informative than the flashy news articles, without requiring to read through a lot of hard science.
To summarize, Harvard’s Dr. Shmerling says daily showering can:
- Cause/worsen dry skin
- Make skin more permeable to pathogens
- Upset our natural balance of bacteria that are supposed to be there
- Weaken our immune system
Read in full: Harvard Health | Showering daily—is it necessary?
But what if I like showering?
Well, don’t let us stop you. But you might consider using less in the way of shower products. We wrote about this previously, in answer to a different-but-related subscriber question:
10almonds | Body Scrubs: Benefits, Risks, and Guidance
PS…
Handwashing, though? Most people could reasonably do that more often:
Would you like this section to be bigger? If so, send us more questions!
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Compact Tai Chi – by Dr. Jesse Tsao
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A very frustrating thing when practicing tai chi, especially when learning, is the space typically required. We take a step this way and lunge that way and turn and now we’ve kicked a bookcase. Add a sword, and it’s goodnight to the light fixtures at the very least.
While a popular suggestion may be “do it outside”, we do not all have the luxury of living in a suitable climate. We also may prefer to practice in private, with no pressing urge to have an audience.
Tsao’s book, therefore, is very welcome. But how does he do it? The very notion of constriction is antithetical to tai chi, after all.
He takes the traditional forms, keeps the movements mostly the same, and simply changes the order of them. This way, the practitioner revolves around a central point. Occasionally, a movement will become a smaller circle than it was, but never in any way that would constrict movement.
Of course, an obvious question for any such book is “can one learn this from a book?” and the answer is complex, but we would lean towards yes, and insofar as one can learn any physical art from a book, this one does a fine job. It helps that it builds up progressively, too.
All in all, this book is a great choice for anyone who’s interested in taking up tai chi, and/but would like to do so without leaving their home.
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Blood-Sugar-Friendly Ice Pops
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This generic food product has so many regional variant names that it’s difficult to get a universal name, but in N. America they’re also known by the genericized brand name of popsicles. Anyway, they’re usually very bad news for blood sugars, being merely frozen juice even if extra sugar wasn’t added. Today’s recipe, on the other hand, makes for a refreshing and nutrient-dense treat that won’t spike your blood glucose!
You will need
- 1 cup fresh blueberries
- 1 can (12oz/400g) coconut milk
- ½ cup yogurt with minimal additives
- 1 tbsp honey (omit if you prefer less sweetness)
- Juice of ¼ lime (increase if you prefer more sourness)
Method
(we suggest you read everything at least once before doing anything)
1) Blend everything
2) Pour into ice pop molds and freeze overnight
3) Serve at your leisure:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Which Sugars Are Healthier, And Which Are Just The Same?
- 10 Ways To Balance Blood Sugars
- Can Saturated Fats Be Healthy? ← the fats in coconut are a good source of medium-chain triglycerides (MCTs), which are easily broken down as a good energy source and (enjoyed in moderation) thus unlikely to cause any cardiovascular problems, as little to nothing (usually: nothing) of it will be stored.
Take care!
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Reflexology: What The Science Says
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How Does Reflexology Work, Really?
In Wednesday’s newsletter, we asked you for your opinion of reflexology, and got the above-depicted, below-described set of responses:
- About 63% said “It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely”
- About 26% said “It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health“
- About 11% said “It works by placebo, at best, and has no evidence for any efficacy beyond that”
So, what does the science say?
It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health: True or False?
False, or since we can’t prove a negative: there is no reliable scientific evidence for this.
Further, there is no reliable scientific evidence for the existence of qi, ki, prana, soma, mana, or whatever we want to call it.
To save doubling up, we did discuss this in some more detail, exploring the notion of qi as bioelectrical energy, including a look at some unreliable clinical evidence for it (a study that used shoddy methodology, but it’s important to understand what they did wrong, to watch out for such), when we looked at [the legitimately very healthful practice of] qigong, a couple of weeks ago:
Qigong: A Breath Of Fresh Air?
As for reflexology specifically: in terms of blockages of qi causing disease (and thus being a putative therapeutic mechanism of action for attenuating disease), it’s an interesting hypothesis but in terms of scientific merit, it was pre-emptively supplanted by germ theory and other similarly observable-and-measurable phenomena.
We say “pre-emptively”, because despite orientalist marketing, unless we want to count some ancient pictures of people getting a foot massage and say it is reflexology, there is no record of reflexology being a thing before 1913 (and that was in the US, by a laryngologist working with a spiritualist to produce a book that they published in 1917).
It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely: True or False?
False, or since we can’t prove a negative: there is no reliable scientific evidence for this.
A very large independent review of available scientific literature found the current medical consensus on reflexology is that:
- Reflexology is effective for: anxiety (but short lasting), edema, mild insomnia, quality of sleep, and relieving pain (short term: 2–3 hours)
- Reflexology is not effective for: inflammatory bowel disease, fertility treatment, neuropathy and polyneuropathy, acute low back pain, sub acute low back pain, chronic low back pain, radicular pain syndromes (including sciatica), post-operative low back pain, spinal stenosis, spinal fractures, sacroiliitis, spondylolisthesis, complex regional pain syndrome, trigger points / myofascial pain, chronic persistent pain, chronic low back pain, depression, work related injuries of the hip and pelvis
Source: Reflexology – a scientific literary review compilation
(the above is a fascinating read, by the way, and its 50 pages go into a lot more detail than we have room to here)
Now, those items that they found it effective for, looks suspiciously like a short list of things that placebo is often good for, and/or any relaxing activity.
Another review was not so generous:
❝The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition❞
~ Dr. Edzard Ernst (MD, PhD, FMedSci)
Source: Is reflexology an effective intervention? A systematic review of randomised controlled trials
In short, from the available scientific literature, we can surmise:
- Some researchers have found it to have some usefulness against chiefly psychosomatic conditions
- Other researchers have found the evidence for even that much to be uncompelling
It works by placebo, at best, and has no evidence for any efficacy beyond that: True or False?
Mostly True; of course reflexology runs into similar problems as acupuncture when it comes to testing against placebo:
How Does One Test Acupuncture Against Placebo Anyway?
…but not quite as bad, since it is easier to give a random foot massage while pretending it is a clinical treatment, than to fake putting needles into key locations.
However, as the paper we cited just above (in answer to the previous True/False question) shows, reflexology does not appear to meaningfully outperform placebo—which points to the possibility that it does work by placebo, and is just a placebo treatment on the high end of placebo (because the placebo effect is real, does work, isn’t “nothing”, and some placebos work better than others).
For more on the fascinating science and useful (applicable in daily life!) practicalities of how placebo does work, check out:
How To Leverage Placebo Effect For Yourself
Take care!
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Demystifying Cholesterol
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All About Cholesterol
When it comes to cholesterol, the most common lay understanding (especially under a certain age) is “it’s bad”.
A more informed view (and more common after a certain age) is “LDL cholesterol is bad; HDL cholesterol is good”.
A more nuanced view is “LDL cholesterol is established as significantly associated with (and almost certainly a causal factor of) atherosclerotic cardiovascular disease and related mortality in men; in women it is less strongly associated and may or may not be a causal factor”
You can read more about that here:
Statins: His & Hers? ← we highly recommend reading this, especially if you are a woman and/or considering/taking statins. To be clear, we’re not saying “don’t take statins!”, because they might be the right medical choice for you and we’re not your doctors. But we are saying: here’s something to at least know about and consider.
Beyond HDL & LDL
There is also VLDL cholesterol, which as you might have guessed, stands for “very low-density lipoprotein”. It has a high, unhealthy triglyceride content, and it increases atherosclerotic plaque. In other words, it hardens your arteries more quickly.
The term “hardening the arteries” is an insufficient descriptor of what’s happening though, because while yes it is hardening the arteries, it’s also narrowing them. Because minerals and detritus passing through in the blood (the latter sounds bad, but there is supposed to be detritus passing through in the blood; it’s got to get out of the body somehow, and it’s off to get filtered and excreted) get stuck in the cholesterol (which itself is a waxy substance, by the way) and before you know it, those minerals and other things have become a solid part of the interior of your artery wall, like a little plastering team came and slapped plaster on the inside of the walls, then when it hardened, slapped more plaster on, and so on. Macrophages (normally the body’s best interior clean-up team) can’t eat things much bigger than themselves, so that means they can’t tackle the build-up of plaque.
Impact on the heart
Narrower less flexible arteries means very poor circulation, which means that organs can start having problems, which obviously includes your heart itself as it is not only having to do a harder job to keep the blood circulating through the narrower blood vessels, but also, it is not immune to also being starved of oxygen and nutrients along with the rest of the body when the circulation isn’t good enough. It’s a catch 22.
What if LDL is low and someone is getting heart disease anyway?
That’s often a case of apolipoprotein B, and unlike lipoprotein A, which is bound to LDL so usually* isn’t a problem if LDL is in “safe” ranges, Apo-B can more often cause problems even when LDL is low. Neither of these are tested for in most standard cholesterol tests by the way, so you might have to ask for them.
*Some people, around 1 in 20 people, have hereditary extra risk factors for this.
What to do about it?
Well, get those lipids tests! Including asking for the LpA and Apo-B tests, especially if you have a history of heart disease in your family, or otherwise know you have a genetic risk factor.
With or without extra genetic risks, it’s good to get lipids tests done annually from 40 onwards (earlier, if you have extra risk factors).
See also: Understanding your cholesterol numbers
Wondering whether you have an increased genetic risk or not?
Genetic Testing: Health Benefits & Methods ← we think this is worth doing; it’s a “one-off test tells many useful things”. Usually done from a saliva sample, but some companies arrange a blood draw instead. Cost is usually quite affordable; do shop around, though.
Additionally, talk to your pharmacist to check whether any of your meds have contraindications or interactions you should be aware of in this regard. Pharmacists usually know contraindications/interactions stuff better than doctors, and/but unlike doctors, they don’t have social pressure on them to know everything, which means that if they’re not sure, instead of just guessing and reassuring you in a confident voice, they’ll actually check.
Lastly, shocking nobody, all the usual lifestyle medicine advice applies here, especially get plenty of moderate exercise and eat a good diet, preferably mostly if not entirely plant-based, and go easy on the saturated fat.
Note: while a vegan diet contains zero dietary cholesterol (because plants don’t make it), vegans can still get unhealthy blood lipid levels, because we are animals and—like most animals—our body is perfectly capable of making its own cholesterol (indeed, we do need some cholesterol to function), and it can make its own in the wrong balance, if for example we go too heavy on certain kinds of (yes, even some plant-based) saturated fat.
Read more: Can Saturated Fats Be Healthy? ← see for example how palm oil and coconut oil are both plant-based, and both high in saturated fat, but palm oil’s is heart-unhealthy on balance, while coconut oil’s is heart-healthy on balance (in moderation).
Want to know more about your personal risk?
Try the American College of Cardiology’s ASCVD risk estimator (it’s free)
Take care!
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