What Menopause Does To The Heart
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World Menopause Day: Menopause & Cardiovascular Disease Risk
Today, the 18th of October, is World Menopause Day.
The theme for this year is cardiovascular disease (CVD), and if your first reaction is to wonder what that has to do with the menopause, then this is the reason why it’s being featured. Much of the menopause and its effects are shrouded in mystery; not because of a lack of science (though sometimes a bit of that too), but rather, because it is popularly considered an unimportant, semi-taboo topic.
So, let’s be the change we want to see, and try to fix that!
What does CVD have to do with the menopause?
To quote Dr. Anjana Nair:
❝The metabolic and clinical factors secondary to menopause, such as dyslipidemia, insulin resistance, fat redistribution and systemic hypertension, contribute to the accelerated risk for cardiovascular aging and disease.
Atherosclerosis appears to be the end result of the interaction between cardiovascular risk factors and their accentuation during the perimenopausal period.
The increased cardiovascular risk in menopause stems from the exaggerated effects of changing physiology on the cardiovascular system.❞
Source: Cardiovascular Changes in Menopause
See also: Menopause-associated risk of cardiovascular disease
Can we do anything about it?
Yes, we can! Here be science:
- Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association
- Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use
This (in few words: get your hormone levels checked, and consider HRT if appropriate) is consistent with the advice from gynecologist Dr. Jen Gunter, whom we featured back in August:
What You Should Have Been Told About The Menopause Beforehand
What about lifestyle changes?
We definitely can do some good things; here’s what the science has to say:
- Mediterranean diet: yes, evidence-based
- High soy consumption: mixed evidence, unclear. So, eat it if you want, don’t if you don’t.
- Supplements e.g. vitamins and minerals: yes, evidence-based.
- Supplements e.g. herbal preparations: many may help, but watch out for adverse interactions with meds. Check with your pharmacist or doctor.
- Supplements; specifically CBD: not enough evidence yet
- Exercise: yes, evidence-based—especially low-impact high-resistance training, for bone strength, as well as regular moderate-intensity exercise and/or High-Intensity Interval Training, to guard against CVD.
For a full low-down on all of these:
Revealing the evidence-based lifestyle solutions to managing your menopause symptoms
Want to know more?
You can get the International Menopause Society’s free downloadable booklet here:
Menopause & Cardiovascular Disease: What Women Need To Know
You may also like our previous main feature:
What Does “Balance Your Hormones” Even Mean?
Take care!
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Delicious Daily Daal
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You’re not obliged to eat this every day, but you might want to. The reason we called this one this, is because it’s a super simple recipe (don’t be put off by the long ingredients list; it’s mostly spices making it look long) which, after you’ve done it a couple of times, you could practically do it in your sleep quickly and easily.
The name “lentil daal” is a bit like “naan bread”—a redundant tautology repeated more than once unnecessarily, but it helps for international clarity. The dish is usually served with naan, by the way, and rice. We don’t have room for those today, maybe we’ll do them another day; for now, you can just cook rice how you normally do, and buy naan if necessary.
Writer’s note: I love strong flavors; many people don’t. For this reason I’m going to give a “basic” version. Please feel free to multiply the spices if you feel so inclined. Where I give “one teaspoon” of a spice below, I’d use a tablespoon at home. Chili peppers can vary in heat a lot even within the same type, so what I do for any given batch is taste one (raw), judge the heat, and use an appropriate number of peppers accordingly. If you don’t want to do that, I suggest just guessing low (as per the instructions below) and if you find at the end you want more heat, you can always stir in a little hot sauce. I know that sounds heretical, but at the end of the day, the primary goal of cooking is to have the meal you want at the end of it.
You will need
- 1 1/2 cups red lentils
- 1 large onion, chopped
- 1 large bulb garlic, minced
- 1 oz ginger, grated
- 2 hot peppers (e.g. serrano), chopped
- 1 tsp ground cumin
- 1 tsp ground coriander
- 1 tsp ground turmeric
- 1 tsp garam masala (this is also ground, but it doesn’t come any other way)
- 1 tsp chili flakes (omit if you’re not a fan of heat)
- 2 tsp cracked black pepper
- 1 tsp salt ← I wouldn’t recommend multiplying this one unless later, to taste. In fact, instead of 1 tsp salt I use 2 tsp MSG, which has less sodium than 1 tsp salt. But “1 tsp salt” is the “easy to find in the store” version.
- 2 large or 3 small tomatoes, chopped (or 1 can chopped tomatoes)
- 2 shallots, thinly sliced
- 1 tsp cumin seeds
- 1 tsp mustard seeds
- 1 tsp coriander seeds
- 1 tsp black peppercorns
- 1 lime
- 1/2 cup fresh cilantro, or if you have the “that tastes like soap” gene, parsley, chopped
- Coconut oil for cooking (if you don’t like coconut, consider springing for avocado oil—if you use olive oil, it’ll add an olivey taste which changes the dish a lot; not inherently bad, but it feels a lot less like traditional daal; seed oils are less healthy and we don’t recommend them; ghee is a traditional option and not bad in moderation, but not as healthy as the oils we mentioned first)
- Water for cooking the lentils
Method
(we suggest you read everything at least once before doing anything)
1) In a saucepan, boil water and add the lentils; let them simmer while doing the next things.
2) Sauté the onions until translucent. This should only take a few minutes.
3) Add the garlic, ginger, and hot peppers, and keep stirring for another couple of minutes.
4) Add the ground spices (cumin, coriander, turmeric, garam masala) chili flakes, and cracked black pepper, as well as the salt or MSG if using (not both), and stir them in quickly but thoroughly.
For the next step, you may need to transfer to larger pan if your sauté pan isn’t big enough to take the volume; if so, that’s fine, the sauté has done its job and can have a rest now. If your sauté pan is big enough, just carry on in the same pan; this is perfect.
5) Add the lentils with the water you cooked them in (there might not be much water left now, as the lentils will have absorbed a lot of it; this is fine) as well as the chopped tomatoes.
6) Simmer until it has the consistency of a very thick sauce (you can add a splash more water here and there if it seems to need more). In the West it’s common to serve lentils “al dente”, but in the East it’s usual to (for dishes like this) cook them until they start to
7) Add the juice of at least 1/2 of your lime, or the whole lime if you feel so inclined.
8) In a pre-heated skillet, flash-fry the sliced shallots and the seeds (cumin, coriander, mustard, black peppercorns) at the hottest temperature you can muster. Don’t worry if the oil smokes; we’re only going to be at this tadka-making stage for a moment and nothing will stick provided you keep it moving. When the seeds start popping, it’s ready. Add it all to the big pan and stir in.
9) Add the cilantro-or-parsley garnish once you’re ready to serve.
Enjoy!
Learn more
For those interested in some of the science of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- How Much Spice Is Right?
- Tasty Polyphenols
Take care!
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Keep Cellulite At Bay
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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 😎
❝Does anything actually get rid of cellulite? Nothing seems to❞
Let’s get the bad news over with in one go:
Nothing (that the scientific world currently knows of) can get rid of cellulite permanently, nor completely guard against it proactively. Which, given that it affects up to 98% of women to some degree, and often shows up not long after puberty (though it can appear at any time and often increases later in life), any pre-emptive health regime would need to be started as a child in any case.
As with many things that predominantly affect women, the world of medicine isn’t entirely sure what causes it, let alone how to effectively treat it.
Obviously hormones are implicated, namely estrogen.
Obviously adiposity is implicated, because one can’t have dimples in one’s fat if one doesn’t have enough fat to dimple.
Other hypothesized contributory factors include genetics, poor diet, inactivity, unhealthy lifestyle (in ways not previously mentioned, e.g. use of alcohol, tobacco, etc), accumulated toxins, and pregnancy.
Here’s an old paper (from 2004); today’s reviews say pretty much the same thing, but we love how succinctly (albeit, somewhat depressingly) this abstract states how little we know and how little we can do:
Cellulite: a review of its physiology and treatment
However, all is not lost!
There are some things that can affect how much cellulite we get, and there are some things that can reduce it, and even some things that can get rid of it completely—albeit temporarily.
First, a quick refresher on what it actually is, physiologically speaking: cellulite occurs when connective tissue bands pull the skin down in places, where fat tissue has been able to squeeze through. One of the reasons it is hypothesized women get this more than men is because our fat is not merely different in distribution and overall percentage, but also in how the fat cells stack up; we generally have have of a vertical stacking structure going on, while men generally have a more horizontal structure. This means that it can be easier for ours to get moved about differently, causing the connective tissue to pull on the skin unevenly in places.
With that in mind…
Prevention is, as we say, probably impossible if your body is running on estrogen. However, those contributory factors we mentioned above? Most of those are modifiable, including these things that it is hypothesized can reduce it:
Diet: as it seems to be worsened by inflammation (what isn’t?), an anti-inflammatory diet is recommended.
Exercise: there are three things here: 1) exercises to improve circulation and thus the body’s ability to sort things out by itself 2) HIIT exercise to reduce body fat percentage, if one has a high enough starting body fat percentage for that to be a healthy goal 3) mobility exercises, to ensure our connective tissues are the right amount of mobile.
Creams and lotions
These reduce the superficial appearance of cellulite, without actually treating the thing itself. Mostly they are caffeine-based, which when used topically increases blood flow and works as a local diuretic, reducing the water content of the fat cells, diminishing the appearance of the cellulite by making each fat cell physically smaller (while still containing the same amount of fat, and it’ll bounce back in size as soon as the body can restore osmotic balance).
Medical procedures
There are too many of these to discuss them all separately, but they all work on the principle of breaking up the tough bands of connective tissue to eliminate the dimpling of cellulite.
The methods they use vary from ultrasound to cryolipolysis to lasers to “vacuum-assisted precise tissue release”, which involves a suction pump and a multipronged robotic assembly with needles to administer anaesthetic as it goes and small blades to cut the connective tissues under the skin:
Tissue Stabilized–Guided Subcision for the Treatment of Cellulite
That last one definitely sounds like the least fun, but it’s also the only one that doesn’t take months to maybe see results.
Cellulite can and almost certainly will come back after all of these.
Home remedies
Aside from at-home versions of the above (not the robots with vacuum pumps and needles and microblades, hopefully, but for example homemade caffeine creams), and of course diet and exercise which can be considered “home remedies”, there are two more things worth mentioning:
Dry brushing: using a body brush to, as the name suggests, simply brush one’s skin. The “dry” aspect here is simply that it’s not done in the bath or shower; it’s done while dry. It can improve local circulation of blood and lymph, allowing for better detoxification and redistribution of needed bodily resources.
Here’s an example dry brushing body brush on Amazon; this writer has one and hates it, but I’ve also tried with other kinds of brush and hate them too, so it seems to be a me thing rather than a brush thing, and I have desisted in trying, now. Maybe you will like it better; many people do.
Self-massage: or massage by someone else, if that’s an option for you and you prefer. In this case, it works by a different mechanism than dry brushing; this time it’s working by the same principle as the medical techniques described in the previous section; it’s physically breaking down the toughened bits of connective tissue.
Here’s an example wooden massage roller on Amazon; this writer has one and loves it; it’s sooooooo good. I got it as a matter of general maintenance for my fascia, but it’s also very good if I get a muscular pain now and again. As for cellulite, I personally get just a little cellulite sometimes (in the backs of my thighs), and whenever I use this regularly, it goes away for at least a while.
A quick note in closing
Cellulite is normal for women and is not unhealthy. Much like gray hair for example, it’s something that can be increased by poor health, but the thing itself isn’t intrinsically unhealthy, and most of us get it to some degree at some point.
Nevertheless, aesthetic factors can also have a role to play in mental health, and we tend to feel best when we like the way our body looks. If for you that means wanting less/no cellulite, then the above are some ways towards that.
As a bonus, most of the nonmedical options are directly good for the physical health anyway, so doing them is of course good.
In particular that last one (the wooden massage roller), because that connective tissue we talked about? It matters for a lot more than just cellulite, and is heavily implicated in a lot of kinds of chronic pain, so it pays to keep it in good health:
Fascia: Why (And How) You Should Take Care Of Yours
(that article, also written by this same writer by the way, suggests a vibrating foam roller—those are very popular; I just really love my wooden one, and find it more effective)
Take care!
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What Teas To Drink Before Bed (By Science!)
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Which Sleepy Tea?
Herbal “tea” preparations (henceforth we will write it without the quotation marks, although these are not true teas) are popular for winding down at the end of a long day ready for a relaxing sleep.
Today we’ll look at the science for them! We’ll be brief for each, because we’ve selected five and have only so much room, but here goes:
Camomile
Simply put, it works and has plenty of good science for it. Here’s just one example:
❝Noteworthy, our meta-analysis showed a significant improvement in sleep quality after chamomile administration❞
Also this writer’s favourite relaxation drink!
(example on Amazon if you want some)
Lavender
We didn’t find robust science for its popularly-claimed sedative properties, but it does appear to be anxiolytic, and anxiety gets in the way of sleep, so while lavender may not be a sedative, it may calm a racing mind all the same, thus facilitating better sleep:
(example on Amazon if you want some)
Magnolia
Animal study for the mechanism:
Human study for “it is observed to help humans sleep better”:
As you can see from the title, its sedative properties weren’t the point of the study, but if you click through to read it, you can see that they found (and recorded) this benefit anyway
(example on Amazon if you want some)
Passionflower
There’s not a lot of evidence for this one, but there is some. Here’s a small study (n=41) that found:
❝Of six sleep-diary measures analysed, sleep quality showed a significantly better rating for passionflower compared with placebo (t(40) = 2.70, p < 0.01). These initial findings suggest that the consumption of a low dose of Passiflora incarnata, in the form of tea, yields short-term subjective sleep benefits for healthy adults with mild fluctuations in sleep quality.❞
So, that’s not exactly a huge body of evidence, but it is promising.
(example on Amazon if you want some)
Valerian
We’ll be honest, the science for this one is sloppy. It’s very rare to find Valerian tested by itself (or sold by itself; we had to dig a bit to find one for the Amazon link below), and that skews the results of science and renders any conclusions questionable.
And the studies that were done? Dubious methods, and inconclusive results:
Nevertheless, if you want to try it for yourself, you can do a case study (i.e., n=1 sample) if not a randomized controlled trial, and let us know how it goes 🙂
(example on Amazon if you want some)
Summary
- Valerian we really don’t have the science to say anything about it
- Passionflower has some nascent science for it, but not much
- Lavender is probably not soporific, but it is anxiolytic
- Magnolia almost certainly helps, but isn’t nearly so well-backed as…
- Camomile comes out on top, easily—by both sheer weight of evidence, and by clear conclusive uncontroversial results.
Enjoy!
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Half Of Americans Over 50 Have Hemorrhoids, But They Can Be Prevented!
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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
❝Hello. I was hoping you could give some useful tips about how to avoid a painful ailment that has affected Ernest Hemingway, Karl Marx, David Livingstone, Napoleon, Marilyn Monroe, King Alfred, and Martin Luther, and, I confess, me from time to time … namely, hemorrhoids. Help!❞
Firstly: that list could be a lot longer! We don’t have global stats, but in the US for example, half of adults over 50 have hemorrhoids.
So, you’re certainly not alone. People just don’t talk about it.
But, there are preventative things you can do:
Fiber, fiber, fiber. See also:
Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Hydrate, hydrate, hydrate.
This one’s simple enough. If you are dehydrated, constipation is more likely, and with it, hemorrhoids.
Watch your meds…
Some medications can cause constipation—painkillers containing codeine are a common culprit, for example.
When you go, go!
Not only can prolonged straining promote hemorrhoids, but also (if you’ll pardon the phrasing—there’s only so delicately we can say this) simply sitting with things partway “open” down there is not good for its health; things can quickly become irritated, and that can lead to hemorrhoids.
So: when you go, go. Leave your phone in another room!
Wash—but carefully.
Beyond your normal showering/bathing routine, a bidet is a great option for keeping things happy down there, if you have that option available to you.
However, if you have hemorrhoids, don’t use soap, as this can cause irritation and make it worse.
Warm water is fine, as is a salt bath, and pat dry and/or use gentle wet-wipes rather than rougher paper.
You can follow up with a hemorrhoid cream of your choice (or hydrocortisone, unless that’s contraindicated by another condition you have)
Know when to seek help
Hemorrhoids will usually go away by themselves if not exacerbated. But if it’s getting unduly difficult, and/or you’re bleeding down there, it’s time to see a doctor.
Note on bleeding: even if you’re 100% sure you have hemorrhoids, there are still other reasons you could be bleeding, and so it needs checking out.
Hemorrhoid treatment, if needed, will vary depending on severity. Beyond creams and lotions, there are other options that are less fun but sometimes necessary, including injections, electrotherapy, banding, or surgery.
Take care!
Don’t Forget…
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What Your Brain Is Really Doing When You’re Doing “Nothing”
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Unless we are dead, our brain is never truly inactive. And it’s not just a matter of regulating autonomic functions, either…
Default Mode Network
When the brain is at rest but not necessarily asleep, the Default Mode Network (DMN) engages. This makes up for around 20% of the brain’s overall activity, and contributes to complex cognitive processes.
What constitutes “at rest”: the DMN activates when external tasks stop and is engaged during self-reflection, mind-wandering, and relaxed memory recall (i.e. reminiscing, rather than answering questions in a difficult test, for example).
As for its neurophysiology, the DMN is connected to the hippocampus and plays a key role in episodic, prospective, and semantic memory (memories of experiences, future plans, and general knowledge), as well as being involved in self-reflection, social cognition, and understanding others’ thoughts (theory of mind). The DMN thus also helps integrate memories and thoughts to create a cohesive internal narrative and sense of self.
However, it doesn’t work alone: the DMN interacts with other networks like the salience network, which switches attention to external stimuli. Disruptions between these networks are linked to psychiatric disorders (e.g., schizophrenia, Alzheimer’s, depression), in various different ways depending on the nature of the disruption.
Sometimes, for some people in some circumstances, the option to disrupt the DMN is useful. For example, research shows that psilocybin disrupts the DMN, leading to changes in brain activity and potential therapeutic benefits for depression* and other psychiatric disorders by enhancing neuroplasticity.
*Essentially, kicking the brain out of the idling gear it got stuck in, and into action
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- The Wandering Mind – by Dr. Michael Corballis ← a book, largely about the DMN and how to use it beneficially
- Taking A Trip Through The Evidence On Psychedelics ← for a shorter read, touching on psilocybin
Take care!
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Health & Happiness From Outside & In
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A friend in need…
In a recent large (n=3,486) poll across the US:
- 90% of people aged 50 and older say they have at least one close friend
- 75% say they have enough close friends
- 70% of those with a close friend say they can definitely count on them to provide health-related support
However, those numbers shrink by half when it comes to people whose physical and/or mental health is not so great, resulting in a negative feedback loop of fewer close friends whom one sees less often, and progressively worse physical and/or mental health. In other words, the healthier you are, the more likely you are to have a friend who’ll support you in your health:
Read in full: Friendships promote healthier living in older adults, says new survey
Related: How To Beat Loneliness & Isolation
Kindness makes a difference to healthcare outcomes
Defining kindness as action-oriented, positively focused, and purposeful in nature, this sets kindness apart from compassion and empathy, when it’s otherwise often been conflated with those, and thus overlooked. This also means that kindness can still be effected when clinicians are too burned-out to be compassionate, and/or when patients are not in a state of mind where empathy is useful.
Furthermore, unkindness (again, as defined by this review) was found in large studies to be the root cause of ¾ of patient harm events in hospital settings. This means that far from being a wishy-washy abstraction, kindness/unkindness can be a very serious factor when it comes to healthcare outcomes:
Read in full: Review suggests kindness could make for better health care
Related: The Human Touch vs AI, The Doctor That Never Tires
The gift of health?
🎵 Last Christmas, I gave you my heart
Which turned out to be a silly idea
This year, to save me from tears
I’ll just get you a Fitbit or something🎵Health & happiness go hand in hand, so does that make health stuff a good gift? It can do! But there are also plenty of opportunities for misfires.
For example, getting someone a gym membership when they don’t have time for that may not help them at all, and sports equipment that they’ll use once and then leave to gather dust might not be great either. In contrast, the American Heart Association recommends to first consider what they enjoy doing, and work with that, and ideally make it something versatile and/or portable. Wearable gadgets are a fine option for many, but a gift doesn’t have to be fancy to be good—with a blood pressure monitoring cuff being a suggestion from Dr. Sperling (a professor of preventative cardiology):
Read in full: Oh, there’s no gift like health for the holidays
Related: Here’s Where Activity Trackers Help (And Also Where They Don’t)
How you use social media matters more than how much
A study commissioned by the European Commission’s Joint Research Centre found that while the quantity of time one spends on social media is not associated (positively or negatively) with loneliness, they did find a correlation between passive (as opposed to engaged) use of social media, and loneliness. In other words, people who were chatting with friends less, were more lonely! Shocking news.
While the findings may seem obvious, it does present a call-to-action for anyone who is feeling lonely: to use social media not just to see what everyone else is up to, but also, to reach out to people.
Read in full: Unpacking the link between social media and loneliness
Related: Make Social Media Work For Your Mental Health Rather Than Against It
Gut-only antidepressants
Many antidepressants work by increasing serotonin levels in the brain; a new study suggests that targeting antidepressants to work only in the gut (which is where serotonin is made, not the brain) could not only be an effective treatment for mood disorders, but also cause fewer adverse side-effects:
Read in full: Antidepressants may act in gut to reduce depression and anxiety
Related: Antidepressants: Personalization Is Key!
Take care!
Don’t Forget…
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