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:

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:

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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  • Beetroot vs Red Cabbage – Which is Healthier?

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    Our Verdict

    When comparing beetroot to red cabbage, we picked the red cabbage.

    Why?

    Both are great, and both have their strengths!

    In terms of macros, beetroot has very slightly more protein, carbs, and fiber, but the margins of difference are very small in each case. However, in terms of glycemic index, red cabbage has the considerably lower glycemic index, of 32 (low) as opposed to beetroot’s GI of 64 (medium). On the strength of this GI difference, we call this category a win for red cabbage.

    In the category of vitamins, beetroot has more of vitamin B9, while red cabbage has a lot more of vitamins A, B1, B2, B3, B6, C, E, K, and choline. By strength of numbers and also by having very large margins of difference on most of those, red cabbage is the clear winner here.

    When it comes to minerals, beetroot has more copper, magnesium, manganese, phosphorus, and potassium, while red cabbage has more calcium (and about ⅓ of the sodium). By the numbers, this is a win for beetroot, though it’s worth noting that the margins of difference were small, i.e. red cabbage was right behind beetroot on each of those.

    Adding up the sections makes for an overall red cabbage win, but as we say, beetroot is great too, especially when it comes to minerals!

    As ever, enjoy either or both; diversity is good.

    Want to learn more?

    You might like to read:

    No, beetroot isn’t vegetable Viagra. But here’s what it can do!

    Enjoy!

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  • The Brain As A Work-In-Progress

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    And The Brain Goes Marching On!

    In Tuesday’s newsletter, we asked you “when does the human brain stop developing?” and got the above-depicted, below-described, set of responses:

    • About 64% of people said “Never”
    • About 16% of people said “25 years”
    • About 9% of people said “65 years”
    • About 5% of people said “13 years”
    • About 3% of people said “18 years”
    • About 3% of people said “45 years”

    Some thoughts, before we get into the science:

    An alternative wording for the original question was “when does the human brain finish developing”; the meaning is the same but the feeling is slightly different:

    • “When does the human brain stop developing?” focuses attention on the idea of cessation, and will skew responses to later ages
    • When does the human brain finish developing?” focuses on attention on a kind of “is it done yet?” and will skew responses to earlier ages

    Ultimately, since we had to chose one word or another, we picked the shortest one, but it would have been interesting if we could have done an A/B test, and asked half one way, and half the other way!

    Why we picked those ages

    We picked those ages as poll options for reasons people might be drawn to them:

    • 13 years: in English-speaking cultures, an important milestone of entering adolescence (note that the concept of a “teenager” is not precisely universal as most languages do not have “-teen” numbers in the same way; the concept of “adolescent” may thus be tied to other milestones)
    • 18 years: age of legal majority in N. America and many other places
    • 25 years: age popularly believed to be when the brain is finished developing, due to a study that we’ll talk about shortly (we guess that’s why there’s a spike in our results for this, too!)
    • 45 years: age where many midlife hormonal changes occur, and many professionals are considered to have peaked in competence and start looking towards retirement
    • 65 years: age considered “senior” in much of N. America and many other places, as well as the cut-off and/or starting point for a lot of medical research

    Notice, therefore, how a lot of things are coming from places they really shouldn’t. For example, because there are many studies saying “n% of people over 65 get Alzheimer’s” or “n% of people over 65 get age-related cognitive decline”, etc, 65 becomes the age where we start expecting this—because of an arbitrary human choice of where to draw the cut-off for the study enrollment!

    Similarly, we may look at common ages of legal majority, or retirement pensions, and assume “well it must be for a good reason”, and dear reader, those reasons are more often economically motivated than they are biologically reasoned.

    So, what does the science say?

    Our brains are never finished developing: True or False?

    True! If we define “finished developing” as “we cease doing neurogenesis and neuroplasticity is no longer in effect”.

    Glossary:

    • Neurogenesis: the process of creating new brain cells
    • Neuroplasticity: the process of the brain adapting to changes by essentially rebuilding itself to suit our perceived current needs

    We say “perceived” because sometimes neuroplasticity can do very unhelpful things to us (e.g: psychological trauma, or even just bad habits), but on a biological level, it is always doing its best to serve our overall success as an organism.

    For a long time it was thought that we don’t do neurogenesis at all as adults, but this was found to be untrue:

    How To Grow New Brain Cells (At Any Age)

    Summary of conclusions of the above: we’re all growing new brain cells at every age, even if we be in our 80s and with Alzheimer’s disease, but there are things we can do to enhance our neurogenic potential along the way.

    Neuroplasticity will always be somewhat enhanced by neurogenesis (after all, new neurons get given jobs to do), and we reviewed a great book about the marvels of neuroplasticity including in older age:

    The Brain’s Way of Healing: Remarkable Discoveries and Recoveries from the Frontiers of Neuroplasticity – by Dr. Norman Doidge

    Our brains are still developing up to the age of 25: True or False?

    True! And then it keeps on developing after that, too. Now this is abundantly obvious considering what we just talked about, but see what a difference the phrasing makes? Now it makes it sound like it stops at 25, which this statement doesn’t claim at all—it only speaks for the time up to that age.

    A lot of the popular press about “the brain isn’t fully mature until the age of 25” stems from a 2006 study that found:

    ❝For instance, frontal gray matter volume peaks at about age 11.0 years in girls and 12.1 years in boys, whereas temporal gray matter volume peaks at about age at 16.7 years in girls and 16.2 years in boys. The dorsal lateral prefrontal cortex, important for controlling impulses, is among the latest brain regions to mature without reaching adult dimensions until the early 20s.❞

    ~ Dr. Jay Giedd

    Source: Structural Magnetic Resonance Imaging of the Adolescent Brain

    There are several things to note here:

    • The above statement is talking about the physical size of the brain growing
    • Nowhere does he say “and stops developing at 25”

    However… The study only looked at brains up to the age of 25. After that, they stopped looking, because the study was about “the adolescent brain” so there has to be a cut-off somewhere, and that was the cut-off they chose.

    This is the equivalent of saying “it didn’t stop raining until four o’clock” when the reality is that four o’clock is simply when you gave up on checking.

    The study didn’t misrepresent this, by the way, but the popular press did!

    Another 2012 study looked at various metrics of brain development, and found:

    • Synapse overproduction into the teens
    • Cortex pruning into the late 20s
    • Prefrontal pruning into middle age at least (they stopped looking)
    • Myelination beyond middle age (they stopped looking)

    Source: Experience and the developing prefrontal cortexcheck out figure 1, and make sure you’re looking at the human data not the rat data

    So how’s the most recent research looking?

    Here’s a 2022 study that looked at 123,984 brain scans spanning the age range from mid-gestation to 100 postnatal years, and as you can see from its own figure 1… Most (if not all) brain-things keep growing for life, even though most slow down at some point, they don’t stop:

    Brain charts for the human lifespancheck out figure 1; don’t get too excited about the ventricular volume column as that is basically “brain that isn’t being a brain”. Do get excited about the rest, though!

    Want to know how not to get caught out by science being misrepresented by the popular press? Check out:

    How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

    Take care!

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  • How Aging Changes At 44 And Again At 60 (And What To Do About It)

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    As it turns out, aging is not linear. Or rather: chronological aging may be, but biological aging isn’t, and there are parts of our life where it kicks into a different gear. This study looked at 108 people (65 of whom women) between the ages of 25 and 75, as part of a longitudinal cohort study, tracked for around 2–8 years (imprecise as not all follow-up durations were the same). They took frequent blood and urine samples, and tested them for thousands of different molecules and analyzing changes in gene expression, proteomic, blood biomarkers, and more. All things that are indicators of various kinds of health/disease, and which might seem more simple but it isn’t: aging.

    Here’s what they found:

    Landmark waypoints

    At 44, significant changes occur in the metabolism, including notably the metabolism of carbs, caffeine, and alcohol. A large portion of this may be hormone related, as that’s a time of change not just for those undergoing the menopause, but also the andropause (not entirely analogous to the menopause, but it does usually entail a significant reduction in sex hormone production; in this case, testosterone).

    However, the study authors also hypothesize that lifestyle factors may be relevant, as one’s 40s are often a stressful time, and an increase in alcohol consumption often occurs around the same time as one’s ability to metabolize it drops, resulting in further dysfunctional alcohol metabolism.

    At 60, carb metabolism slows again, with big changes in glucose metabolism specifically, as well as an increased risk of cardiovascular disease, and a decline in kidney function. In case that wasn’t enough: also an increase free radical pathology, meaning a greatly increased risk of cancer. Immune function drops too.

    What to do about this: the recommendation is of course to be proactive, and look after various aspects of your health before it becomes readily apparent that you need to. For example, good advice for anyone approaching 44 might be to quit alcohol, go easy on caffeine, and eat a diet that is conducive to good glucose metabolism. Similarly, good advice for anyone approaching 60 might be to do the same, and also pay close attention to keeping your kidneys healthy. Getting regular tests done is also key, including optional extras that your doctor might not suggest but you should ask for, such as blood urea nitrogen levels (biomarkers of kidney function). The more we look after each part of our body, the more they can look after us in turn, and the fewer/smaller problems we’ll have down the line.

    If you, dear reader, are approaching the age 44 or 60… Be neither despondent nor complacent. We must avoid falling into the dual traps of “Well, that’s it, bad health is around the corner, nothing I can do about it; that’s nature”, vs “I’ll be fine, statistics are for other people, and don’t apply to me”.

    Those are averages, and we do not have to be average. Every population has statistical outliers. But it would be hubris to think none of this will apply to us and we can just carry on regardless. So, for those of us who are approaching one of those two ages… It’s time to saddle up, knuckle down, and do our best!

    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:

    Also, if you’d like to read the actual paper by Dr. Xiaotao Shen et al., here it is:

    Nonlinear dynamics of multi-omics profiles during human aging ← honestly, it’s a lot clearer and more informative than the video, and also obviously discusses things in a lot more detail than we have room to here

    Take care!

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  • What’s Lurking In Your Household Air?

    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.

    As individuals, we can’t do much about the outside air. We can try to spend more time in green spaces* and away from traffic, and we can wear face-masks—as was popular in Tokyo and other such large cities long before the pandemic struck.

    *The well-known mental health benefits aside (and contrary to British politician Amber Rudd’s famous assertion in a televised political debate that “clean air doesn’t grow on trees”), clean air comes mostly from trees—their natural process of respiration scrubs not only carbon dioxide, but also pollutants, from the air before releasing oxygen without the pollutants. Neat!

    See also this study: Site new care homes near trees and away from busy roads to protect residents’ lungs

    We are fortunate to be living in a world where most of us in industrialized countries can exercise a great degree of control over our home’s climate. But, what to do with all that power?

    Temperature

    Let’s start with the basics. Outside temperature may vary, but you probably have heating and air conditioning. There’s a simple answer here; the optimal temperature for human comfort and wellbeing is 20℃ / 68℉:

    Scientists Identify a Universal Optimal Temperature For Life on Earth

    Note: this does not mean that that is the ideal global average temperature, because that would mean the polar caps are completely gone, the methane stored there released, many large cities underwater, currently hot places will be too hot for human life (e.g. outside temperatures above human body temperature), there will be mass extinctions of many kinds of animals and plants, including those we humans require for survival, and a great proliferation of many bugs that will kill us. Basically we need diversity for the planet to survive, arctic through to tropical and yes, even deserts (deserts are important carbon sinks!). The ideal global average temperature is about 14℃ (we currently have about 15℃ and rising).

    But, for setting the thermostat in your home, 20℃ / 68℉ is perfect for most people, though down as far as 17℃ / 61℉ is fine too, provided other things such as humidity are in order. In fact, for sleeping, 18℃ / 62℉ is ideal. This is because the cooler temperature is one of the several things that tell our brain it is nighttime now, and thus trigger secretion of melatonin.

    If you’re wondering about temperatures and respiratory viruses, by the way, check out:

    The Cold Truth About Respiratory Infections: The Pathogens That Came In From The Cold

    Humidity

    Most people pay more attention to the temperature in their home than the humidity, and the latter is just as important:

    ❝Conditions that fall outside of the optimal range of 40–60% can have significant impacts on health, including facilitating infectious transmission and exacerbating respiratory diseases.

    When humidity is too low, it can cause dryness and irritation of the respiratory tract and skin, making individuals more susceptible to infections.

    When humidity is too high, it can create a damp environment that encourages the growth of harmful microorganisms like mould, bacteria, and viruses.❞

    ~ Dr. Gabriella Guarnieri et al.

    So, if your average indoor humidity falls outside of that range, consider getting a humidifier or dehumidifier, to correct it. Example items on Amazon, for your convenience:

    Humidity monitor | Humidifier | Dehumidifier

    See also, about a seriously underestimated killer:

    Pneumonia: Prevention Is Better Than Cure

    Now, one last component to deal with, for perfect indoor air:

    Pollution

    We tend to think of pollution as an outdoors thing, and indeed, the pollution in your home will (hopefully!) be lower than that of a busy traffic intersection. However…

    • The air you have inside comes from outside, and that matters if you’re in an urban area
    • Even in suburban and rural areas, general atmospheric pollutants will reach you, and if you’ve ever been subject to wildfire smoke, you’ll know that’s no fun either.
    • Gas appliances in the home cause indoor pollution, even when carbon monoxide is within levels considered acceptable. This polluting effect is much stronger for open gas flames (such as on gas cookers/stoves, or gas fires), than for closed gas heating systems (such as a gas-powered boiler for central heating).
    • Wood stoves/fireplaces are not an improvement, in fact they are worse, and don’t get us started on coal. You should not be breathing these things, and definitely should not be burning them in an enclosed space.
    • That air conditioning, humidifier, dehumidifier? They may be great for temperature and humidity, but please clean/change the filter more often than you think is necessary, or things will grow there and then your device will be adding pathogens to the air as it goes.
    • Plug-in air-freshening devices? They may smell clean, but they are effectively spraying cleaning fluids into your lungs. So please don’t.

    So, what of air purifiers? They can definitely be of benefit. for example:

    Air Purifiers & Sleep

    But watch out! Because if you don’t clean/change the filter regularly, guess what happens! That’s right, it’ll be colonized with bacteria/fungus and then be blowing those at you.

    And no, not all of them will be visible to the naked eye:

    Is Unnoticed Environmental Mold Harming Your Health?

    Taking a holistic approach

    The air is a very important factor for the health of your lungs (and thus, for the health of everything that’s fed oxygen by your lungs), but there are more things we can do as well:

    Seven Things To Do For Good Lung Health!

    Take care!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Hope Not Nope – by Dr. Dillon Caswell

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    The author a Doctor of Physical Therapy, writes from both professional expertise and personal experience, when it comes to the treatment of long term injury / disability / chronic illness.

    His position here is that while suffering is unavoidable, we don’t have to suffer as much or as long as many might tell us. We can do things to crawl and claw our way to a better position, and we do not have to settle for any outcome we don’t want. That doesn’t mean there’s always a miracle cure—we don’t get to decide that—but we do get to decide whether we keep trying.

    Dr. Caswell’s advice is based mostly in psychology—a lot of it in sports psychology, which is no surprise given his long history as an athlete as well as his medical career.

    The style is very easy-reading, and a combination of explanation, illustrative (often funny) anecdotes, and a backbone of actual research to keep everything within the realms of science rather than mere wishful thinking—he strikes a good balance.

    Bottom line: if your current health outlook is more of an uphill marathon, then this book can give you the tools to carry yourself through the healthcare system that’s been made for numbers, not people.

    Click here to check out Hope Not Nope, and keep going!

    Don’t Forget…

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    Learn to Age Gracefully

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  • Type 2 Diabetic Foot Problems

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    It’s Q&A Day!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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

    Q: I’d like to know more about type 2 diabetic foot problems

    You probably know that the “foot problems” thing has less to do with the feet and more to do with blood and nerves. So, why the feet?

    The reason feet often get something like the worst of it, is because they are extremities, and in the case of blood sugars being too high for too long too often, they’re getting more damage as blood has to fight its way back up your body. Diabetic neuropathy happens when nerves are malnourished because the blood that should be keeping them healthy, is instead syrupy and sluggish.

    We’ll definitely do a main feature sometime soon on keeping blood sugars healthy, for both types of diabetes plus pre-diabetes and just general advice for all.

    In the meantime, here’s some very good advice on keeping your feet healthy in the context of diabetes. This one’s focussed on Type 1 Diabetes, but the advice goes for both:

    !

    Don’t Forget…

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    Learn to Age Gracefully

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