MOST DAILY nutrition requirements are best met through diet. But when it comes to Vitamin B12, an extra boost can help, especially for those 50 and older. For this age group, the recommendation from the Institute of Medicine (IOM) is to get “most” daily B12 through supplements or fortified foods.
Low vitamin B12 has been linked to both depression and dementia—specifically “poor memory and trouble thinking”—as well as fatigue, muscle weakness, constipation and other intestinal difficulties, and trouble maintaining balance, according to a recent article in Live Science.
Vitamin B12 deficiency was listed as one of two causes of depression, alongside hypothyroidism, in a New York Times diagnosis column last month.
Many of these symptoms are related to anemia, but neurological difficulties can occur before or without anemia. (These symptoms can also be triggered by medical conditions other than B12 deficiency.)
Though low B12 levels have been found across all age groups starting at age 26, adults over age 50 are at particular risk due to thinning of the stomach lining —“atrophic gastritis”—that interferes with B12 absorption.
Other impediments to absorption include antibiotics, especially when taken over a long period of time, and tetracycline in particular—as well as other medications such as colchicine (used to treat gout). Vitamin B12 deficiency caused by absorption problems affects between 1.5% and 15% of the public.
Vitamin B12 aids in the production of red blood cells, facilitating transport of oxygen to the organs, and affects cell metabolism and DNA production—with notable effects on immune function and mood.
B12 supplements can work quickly to improve mood. After little more than a week taking supplements, a friend who had been struggling with low-mood issues for years, wrote via e-mail that he felt “pretty good.” He said, “I am still amazed that none of my doctors or psychologists raised this issue, and [previous] tests never flagged the level in the same way as the University of Pittsburgh Medical Center (UPMC) did.”
Before taking supplements, his level was 321 pg/ml (picograms/milliliter) and over the years had hovered around 300. At UPMC, he was advised to take the oral dose typical for those with low levels: beginning with 2000mcg/day for 4-5 days, and then moving to 1000/day.
(These amounts are 50-100 times the RDA: in fact, in 2016, the FDA lowered the daily value recommended for adults to 2.5 mcg.)
After one month, his level registered 738, and he’s feeling good. Although aware that the placebo effect may be playing a role, he has high hopes.
The “reference range” for B12, which includes 95% of the healthy population, is 200-1100 pg/ml. However, according to the UPMC evaluation report, 5 to 10% of patients with values between 200-400 pg/ml (picograms/milliliter) report neuropsychiatric difficulties. Only 1% of patients with values above 400 report problems.
Most people with difficulty absorbing B12 from food can more easily absorb the synthetic vitamin added to fortified foods and dietary supplements, according to the NIH Vitamin B12 factsheet. While intramuscular injections of vitamin B12 traditionally given to bypass absorption problems are still often the standard treatment for B12 deficiency, research on oral supplements shows they work equally well.
Although B12 has not been proven to have an independent effect on cognition, low B12 levels have been positively associated with cognitive decline. Because B12 is water-soluble, the body generally absorbs as much as it needs and gets rid of the rest. As a result of its “low potential for toxicity,” the IOM has not established an upper level for B12, although blood levels over 900 pg/ml could reflect poor absorption.
Anyone who wants to raise their B12 levels should not forget food. Except for vegans, most people get a healthy amount of B12 from animal sources: fish, red meat, poultry and eggs. For a quick boost, the highest B12 levels are found in clams and beef liver, but even containing much lower levels, fortified breakfast cereals can supply 100% of the daily recommended amount. (See NIH chart.)
—Mary Carpenter
Well-Being Editor Mary Carpenter writes every Tuesday about the ins and outs of staying healthy.
THIS FLU SEASON, a little more than halfway over, is turning out to be the worst in 10 years. Unusually, those ages 50-64 —rather than infants—are the second most likely to be hospitalized after those over 65.
“Baby boomers have higher hospitalization rates than their grandchildren right now,” said Daniel B. Jernigan, director of the Centers for Disease Control and Prevention’s (CDC) influenza division.
Anyone who has not yet had a shot should get one—even those who have already had the flu, because there are several flu strains involved. For those whose first bout was caused by Strain B—which occurs in about 10 to 15% of the cases, though most don’t get tested—there is little cross-protection, and this year Strain A (H3N2) is the worst culprit.
In 2018, we’re seeing more of the Influenza A-H3N2 than any other strain, according to Kristen Nordlund, press officer for the CDC. And any year in which this is the dominant strain tends to be worse than usual—like during the 2014-15 season, when an estimated 34 million people came down with the flu.
The reason: this year’s vaccine protection for H3N2 is estimated around 30% in the U.S., although small studies found it as low as 10% in Australia and around 17% in Canada. Still, the vaccine is reported to reduce severity and duration of symptoms.
This flu season may well surpass that of 2014-2015, when 710,000 were hospitalized and about 56,000 died. “We’ll expect something around those numbers,” Jernigan said.
For three weeks straight, the health departments of 49 states (all except Hawaii) reported “widespread” flu activity. California and the West Coast were hard hit, with four times as many people hospitalized as in 2014-2015, according to Jernigan. Then New York and the Northeast began catching up. Intensity is high by two different CDC measures.
Flu activity for the past five flu seasons has remained elevated for about 16 weeks. On Friday, February 9 — about week #10— acting CDC Director Anne Suchat said: “We were hoping to have better news to share today, but unfortunately, it looks like the flu season continues to be particularly challenging. Our latest tracking data indicate that influenza activity is still on the rise overall. … We could potentially see several more weeks of increased threat.”
H3N2, which emerged in 1968 as the “Hong Kong” flu, was also responsible for bad seasonal flu in 1997-98 and 2003-04. The most recent bad flu year, 2009, was the “swine flu epidemic” of H1NI, a new virus that was thus more difficult to combat.
Once flu strikes, the CDC recommends prescription antiviral medications like Tamiflu, which work best when taken within 48 hours of onset but can offer some benefits if taken later. Antivirals decrease the flu virus’s ability to reproduce, shortening the severity of symptoms and helping prevent complications.
The way flu strikes makes it different from a cold. Within hours, symptoms can go from nonexistent to severe; and the first symptoms are often fever, up to 103 degrees and higher, and cough, as opposed to the scratchy throat and sniffles that usually precede common colds.
Also unusual about this season, at least anecdotally, is how long symptoms persist —especially a nagging cough—from both flu and garden-variety head colds. Coughing can last for weeks, disturbing sleep as well as the peace of friends, fellow theater and movie-goers and airline passengers.
On airplanes, the most common advice is to rub Neosporin inside the nostrils; trying to avoid proximity to anyone coughing or sneezing; and not turning on the air-blowers, although other passengers’ behavior is hard to control. Some swear by Airborne, which promises to boost the immune system with vitamins and antioxidants as well as the herbal supplement echinacea. Others prefer wearing a mask. Neither has been proven effective against flu.
For the latest information on symptoms to watch out for locally, check out this map.
—Mary Carpenter
Well-Being Editor Mary Carpenter writes our weekly posts about healthy living. Read more here.
SEX AND AGE can increase the risk of a urinary tract infection (UTI), although it’s most common in young to middle-aged women. Waiting too long to go to the bathroom can also up the risk.
The most common bacteria involved in urinary tract infections, E.coli, lives in the intestine of healthy people but causes problems when it moves out of the intestine and into some component of the urinary tract (bladder, kidneys, ureter, urethra).
The most common, cystitis, is E.coli infection of the bladder, known to cause pain while peeing, described as anything from a burning sensation to feeling like you’re peeing razor blades. Other symptoms include the intense urge to pee, needing to pee more often and peeing little when you go. Also urine that looks cloudy, is reddish or smells bad; and pain below the rib cage.
Despite extreme discomfort, bladder infections are considered mild and respond well to antibiotic treatment. On the other hand, infection in the kidneys, responsible for filtering out body waste and creating urine, can have serious health consequences.
Bacteria most often migrates from the intestines during or after sex (when tiny bits of feces can enter the urinary tract). Once its presence is detected in a urine sample, a culture is done to determine which bacteria are causing the infection to pinpoint which medications are most effective.
Alternatively, an over-the-counter (OTC) dipstick test comes with strips that can be dipped in urine, like a pregnancy test, and turn a different color depending on the results, although a positive outcome requires visiting the doctor for a culture. Furthermore, the reliability of these tests can be affected by medications and other factors.
“Azo, however, is very reliable. “Never leave home without it,” one user recommends. OTC Azo is the pain reliever phenazopyridine, which deals with symptoms of pain, burning, increased urination and the increased urge to urinate but doesn’t treat the infection. Azo is known for turning urine dark orange or red, along with causing permanent stains on clothes, discoloring soft contact lenses and altering results from urine tests.
Those who are susceptible to recurring UTIs should drink a lot of water to help dilute the urine and flush out any bacteria in the urinary tract. One woman believes her infection arose after a conference where she didn’t drink enough water and held her pee too long.
Empty your bladder at least every four hours during the day, advises Johns Hopkins gynecologist Tola Fahsokun. And very important: Wipe from front to back. Many suggest urinating as soon as possible after intercourse to help wash bacteria from the urethral opening. Take showers instead of baths and use birth control other than diaphragms or spermicides.
Fahsokun also recommends loose clothing and cotton underwear. If possible, wear nothing at all a few hours a day. Tight and/or synthetic materials can trap heat and moisture, creating more opportunity for bacteria to multiply around the area.
As for cranberry juice, the medical jury is still out. Many sufferers think it’s still worth trying, and some recommend cranberry pills. Used as a treatment in Europe, cranberry pills and herbal teas helped DC-area resident L.S. recover, albeit after days of “misery.” But when she used the remedy again several years later and it didn’t work, she was sorry she’d spent any time trying. “I do not recommend delaying getting medical attention,” she says now.
With aging, decreased vaginal estrogen causes changes in the cellular lining of the vagina, allowing bad bacteria to move too close to the urethra with access to the bladder. For chronic UTIs that occur with menopause, vaginal estrogen therapy can help.
Less than a week of antibiotics resolves most UTIs, but those susceptible to chronic infection are often prescribed low-dose antibiotics for anywhere from a week to up to two years, or are advised to take ahead of time at the first hint of infection.
—Mary Carpenter
For more posts on well-being, check in right here.
FEELING VERY SLEEPY or crappy during the day—even after a good eight hours or more—could be the result of sleep apnea. Sleep apnea treatment has helped at least two DC-area women —though neither had any idea that was the problem.
Sleep disruption may affect more than daytime sleepiness. Recent studies suggest that people experiencing early memory loss can reverse symptoms. Taking measures to improve sleep can help clear toxins from the brain, specifically amyloid-beta proteins that have been linked to Alzheimer’s Disease.
Usually the last to be considered or evaluated among causes of daytime fatigue, sleep apnea is defined as periods during sleep when breathing stops for more than 10 seconds. In the moderate to severe range (waking more than 15-30 times per hour), sleep apnea affects one in 15 adults, is a risk factor for hypertension and occurs in 65% of stroke patients. Of severe cases, 75% remain undiagnosed.
Signs of sleep apnea include lack of energy, morning headaches, frequent nocturnal urination and excessive daytime sleepiness. It has also been linked to depression, susceptibility to frequent illness and gastroesophageal reflux (GERD).
DC-area resident D.T. had several reasons for not investigating the possibility: she’d heard sleep apnea woke you up, but that wasn’t a problem for her; she also believed having a sleep evaluation meant spending a night in a clinic, which sounded “distinctly unappealing.” But most unappealing was what she thought she knew about the solution—a breathing machine that made lots of noise with a mask that looked “horrific.”
But when “pretty crummy” was how D.T. described feeling when she woke up in the morning, the immediate reaction from a retreat group was: it sounds like sleep apnea. One by one, her preconceptions were overcome. First, it turns out that apnea wakes you enough to start breathing again but not necessarily enough to notice.
Next, the sleep evaluation offered by her health provider (Kaiser) is done at home—“in your own bed,” D.T. said, using a clip on the finger to test blood oxygen and a disc taped to the chest. A wristwatch-sized computer logs data to be analyzed when you return the kit.
D.T. learned she had “moderate” apnea—between 15 and 30 incidents of breath-stopping each hour. At a 17-incident average, hers was at the low end. But, very importantly, all the incidents occurred during REM (rapid eye movement) sleep – during which her breath stopped much more often than 17 times/hour. “Basically I was getting no decent REM sleep,” she said.
(REM sleep takes up about 25% of each sleep cycle and begins 70 to 90 minutes after falling asleep. REM sleep helps stabilize the circadian cycle, maintain neural pathways, consolidate memories and clear toxins from the brain and is the period when most intense dreams occur. Missing out on REM sleep interrupts all these processes.)
Besides interrupting sleep, low blood oxygen due to apnea can increase heart and breathing rates and cause anxiety, restlessness, fatigue and headaches. Severe hypoxia can damage the brain, liver and other organs. The most alarming finding for D.T. from her sleep study was that her blood oxygen levels fell as low as 67%.
The treatment generally offered for anything above mild (15 incidents/hour) sleep apnea is the CPAP (Continuous Positive Airway Pressure) machine that pumps oxygen through a hose into the nose. Among the choices that included a nose-and-mouth mask, D.T. chose a mask that covers her nose.
A few weeks into treatment, results are good. She feels less sluggish when she wakes up and better throughout the entire day, especially in the late afternoon when she no longer feels “the urge for a nap or the desire to just veg.” And, going without it for one night, D.T. said: “Big mistake. Same sluggish, super-crummy-but-not-sick feeling as before I started this.”
For A.F., who has been using a CPAP machine for almost 10 years, the difference was dramatic after the very first night, and even one night without it caused enough problems on a four-day business trip that she had a machine overnighted.
“For me, it was huge,” A.F. said. “Now I have so much more energy during the day,” unlike before when her kids often said, “Mom, you’re so tired.” Also, A.F. frequently had a sore throat or felt like she was getting sick. Her sleep study showed 19 incidents/hour.
Noting that she was the one who kept asking for an evaluation, A.F. advises: “You need to be your own advocate.” Her doctors kept suggesting more exercise and a better diet; she also tried typical treatments like thyroid medication and a small device worn over the nose, as well as drinking lots of coffee all day.
Obstructive sleep apnea (OSA) is most often caused by collapse of the upper airway when muscles controlling the soft palate and tongue relax. OSA occurs more often in those who are overweight and those with a large neck circumference, but also in people without those physical attributes and in those with a family history. Incidence increases with age and for post-menopausal women, along with behaviors like smoking and drinking alcohol.
Mild apnea sufferers who cannot tolerate the CPAP machine —because of the noise or discomfort—can try a mechanical device in the mouth that moves the lower jaw forward during sleep to help keep the airway open, known as OAT (oral appliance therapy) or MRD (mandibular repositioning device).
D.T. notes a few weird effects of using the CPAP: If you open your mouth, air streams out and bubbles emerge from your mouth if air pressure builds up. While she likes the humidified air going into her nose, her lips are “very dry” by morning. And there’s the inconvenience of regularly needing to clean the machine’s components, from once weekly to every day.
Another reason for trouble tolerating CPAP is complaints from sleeping partners. The latest version A.F. uses is noisier than before, she said. On the other hand, needing the machine means she is given her own room whenever possible when traveling with friends. And at home, her boyfriend also has a CPAP, as did a previous boyfriend.
Because the diagnosis is not uncommon and many feel well rested after treatment, it might just be worthwhile for anyone experiencing daytime fatigue to take the test.
TOURISTS ENROUTE to Cuba are bombarded with the wonders of the country’s medical prowess: more doctors per capita than anywhere in the world; impressively low rates of heart disease and diabetes; and a cure for lung cancer!
The truth about each of these claims, however, is “muy complicado”—very complicated—a phrase tour guides intone repeatedly in answer to questions about everything from healthcare access to air pollution to the day’s touring schedule.
My cultural excuse for going to Cuba in December was the International Film Festival of New Latin American Cinema, but was mostly to celebrate my sister’s 60th birthday with a bunch of her college friends. Although the trip wasn’t focused on healthcare, I was in contact with a German medical resident in Havana and an American medical volunteer after returning. A trip bonus: my sister’s younger, more energetic and party-loving group, who make fewer references to getting older than mine, gave me a fresh outlook.
The best medical information about Cuba is available about the lung cancer treatment: it’s not a cure but is the first “vaccine” to combat lung cancer, developed by researchers in Cuba. Called CimaVax-EGF, the vaccine mobilizes the patient’s immune system to create antibodies against a protein that contributes to tumor growth.
To date, the vaccine has been given to some 5,000 patients worldwide who lived an average of three to eleven more months, longer for some. It is currently being tested at the Roswell Park Cancer Institute in Buffalo. Most exciting, such a vaccine could eventually transform lung and other cancers into chronic rather than deadly diseases.
In numbers of doctors, Cuba has the highest per capita and earns hefty fees by exporting medical care around the world. Doctors remaining in Cuba are offered a house and office to practice in small communities around the country, as well as no financial incentives to move elsewhere. Thus primary care doctors can become familiar with their patients and begin treating chronic health problems, such as elevated blood pressure, at the earliest signs, writes surgeon and former Republican Senator from Tennessee Bill Frist in Forbes magazine after traveling to Cuba twice in 2015.
Frist describes the “Cuban Health Paradox”—an impoverished country with medical expertise in demand worldwide, and a population with life expectancies rivaling those of much richer countries. Infant mortality rates are lower in Cuba than in the U.S. and much lower than in neighboring Latin American countries. And rates of measles vaccinations are higher than those in the U.S., an important consideration for tourists.
In addition, the government is credited with “providing access to education, housing, and nutrition—key non-medical or social determinants of health,” writes Frist. Cubans “boast ‘first world’ population health status’ because of a combination of attention to social and environmental factors of health paired with planned, accessible primary care.”
The potential downsides of Cuban medicine are also muy complicado. Frist reports shortages of basic medications like aspirin and antibiotics, which are unavailable or sold only on the black market. Others charge that patients must often buy their own sutures and provide bedsheets for hospital stays. Recent medical volunteers, however, say everyone has access to basic medications.
Meanwhile, the best-stocked drug store stopped doing business in 1962. The Museo Farmaceutico in Matanzas, founded in 1882, is a beautifully preserved apothecary shop, with shelves filled floor to (25-foot) ceiling with large glass jars labeled (and apparently containing) everything from laudanum and coca to cod liver oil.
Rates of diabetes and heart disease dropped significantly in the early 1990s during what some call the first “natural experiment” in “sustained population-wide weight loss”—caused by near-famine conditions that occurred after the loss of Soviet economic support. (The situation, called the “special period,” has been compared to that of North Korea; both countries are run by authoritarian regimes that denied food to ordinary people when the public food distribution collapsed.)
Since then, however, average weight has risen along with rates of related conditions, including heart disease. Organic gardens sprout throughout Havana but the produce is too expensive for most Cubans and goes mostly to private restaurants that cater to tourists and the country’s elite. Even in one of the best, though, a “vegetable- and-rice dish” included only olives and a few small pieces of green pepper.
While some say fresh fruit and vegetables are available to Cubans, grocery stores display very few; one had only a few shriveled watermelons. Some visiting doctors charge that Cubans simply prefer tastier fried food, and junk food consumption has been rising steadily over the past 20 years.
Rates of lung disease and asthma are high in Cuba, although reliable statistics are hard to come by. The air feels clean, even in Havana, and there is very little industry. But smoking (including cigars) is allowed almost everywhere. Those gorgeous pre-1959 cars spew all sorts of unfiltered exhaust, and the crumbling buildings where most people live are riddled with mold.
As for the low infant mortality rate, skeptics say pregnant women may be forced to undergo abortions if fetal abnormalities are detected. The rate of abortion is among the highest in Latin America, and abortions are permitted up to 26 weeks. Others suggest that doctors falsify infant and maternal mortality statistics out of fear of losing their jobs.
Finally, many Cubans practice Santeria, which combines beliefs and practices from African sects with those from established religions. Santeria offers spiritual as well as medical help, using mostly herbs and sacred stones, focusing mainly on GI and respiratory problems, inflammations and skin eruptions and the female reproductive system.
In all, Cuban medicine provides a model of primary care that countries like the U.S. could do well to study. On the other hand, travelers are advised to bring any medications they might need during the trip, especially those for treating digestive issues related to consuming, on purpose or by accident, local food and water.
—Mary Carpenter Read more of our well-being columns right here.
YOU’VE TRAVELED enough in developing countries to take all the usual precautions. Water: don’t drink it, don’t use it to brush your teeth, don’t open your mouth in the shower and say no to ice. Food: eat fruit and vegetables only if they can be peeled or cooked. Just in case, pack Imodium (loperamide).
You go, you are careful, but you always get sick—a night of chills and fever, followed by days of stomach cramps and diarrhea—and for the rest of the trip you stick to rice and tea, cheese and bananas. This can happen in Cuba but also in Paris, where water, fruit and veggies should be worry-free.
The culprit could be inflammation. Gastritis—inflammation of the stomach and intestinal lining —has two main causes: a bacterium (H.pylori) and NSAIDs. Gut inflammation is caused paradoxically by the same NSAIDs used to counter arthritis-related inflammation, or a low-dose daily aspirin taken to lower a familial risk of colon cancer.
When traveling, your inflamed gut overreacts to an onslaught of unaccustomed foods: spicy, fried, rich and fatty (fatty pork is a specific villain), as well as to caffeinated and carbonated drinks, fruit juices, tomatoes and peppers and alcohol. An aggravating problem may be insufficient fiber to keep food moving quickly through your system.
Inflammation is a complex process involving many different physiologic responses. NSAIDs decrease pain-causing inflammation by inhibiting the body’s production of prostaglandins, some of which, however, are important in protecting the gut from the corrosive effects of acid produced to aid digestion.
Another example of inflammation’s complexity: while it helps spur muscle growth as a result of exercise, it also contributes to muscle loss that occurs with aging. In the case of blood sugar, inflammation activates proteins crucial to maintaining normal blood sugar levels but can also contribute to insulin resistance leading to type-2 diabetes.
And there’s timing: NSAIDs can actually speed up the progression of Alzheimer’s disease in patients in advanced stages—while those who start taking NSAIDs regularly in midlife, when their brains were healthier, appear to have slower cognitive decline, according to a 2015 Nova report.
“Good” inflammation, generally acute, fights foreign invaders and heals injuries. But it’s also at work on a regular basis, for example, during sleep to mop up unnecessary or used-up cells left over from the day’s activities, especially helping to protect the brain from Alzheimer’s disease.
“Bad” inflammation, generally chronic, is a culprit in arthritis, asthma, atherosclerosis and cancer; maybe in depression and other mental illness; maybe in autism. And it may contribute to Alzheimer’s disease when insufficient sleep or other causes allow cellular debris to remain in the brain.
But complex processes are also involved in efforts to reduce bad inflammation. Statins taken to counter high cholesterol (blamed for cardiac disease-related inflammation) may at the same time decrease the brain’s good debris-collecting inflammation.
Foods hyped as anti-inflammatory may also be combating good inflammation. It’s a question of context, of what else you’re eating. “Turmeric may work anti-inflammatory wonders for mice,” writes Scientific American columnist Claudia Wallis. But nutrition experts point out that’s in the context of rodent chow.
Many recommend the Mediterranean Diet for a good balance of foods to reduce bad inflammation, in particular, seafood twice a week. But the little benefit shown in studies of fish-oil supplements indicates that positive effects may be due not to fish alone but to what else is being eaten.
What’s a traveler to do? If experience suggests a susceptible gut, try not to over-consume the negatives: spicy, fried, rich and fatty, especially pork, and alcohol. Pack portable fiber-rich foods like granola bars and walnuts. If that proves insufficient, add prophylactic fiber-rich supplements like psyllium.
For treating symptoms, the first step is usually a bland diet, at least until the discomfort subsides. Reducing stress can also help. Antacids like Pepto Bismol can neutralize the acid, though they come with side effects—turning your tongue black as well as interacting with other drugs including NSAIDs, the original culprit.
Stopping NSAIDs might be an obvious solution, but can involve a tough trade-off between sticking to chicken soup and granola bars or suffering nasty, nagging pain.
—Mary Carpenter To read more well-being posts, click here.
New Yorker ‘Cat Person’ Short Story Stirs Controversy
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ARGUMENTS ABOUT the New Yorker short story “Cat Person” by Kristen Roupenian streaked across the internet and into coffee and shopping encounters around the holidays, including at Leopold’s Kafe and Relish on Cady’s Alley in Georgetown.
As the narrator flirts with a new guy, Robert, via texts, he tells her about his cats. Later en route to his house, seeming to forget about the texts, and says, “darkly like a warning, just so you know, I have cats.” Arguments about “Cat Person” led to an outpouring of comments and questions about cat people (versus dog people)—with many echoing the general consensus: cat people are more introverted than dog people.
Although dogs may “expand your social circle in the real world”—because their need to be walked leads to impromptu friendships, cats are the stars of cyberspace, writes Peg Streep on a Psychology Today blog post. Streep notes that Grumpy Cat became a real-world star making real-world money.
Studies examining the “Big Five” personality traits find dog people to be more extroverted and less neurotic while cat people are “more open to experience.” In a 2017 study of more than 400 undergrads at three universities: “dog people scored higher on warmth, liveliness, rule consciousness and social boldness compared to the cat people. The latter scored higher on general intelligence, abstractedness and self-reliance.”
“Dogs look up to us. Cats look down on us,” Winston Churchill’s oft-quoted remark, has been interpreted as indicating that dog people need more external validation and have “control issues,” while cat people are more self-sufficient. But, Streep writes, “since cats generally live longer than dogs, the cat person enters into a longer contract.”
Liberals tend to prefer cats, based on a Time magazine survey. In 2012, nine of the top dog-owning states voted solidly Republican while nine of the bottom ten dog-owning states voted for President Obama, according to Streep. She queries whether owning a dog or cat might reveal hidden partisan feelings contrary to voting habits.
Testing the related hypothesis that dog people prefer “having pets that are submissive to them,” further research showed dog people scoring higher on competitiveness but not on assertiveness or narcissism. The conclusion: conservatives simply like dogs more.
On the other hand, Bill Clinton and George W. Bush had both a cat and a dog
And Occidental College sociologist Lisa Wade criticizes the cat/dog person dichotomy as gendered: “Don’t we stereotype women as cat people and men as dog people…don’t we think that men with cats are a little femmy, or, at minimum, sweeter than most…even, maybe gay!” Wade points out that nobody worries about becoming a crazy dog person.
In the end of the New Yorker story, Robert’s cat-personness is questioned in the narrator’s musings: “Perhaps she was being unfair to Robert, who really had done nothing wrong, except like her, and be bad in bed, and maybe lie about having cats, although probably they had just been in another room.”
—Mary Carpenter Well-Being Editor Mary Carpenter is a proud cat owner. Read more of her posts.
THE PINEAL GLAND has been called the brain’s “third eye” and the “seat of the soul.” Along with the pituitary and hypothalamus, the pineal makes up what Daoist philosophers call the “Crystal Palace”—because it’s these three glands that affect the body’s response to light. They are components of the endocrine system, of which the pituitary and hypothalamus are in charge, directing different functions or interacting to direct the same ones, according to Mantak Chia and Joyce Thom in Conscious Lifestyle Magazine.
(The endocrine system – which regulates the body by way of hormones the way the nervous system uses electrical impulses – includes other glands: the thyroid, parathyroid, adrenals, pancreas and ovaries/testes. While most of the body’s hormones are produced by endocrine glands, other organs with hormone-secreting cells include the stomach, liver, intestines, kidneys and heart.)
Ambient light affects all three glands—which in turn regulate wakefulness and response to stress—making it rare these days to “receive the deep relaxation that occurs in total darkness,” write Chia and Thom. Urban environments provide few refuges that are so dark—except maybe flotation tanks, with darkness helping provide their heightened restfulness.
Among light receptors in the eye—besides cones that handle color vision and rods for low light—a third kind sends messages to the hypothalamus. That gland, in turn, signals the pineal gland to produce melatonin, which affects circadian rhythms that include waking, sleeping, temperature, and digestion.
Melatonin production is activated by darkness and inhibited by light, with irregular production causing mood swings and depression. It directs the pituitary to release vasopressin, which adjusts circadian rhythms. And because melatonin suppresses cortisol and acts as an anti-oxidant, it is considered anti-stress and anti-aging.
Besides the pineal gland’s role in sleep disorders, other processes it might affect—most described as “needing more research”—include cardiovascular health; female hormones; mood disorders, including increasing the risk for schizophrenia; and colon cancer, by way of cellular damage caused when overexposure to light depresses pineal gland function.
The pineal acts as the body’s internal clock, telling the brain whether it’s day or night, hence its label, the brain’s “third eye.” The pineal is also considered the spiritual center of inner vision, insight and wisdom and is thought to provide the visuals during dreams and psychedelic experiences. Spiritual significance is also found in its pinecone shape, with its spines and spirals creating a perfect Fibonacci sequence.
Located at the geometric center of the brain, the pineal gland is unusual as the only unpaired organ deep in the brain and the only one not protected by the blood-brain barrier. Bathed in cerebrospinal fluid, the pineal has more blood flow per cubic volume than other organs—and thus, some believe, the brain’s highest concentration of energy.
Looking for the source of thought, Rene Descartes dubbed the pineal gland “the seat of the soul” —with the idea that its connections to the sensory and emotional centers of the brain create a bridge between physical and spiritual experiences.
Both the pituitary and hypothalamus secrete hormones that can increase or reduce nerve impulses—thereby linking the endocrine and nervous systems—and connect to the limbic centers of emotion and affect. Together these two glands direct the “survival processes”: body temperature, hunger, thirst, fatigue, pain relief, blood pressure, sexual function, weight, circadian rhythms, sleep and response to stress.
To optimize function of the Crystal Palace—instead of leaving curtains open to enjoy the moonlight or for morning light to help with waking—creating a darker sleep environment could make way for deeper sleep and richer dreams.
—Mary Carpenter Mary Carpenter writes about health and well-being. Read more of her posts by clicking here.
IN THESE DAYS of unreliable journalism, articles that go behind the news to pose unanswered questions or parse statistics are more valuable than ever. Two recent examples —the New York Times’s critical review of the alarmist link between light drinking and cancer; and the website STAT’s examination of FDA warnings against the herbal supplement kratom—helped calm alarms raised recently by headlines and reporting in The Washington Post.
“Cancer doctors call for cutting back on alcohol,” read the Post’s Nov. 14 headline, with the subhead: “Even light drinkers face an increased risk of disease, oncologists warn.” The Post article details a “call to action” from the American Society of Clinical Oncology, specifying that “among women, light drinkers have a 4 percent increased risk of breast cancer.”
The New York Times “Upshot” piece, published (earlier) on Nov. 10, covered the same statistics but came to a different conclusion: while 3.5% of cancer deaths in the U.S. are attributed to alcohol, by eliminating heavy drinkers and smokers “the number of cancer deaths not attributable to alcohol approaches 100%.”
Sometimes statistics point to nothing more than a connection: “We still don’t know if the relationship is causal,” says the Times article. But accepting that possibility, if the absolute risk increase of developing breast cancer over the next 10 years for a woman over 40 is 1.45 percent, for the light-drinking woman it’s .06 percent—which “could be interpreted such that if 1,667 40-year old women become light drinkers, one additional person might develop breast cancer.”
On top of that, the Times describes the results of a 2013 meta-analysis that examined all cancers and concluded that “over all, light drinking was protective.” Specific studies have shown “light to moderate drinking can lead to a reduction in risk factors for heart disease, diabetes and stroke…more women die in the United States of heart disease than cancer.”
Among tips on how to interpret research, the Times warns against giving too much weight to observational data, focusing on one disease while ignoring others, cherry-picking which studies to focus on —and finally: “Acknowledge the harms, as well as the benefits, or recommendations. Consider both cost and joy.”
About the herbal supplement kratom—available online and elsewhere—taken for pain, anxiety and opioid withdrawal, the Post’s Nov. 20 front-page summary said, “The FDA has issued a warning against the herbal supplement kratom, which has been linked to 36 deaths.” Inside the paper, under the headline “FDA warns against using the herbal supplement kratom,” came the sentence: “Calls to U.S. poison control centers involving kratom increased tenfold between 2010 and 2015.”
Searching for the original Post article online led only to an earlier version, published on Nov 14 with a slightly different headline: “FDA warns of ‘deadly risks’ of the herb kratom, citing 36 deaths.”
Among questions to ask about kratom’s risks: tenfold compared to what—to the years before opioid abuse became a nationwide scandal? Because once the numbers are put into a historical context—the tenfold increase in poison control center calls about kratom occurred between 2010 and 2015 —it makes sense that there would be a huge rise in something connected to both pain relief and opioid withdrawal, because it was during exactly those years that opioid abuse rose across the U.S., and death attributed to opioids nearly doubled from 16,651 to 33.091 (statistics compiled from CDC reports).
To its credit, the Post article goes on to compare risks of kratom and opioids, with an addiction specialist pointing out that “restricting or banning the substance could drive some people back to opioids.” It also notes that “the herb is used recreationally because it produces symptoms such as euphoria.” Most damning, the article quotes FDA Commissioner Scott Gottlieb saying, “there is no ‘reliable evidence’ to support [its use] as a treatment for opioid-use disorder.” Turns out there might be an explanation for this evidence problem.
A 2016 article on the STAT website—with contributions from longtime science and medicine journalists—points out that although “the plant poses some risks,” scientists have been enthusiastically pursuing research on kratom’s properties as a painkiller with fewer side effects than opioids, and as an aid in opioid withdrawal. Much of this research, however, was cut off by government restrictions (from the DEA) before answering the important question, according to Boston toxicologist Edward Boyer: “Is it an effective treatment for opioid withdrawal or is it another pathway to addiction?”
When even trusted sources mislead, readers must take on more of the burden of looking behind the news. This was the case with the alcohol story because women who drink lightly became concerned about the report on women and alcohol, but few considered questioning statistics from a reputable source like the Washington Post.
While some 200 drugs have been tested and failed to make much difference for Alzheimer’s patients, Bredesen’s protocol involves mechanisms similar to those proposed for drug development, such as fighting inflammation and improving blood sugar regulation—interventions for which there is “good evidence” of potential effectiveness, according to DC-area psychiatrist Susan Molchan.
With genetic testing currently available and less expensive blood tests anticipated for the near future, Bredesen’s successes may help answer the question: why get tested? Based on his findings, someone who learns they carry “the most important genetic risk factor for AD”—two copies the Apo-E4 gene —finally have some recourse and thus some reason for hope.
Dale Bredesen first made news in 2014 with a small study of 10 patients who were struggling with memory loss at work, some of whom had quit their jobs as a result. Of these, nine patients who chose to implement different elements among Bredesen’s list of 36 possible interventions experienced a groundbreaking reversal of symptoms.
Persevering with a second group of 10 patients, Bredesen reported similar positive results in 2016 and has since developed a complicated algorithm called Reversal of Cognitive Decline (ReCODE) to evaluate the status and needs of each patient. At this point, more than 1,000 people are enrolled in the protocol, with 150 currently being followed actively, and 450 physicians worldwide have been trained to use it.
Many in the scientific community criticize Bredesen’s studies for their small numbers and lack of controls, but these qualities of good research are hard to impose on his protocol, because assessments of need and subsequent recommendations are so different for each person.
Dr. Mikhail Kogan, head of the Center for Integrative Medicine (CIM) at George Washington University, has been trained to use ReCODE to slow or reverse symptoms of AD by addressing its metabolic roots. Kogan offers these personally tailored evaluations and recommendations at his newly established MK Cognition Institute.
For more than 10 years at CIM, Kogan has created similarly individualized treatments for those with AD as well as those with chronic health complaints that traditional medicine has failed to resolve.
Bredesen bases his treatment on a novel concept of AD: that mental deterioration is caused not by amyloid plaques but by imbalances in the body that allow for the invasion of the brain by pathogens. The brain responds to these pathogens by amassing sticky plaques of amyloid-beta protein—which in turn destroy synapses crucial to nerve cell communication, according to Kathleen Doheny on Senior Planet.
Some three dozen imbalances—created by such factors as inflammation, hormonal status, vitamin levels and toxins —are described by Bredesen as “holes in the roof” that contribute to cognitive decline. “You cannot just plug one hole,” Bredesen told MyLittleBird.
Many of Bredesen’s interventions are intuitive: less stress; more sleep and more exercise; less processed food and more vegetables and fruit. Other diet recommendations include avoiding all simple carbohydrates, all sugar, all gluten—and adding herbs such as turmeric as well as coconut oil, fish oil and blueberries.
A related measure is a three-hour fast between dinner and bed to allow after-meal insulin levels to go down before sleeping, because increased circulating insulin levels have been linked to AD. Also recommended is a 12-hour fast between dinner and breakfast to provide time for the amyloid-beta proteins to be flushed out of the brain, a process aided by melatonin. Other supplement interventions include vitamins B, C, D and E, antioxidants, omega-3 fatty acids and probiotics.
About the most controversial recommendation, hormone replacement therapy—because of the link between HRT and increased risk of breast cancer—Bredesen believes the trade-off (increased risk of future cancer vs. immediate and worsening symptoms of dementia) is worthwhile, and his patients back that up. Bredesen told Senior Planet, “Hormones levels play a critical role in cognition…one husband said that he and his wife would monitor her status regarding cancer, but that they’d both rather do that than continue to watch her cognitive decline.”
Bredesen agrees that his protocols can be demanding—rigid sleep times, exercise prescriptions and dietary restrictions—but that “when people start getting very mild cognitive impairment, they’ll have the incentive. Right now what keeps people away is thinking they can do nothing.”
As a spouse of one of Bredesen’s patients who did well on the protocol wrote on Amazon: “[Bredesen’s] book and the ReCode protocol offers something that cannot be measured, real hope.”
—Mary Carpenter Well-Being Editor Mary Carpenter often writes about new studies related to cognition, memory loss and the brain.
ON THE LIST of high-fiber foods, raspberries appear to be loaded (one cup provides 8 grams), but raspberries don’t do everything “fiber” is given credit for. As it turns out, not all fiber is created equal.
The best life-prolonging fiber based on clinical evidence is that found in “cereal”—whole wheat bread and pasta, brown rice, seeds, barley and other food containing intact whole grains—for both healthy people and those diagnosed with cancer.
The conclusion: credit should in fact go to the whole grain containing the fiber—and not the fibrous component alone—for contributing to the longest and healthiest life. Accordingly, recommendations from the 2016 federal Dietary Guidelines for Americans advise making whole grains half of all the grains consumed.
“Whole grain is not the same as fiber, because fiber doesn’t always include the whole grain,” explains Kay Cahill Allison, former editor of Harvard Health.
Whole grain refers to any grain—corn, rice, wheat, oats, rye—remaining in its natural form, which is comprised of bran, a germ and an endosperm. The latter is all that remains after refining, and bran is simply the high-fiber casing. For packaged food, to be certain it contains the whole grain, one of the first five ingredients on the label should read “whole grain, “whole wheat, “whole grain oats,” etc.
The average American woman gets half of the recommended amount of fiber, which is about 25 g./day for the 50-and-under crowd, and 21 g./day for anyone older. Another formula is 14 grams of fiber for every 1,000 calories consumed (see chart).
Of almost 400,000 people (AARP members ages 50-71) in a 2011 National Cancer Institute Study, controlling for variables like smoking and alcohol intake, those who ate the most fiber over a nine-year period (26 g./day for women) were 22% less likely to die from any cause compared with those who ate the least (11 g./day for women).
The healthiest of all were those who got the most fiber from grains, not from fruit and vegetables. A more recent study that followed 1,575 health professionals diagnosed with colon cancer over eight years also linked fiber from cereal to the greatest decrease in risk of death from cancer and other causes, compared to fiber from other sources.
Fiber refers to indigestible carbohydrates—with different health benefits based on the category of fiber. Cereal fiber, including nuts, whole wheat, grains, brown rice and produce skins, is “insoluble,” meaning unable to blend with water, which allows it to pass through the digestive system mostly intact. Dubbed “nature’s laxative,” insoluble fiber can speed the passage of food and waste through the gut to help prevent constipation.
On the other hand, fruits—berries, bananas, oranges and apples along with oats, legumes and flax—are soluble fibers that blend with water to form a gel-like substance that binds with fatty acids to flush them out, which lowers unhealthy cholesterol. The gel slows digestion, making it take longer for the body to absorb sugar, which helps prevent spikes in blood sugar levels blamed for metabolic conditions like diabetes.
Among the soluble fibers is a further division: the more viscous the fiber, the thicker the gel and the longer it remains in the gut, slowing digestion, creating a longer-lasting feeling of fullness and reducing appetite. The only fiber to reduce food intake and cause weight loss in dozens of studies, viscous fiber is found in legumes, oats, flax seeds and pectins (in fruits, berries and seeds), as well as in asparagus and Brussels sprouts.
A third division puts some fiber in the “fermentable” category, most of which is soluble, including beans and legumes, as well as pectins. This fiber is digested, or fermented, by the gut to be used as fuel for producing more “gut-friendly” bacteria, increasingly considered essential for good health, including weight management, blood-sugar control and mental health and especially for enhancing the immune system’s ability to fight infection.
The downside of fermentable fiber: its notorious gas production.
Although such categorizing of fibers seems to emphasize health benefits of soluble, viscous and fermentable fibers, like raspberries, clinical evidence traces long-term health to the opposite—insoluble, whole-grain cereal fibers—leading to the conclusion that it’s not the fiber.
Instead it’s “the natural package of nutrients that comes with fiber—vitamins, minerals and other phytonutrients ranging from antioxidants to zinc— that protects human tissues from the damage and inflammation common to diseases such as heart disease,” two Harvard Public Health researchers told Allison.
If fiber alone is not the answer, most boxed cereal, in which grains have been stripped of fiber and then “fortified,” is less healthy than a hefty bowl of air-popped corn.
On the other hand, when choosing among whole grains, oats and wheat are generally the healthiest. Whole oats are especially effective in lowering cholesterol, have more protein than wheat or corn, and along with legumes create a feeling of fullness that can help with weight loss. Fullness is also a benefit of whole wheat, as is reduced risk of the metabolic conditions that lead to heart disease and diabetes.
If there was ever a good reason for a cookie diet, recent entries in meal-replacement cookies boast loads of whole grain, along with protein and omega-3 fatty acids. Susie’s Smart Breakfast Cookies, at least the orange, cranberry nut flavor (at DC’s Yes! Organic Markets) list as the first ingredient “whole grain oats” and boast 2000mg of omega-3 fatty acids and 8 grams of protein.
Nutritionists believe that the weight-loss potential of meal-replacement cookies comes from a combination of the fullness created by eating whole grains, the reliability of the number of calories in a cookie-meal (410 in a Smart Cookie) and the satisfaction. Who doesn’t feel better after eating a cookie?
—Mary Carpenter Learn more about healthy living in our well-being columns.
THE CAUSE OF Raynaud’s disease is mostly unknown, and there is no simple treatment other than avoidance—of triggers like cold and stress; and shopping—for handwarmers and high-quality gloves.
Without a problem to address, sufferers mostly trade suggestions: using oven gloves to take food out of the freezer; choosing mittens over gloves for outdoor cold, so that fingers keep each other warm; and, the least appealing, wearing socks and gloves to bed.
Raynaud’s disease, however, can be explained. Symptoms are due to narrowing of the smaller arteries that supply blood to the skin, which limits blood circulation to affected areas, a process called vasospasm or vasoconstriction. The body’s ploy for minimizing heat loss in cold weather, vasospasm that occurs with Raynaud’s is triggered by both cooling and stress. (In warm temperatures, the small vessels dilate to allow heat to leave the body.)
Raynaud’s affects 3 to 5% of the population, women more than men, and people in cold climates more than those in warmer ones. It can run in families. Although Raynaud’s usually appears in fingers and toes, the nose, lips, ears and nipples can also be affected.
Increased stress ratings and tachycardia without declines in temperature caused one third of the vasospastic attacks in one Raynaud’s study. Simply being startled can spur the release of neurotransmitters related to stress and emotional upset, in turn activating receptors on the blood vessel muscles to signal their narrowing. In Raynaud’s sufferers, these receptors appear overly sensitive.
Symptoms can appear with any temperature shift from warm to cool—even with mild exposure, such as air-conditioning, refrigerated grocery store food sections and a general body chill.
Besides unpleasant cooling of the extremities, the affected skin can change color: pale or whitish when blood stops flowing to the skin, called a “white attack”; purple-bluish, a “blue attack,” that sometimes mottles the skin and can occur as blood flow returns following a white attack; and reddish, often accompanied by throbbing or tingling, with recovery.
An attack can begin with a single finger, most commonly the index, middle or ring finger. Sores or infections, which can occur rarely in affected fingers or toes, should get immediate medical attention.
Raynaud’s comes in two forms; the more familiar and common is called Primary Raynaud’s, which can be mild. The more serious Secondary Raynaud’s can be caused by an underlying problem, such as atherosclerosis or carpal tunnel syndrome. It can also be traced to medications that cause vasoconstriction, such as those for high blood pressure and ADHD, and some OTC cold medications, as well as caffeine and alcohol.
Raynaud’s sufferers are advised to avoid repetitive hand actions like typing or playing the piano, and to limit the use of vibrating tools like electric drills. Serious treatment—medications and prescription skin creams, as well as surgery or shots to block the nerves in the hands and feet that control the arteries—are used for those with severe symptoms.
The most common advice for sufferers is to exercise more, which both reduces stress and increases blood flow, as well as warming the body. Also, warm water can heat up hands and feet surprisingly quickly; and putting hands under the armpits helps in a pinch.
Home remedies include cinnamon and astragalus. For one sufferer whose fingers turned white even in the summer, daily cinnamon capsules helped relieve symptoms both in freezing weather and when extracting food from the freezer.
Astragalus root, also called milk vetch and used in China to boost immunity and circulation, allowed one user to avoid moving to Florida, according to Joe and Terry Graedon in “The People’s Pharmacy: Quick and Handy Home Remedies” (National Geographic).
The good news: Age can help. Many who suffer (Primary) Raynaud’s in their 20s and 30s report symptoms fading over time—and for some, disappearing entirely.
YOU’RE NOT IMAGINING IT. The effects of light drinking —one mojito, one beer, one glass of wine—intensify with age as muscle mass is replaced by fat tissue. The rule is the higher the ratio of body fat, the lower the tolerance to liquor.
The effects are stronger in women, who typically have a higher ratio of body fat than men. Because fat does not absorb alcohol, the same amount of liquor over the years causes higher alcohol concentrations to remain in the bloodstream, where it travels to other tissues and most importantly the brain.
Water is another age- and gender-related factor. Even for those who imbibe many glasses during the day, the body retains less water with age, so that alcohol in the system remains in a more concentrated form for longer. In addition, women retain proportionally less body water than men, and they may also metabolize alcohol in a slightly different way.
Foods high in fat—most late-night snacks like pizza and chips—cause the liver to work overtime and delays its capacity to metabolize alcohol so that the byproducts can be excreted. Thus, the conventional wisdom that eating alleviates alcohol’s negative effects —because food slows down absorption of alcohol in the stomach and small intestines— is contradicted when high-fat foods interfere with benefits.
The liver metabolizes between 90 and 95% of alcohol consumed, with the rest excreted via urine, breath and sweat. The longer alcohol remains in the liver, the higher the risk of liver damage. Usually the body can metabolize alcohol at a speed of about one cocktail/hour, unless the liver is overloaded by too much alcohol consumed too quickly or by fatty foods. High levels of alcohol can also interfere with the liver’s ability to handle fat, resulting in a condition called fatty liver, which can lead eventually to cirrhosis.
Other causes of age-related changes in alcohol’s effects are familiar: interaction with medications—everything from antihistamines and antibiotics to anti-anxiety and anti- depressant drugs; and the increased stresses of life.
Negative effects on sleep of light drinking may also worsen with age —along with a general increase in nighttime wakefulness—caused by higher levels of alcohol in the brain. While alcohol may decrease the time needed to fall asleep, it affects levels of serotonin, norepinephrine and other chemicals that orchestrate sleep.
Even when consumed up to six hours before bedtime, alcohol can interfere with REM sleep—causing more frequent awakenings from dreams and difficulties returning to sleep, and reducing the overall quality of rest achieved during the night.
That hangovers get worse with age is traced to many of the same issues connected to higher blood alcohol levels: higher ratio of body fat and less water retention. Just as recovery from a host of insults such as infections and head injuries takes longer with age, hangovers—caused by a complicated inflammatory response—can be more debilitating and hang around for longer
Heavier drinking creates more serious problems: between 2006 and 2010, some 88,000 Americans died every year of alcohol-related causes, according to the Centers for Disease Control and Prevention—compared to annual deaths from drug overdoses (64,000), breast cancer (42,000) and prostate cancer (28,000). Surveys suggest that more than 15 million American adults suffer from alcohol dependence or abuse within a given year.
The website DrinkWise lists how aging negatively affects the body’s reactions to alcohol—but proceeds quickly to the benefits of “light to moderate” drinking on risks for everything from osteoporosis to dementia, as well as on reducing anxiety and stress. Alleviating depression appears on the benefits list, but because alcohol is a depressant it can also make existing depression worse, in part related to its effects on sleep: Increased nighttime waking interferes with the deep stages of sleep essential to the brain’s recovery.
Also, alcohol interferes with anti-depressant medication. Finally, as effects of drinking wear off, feelings of depression as well as anxiety can become more intense before normal brain activity resumes, according to Aaron White, senior scientific advisor at the National Institute on Alcohol Abuse and Alcoholism.
The main suggestion for minimizing unwanted effects of alcohol is to drink water or juice between alcoholic drinks, which both increases hydration and delays the next drink. The other, less welcome, suggestion: Drink less.
—Mary Carpenter
Mary Carpenter most recently wrote about the usefulness of personality assessment tests. Click here to read more of posts about well-being.
THE MOST POPULAR personality assessment, the Myers Briggs Type Indicator (MBTI)—given more than 2.5 million times each year and used by 89 of the Fortune 100 companies—has long been criticized for its purported usefulness in selecting a profession or career direction.
On the other hand, most people who take the MBTI and other such assessments come away with insights into their own behavior and sometimes even more into their relationships with others. “Personality” is defined generally as “differences between people in the way they act and react in particular situations” and “reflect the settings of [their] motivational system,” which for each person is “tuned slightly differently to the world,” Art Markman writes on FastCompany.
There is “no evidence to show a positive relation between MBTI type and success within an occupation,” according to Marshall University psychologist David Pittenger. “…nor is there any data to suggest that specific types are more satisfied within specific occupations than are other types.”
Because there is a learning curve for anyone trying to understand their Myers Briggs results, it is advised to take the test under the auspices of someone who has been certified, usually a psychologist or career counselor, and usually as part of a MBTI workshop or career-counselling package, with the test costing around $20. The MBTI can also be taken online, minus extensive and personal explanations, for $49.95 plus tax.
Most complaints about the Myers Briggs center around each person being labeled one of 16 types —derived from their placement on four axes, for example, introvert/extrovert: in fact, most people’s MBTI scores fall around the middle of each axis rather than at the low and high ends.
The preponderance of borderline scores also gives the MBTI low “test-retest reliability:” If you retake the test after only five weeks, there’s a 50% chance you will fall into a different personality category than your previous result, British sociologist and philosopher Roman Krznaric writes in Fortune Magazine. Krznaric considers the MBTI as unreliable as phrenology.
Better regarded assessments provide weighted results that can be more reliable and more useful than the mutually exclusive categories of the MBTI. Among career-focused assessments for which a free (often simplified) version is available online, the Holland Code Career Test is considered by many to be the most helpful.
Of its six “interest areas,” for example, D.C. resident M.W. scored “high” for “thinking careers” (involving research, analysis and solving problems) as well as for “helping careers” —considered her most relevant scores. (Her other scores—the “low” for “building careers, “persuading careers” and “organizing careers,” and even the “moderate” for “creating careers”—were considered less relevant.)
The personality traits widely used by psychologists, and therefore most evidence-based as well as most well-respected by experts, are known as the “Big Five,” also the Five Factor Model (FFM). For personality assessments, there is “an enormous amount of research indicating the impact of the five major personality factors on significant life outcomes,” according to Pennsylvania State University professor John Johnson.
The Big Five traits are Openness, Conscientiousness, Extroversion, Agreeableness and Neuroticism (OCEAN)—and most assessments, such as the “Big Five Personality Test,” rank scores on each so that those traits at extreme highs and lows are given the most importance. The usefulness of the Big Five most often touted is that the traits predict outcomes, for example, openness predicting creativity. (Click here to take one of these tests.).
On the Big Five test, for example, M.W.’s most relevant scores were Extroversion at 1 (“very low”) and Agreeableness at 96 (“very high”). Next came Openness at 77 (“high”). Very little weight was given to her other scores, both in the 30s, for “Conscientiousness (work ethic)” and “Natural reactions” (this test’s label for Neuroticism, while other tests call it “emotional stability”). Another criticism of the MBTI is its failure to assess “bad” traits like neuroticism.
Johnson points out, however, that four of the traits in the widely accepted FFM are very similar to the “psychological tendencies measured by the MBTI.”
For DC-area resident S.H., an experienced lawyer in search of a second career, the most helpful career-related conclusion from a series of assessments was how highly she valued authenticity, followed by cooperation, helping and flexibility; and that she prefers working with data or words rather than people but is better working with people some of the time. These results encouraged her to consider professions like mediator and to rule out those, like advertising and politics, that might involve veering from the truth.
But S.H.’s Myers Briggs type (ENTJ) has given her important insights into personal relationships—why some people get along easily while others struggle to do so. For her, one workshop exercise that illuminated the usefulness of Myers Briggs types divided participants based on their type on the axis of N for intuition/S for sensing.
Each group was given an orange and a poster-sized paper on which to describe the orange. When S group members came up with descriptors like juicy, the group was unanimous in their need to discuss the accuracy, importance, etc., of each before recording it neatly on the paper. The N group, on the other hand, agreed without discussion on a completely different approach: allowing each member to write or draw simultaneously all over the paper recording individual impressions of the orange —it can be used for juggling—acknowledging that each member’s responses to the orange were important to the final product.
Simply understanding these differences and how they might lead to disagreements can help relationships work more smoothly.
For many people, the most useful axis, measured on almost all assessments and useful for both career and personal insights, is that of introvert/extrovert. Especially for those who discover for the first time that they are an introvert, the label provides understanding and, sometimes more important, acceptance of their physical and mental need for downtime away from other people to recharge—in contrast to extroverts who gain energy from interaction with others.
Although Myers Briggs suffers from both lack of evidence and retesting support, it is still popular. Others with even less scientific backing are also popular. The Primary Colors Personality Test, used by military bases, prisons, universities and other organizations, divides people into six color groupings according to behavior in different contexts, such as at home and at work.
And “16 personalities” is free for everyone, boasting its reliability is based on making the assessment “open to the community, making its tools and information accessible and accepting feedback from many sources”—somewhat like crowd-sourcing—and that it has been taken “nearly 100 million times.”
For anyone familiar with Myers Briggs, 16 Personalities can be confusing because it uses the same labels but gives them different definitions. And it adds one more axis, Turbulent/Assertive, which in fact brings the number of possible outcomes to 32, not 16; also, the traits are not obviously opposites or even related to each other, but do appear suspiciously close to the Big Five variable of Neuroticism.
On the other hand, 16 Personalities weights its labels as do the most evidence-based assessments: Test takers falling near the middle on the introvert/extrovert scale, for example, are given their own label of “ambiverts” instead of being forced into one category or the other. For M.W., the only 16 Personalities trait given important weight is that based on her Introvert score of 81%—like her score of 1 on the Holland Test. Her borderline scores on other three axes make them less relevant.
On 16 Personalities, her additional score of 68% Turbulent comes up with the descriptors sensitivity (including sensitivity to stress), openness and perfectionist—while those scoring high on Assertive are more self-assured, even-tempered and stress-resistant.
After a certain number of personality assessments, however, the results begin to merge and even become murky. On 16 Personalities, for example, extroverts are more likely to be “assertive”—and on the Big Five scales, assertiveness is one of the significant features of extroversion. And, while combining results from different tests can be helpful, the best understanding of one’s personality often comes from an entirely different combination of inputs—from other people, especially experts, along with ongoing life experience both in the workplace and in personal relationships.
—Mary Carpenter Mary Carpenter most recently wrote on brain differences between liberals and conservatives. Read more of her well-being posts on lots of different subjects here.
DIFFERENT BRAIN structures in liberals and conservatives affect how each processes information as well as their different cognitive strategies. In theory, if we understood better how each other’s brains worked, we could communicate better—both with those of opposing views and in efforts to influence those of our own persuasion.
Political opponents differ in self-regulatory conflict monitoring, recognition of emotional faces and moral profiles—also in beer preferences, room organization and cleanliness and travel—a result of both genetic influences and environmental factors.
Political views are influenced by age as well as experiences of fear and anxiety occurring both in childhood and in current events. Because the brain is more plastic in youth, early exposure to fear and anxiety is likely to enlarge the brain’s emotional centers like the amygdala. And after 9/11, Americans across the political spectrum became more conservative.
In the distribution of gray matter, liberal brains have greater volume in the anterior cingulate cortex—responsible for taking in new information and using that information to make choices, Weill-Cornell Medical College psychiatrist Gail Saltz told Salon. Conservatives, by contrast, have more volume in the right amygdala, making their choices more likely to be informed by fear-based responses.
Accurate prediction of political choices based on these brain structural size differences was higher than 70%—better than that achieved based on political preferences of the subjects’ parents, according to Saltz.
When asked to look at photographs, the eyes of conservatives lingered 15% longer on repellant images, such as car wrecks and excrement, in a University of Nebraska-Lincoln study—“suggesting that conservatives are more attuned than liberals to assessing potential threats,” according to Scientific American.
In personality studies, “conservatives rate higher in areas of stability, loyalty, not liking change,” said Saltz. Liberals, by contrast, have stronger ratings for liking change and basing decision-making on new information, such as scientific studies.
Comparing 22 self-identified liberals with the same number of conservatives, and controlling for age and ethnicity, a Northwestern University study found that the two groups solved a similar number of problems correctly but used different strategies, Northwestern cognitive psychologist Carola Salvi told Huffingtonpost. Liberals were more likely to use “insight thinking,” defined as finding the solution without using a formalized strategy. Conservatives relied more on analytical methods.
In a 2008 study of 76 college student bedrooms, conservatives owned more ironing boards and calendars, compared with liberals who had more books and travel-related memorabilia, according to research by New York University psychologist John Jost, reported in Scientific American.
Moral profiles of those belonging to the two political persuasions are also different: “Liberals tend to value equality, fairness and protecting the vulnerable,” according to the Huffington Post. Conservatives, on the other hand, emphasize group loyalty and respect for authority along with patriotism and moral purity.
Their different world views, however, are equally grounded in ethics, writes NYU psychologist Jonathan Haidt in his book “The Righteous Mind.” The fairness valued by liberals means sharing resources equally, while for conservatives it means proportionality: people should get what they deserve based on the effort they have expended, according to Scientific American. Haidt wishes people could see that the opposing side is not immoral but instead is emphasizing different moral principles.
Political views, in addition, can be easily manipulated. Republicans who were told to imagine that they possessed superpowers and were impermeable to injury became more liberal, according to a Yale University study described by Jost.
In the NYU research, conservatives were first told that climate change was not a challenge to government and industry but “a threat to the American way of life,” and then given a passage to read describing environmental action as patriotic. Afterwards, they were more likely to sign petitions, for example, to protect the Arctic National Wildlife Refuge.
Voters of all persuasions can react emotionally, as in the across-the-board response to 9/11. Emory psychologist Drew Westen points to the fallacy of believing the rational mind prevails when it comes to politics. Westen contends that Democrats have been losing because they use laundry lists of policies and arguments bolstered with evidence, and they ignore emotional cues. For example, he notes that the right side of John Edward’s mouth tends to curl up, a problem because “humans innately dislike facial asymmetries,” according to David Brooks’s review of Westen’s book “The Political Brain.”
Westen also points out how Republicans are adept at using words connected to strong emotions: Ronald Reagan used “freedom fighters” to describe the Nicaraguan Contras to get funding for them, and “confiscation” referring to taxes.
For now, Scientific American paraphrases humor columnist Dave Barry, emphasizing the great divide: “Republicans think of Democrats as godless, unpatriotic, Volvo-driving, France-loving, elitist latte guzzlers whereas Democrats dismiss Republicans as ignorant, NASCAR-obsessed, gun-fondling religious fanatics.”
—Mary Carpenter To read more of Mary Carpenter’s well-being columns, click here.
“THE GEOGRAPHY of Happiness” is an upcoming National Geographic talk on “blue zones” by a panel of scientists. Blue zones? Those are the five regions around the world with the highest concentrations of centenarians. The panel will include Dan Buettner, author of the 2005 National Geographic article and subsequent book that described the zones and the variables contributing to their people’s longevity.
The original study—by Belgian researcher Michael Poulain, who came up with the concept of blue zones, and other researchers—identified Nuoro province in Sardinia as having the highest concentration of males age 100 and over, including the village of Seulo, which holds the record of 20 centenarians (in a total population of around 1,000 between 1996 and 2016).
Later research in Sardinia found a one-to-one ratio of centenarian women to men, compared with five to one elsewhere. Another blue zone, the islands of Okinawa, Japan, boasts about 6.5 centenarians for every 10,000 people—compared with 1.73/10,000 in the United States. And women over 70 in Okinawa are the longest-lived population in the world.
In 2004, according to NPR’s The Salt, Buettner “rounded up a group of anthropologists, demographers, epidemiologists and other researchers” to travel around the world interviewing “hundreds of people who’d made it to age 100 about how they lived”—and came up with the five winning locales described in his book The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest.
The blue zone all-stars of the U.S. are a group of Seventh-day Adventists in Loma Linda, California, who live 10 years longer than their North American counterparts. For a nearby dip into this good life, another blue zone is Costa Rica’s Nicoya Peninsula, where lodgings range from boutique hotels to an Airbnb treehouse.
The fifth blue zone, the island of Ikaria, Greece—featured in Buettner’s 2012 New York Times article “The Island Where People Forget to Die”—in 2009 had the highest percent of nonagenarians on the planet, with nearly one out of three people making it to the ninth decade. The island boasts low rates of cancer and heart disease as well as little dementia.
Among lifestyle variables that contribute to blue zone residents’ longevity: moving their bodies “a lot”; participating both in social circles that “reinforce healthy behaviors” and in the broader community; taking time to de-stress; and focusing on their families, according to NPR. Recent blue zone projects in dozens of U.S. communities focus on the “Power 9”—nine “evidence-based lessons of longevity” that can be implemented to create blue zones.
“Family—put ahead of other concerns” is the No. 1 variable on the Venn diagram of overlapping longevity clues from Okinawa, Sardinia and Loma Linda. The diagram overlap also specifies “constant moderate physical activity—an inseparable part of life.” Beaches for swimming and surfing line the Okinawan islands and the Nicoya Peninsula.
And, of course, there’s diet. The Venn diagram overlap lists “semi-vegetarianism—the majority of food consumed is derived from plants”; and “legumes—commonly consumed.”
In his second book, The Blue Zones Solution, Buettner focuses on food, for example, the “80% rule”: “stop eating when your stomach is 80% full to avoid weight gain”—though how to determine fullness at that percentage is unclear. Also, he advises eating the smallest meal of the day in the late afternoon or evening.
The Bluezones website has 10 food recommendations with catchy labels, starting with the “95/5 Rule: Eat plants. 90-95 percent of your food should be fruits, vegetables, grains, greens and beans.” Others are Retreat from Meat; Take or Leave Fish (because “modern-day fish has become so contaminated with pesticides and other chemicals”) and Diminish Dairy (egg limit of 3/week). Also, Slash Sugar and Go Wholly Whole (“only whole foods or foods processed with fewer than five ingredients”).
Eating preferences differ by blue zone. The Ikarians’ diet is notable for “its emphasis on potatoes, goat’s milk, honey, legumes, wild greens, some fruit,” according to Buettner. The longest-lived Sardinians are shepherds of grass-fed animals —and thus consumers of large quantities of goat’s milk and sheep’s cheese, including a sharp pecorino, with high levels of healthy omega-3s—along with bread, fennel, tomatoes, almonds and wine.
The Seventh-day Adventists in Loma Linda follow a “biblical” diet focused on grains, fruits, nuts and vegetables; they drink only water; and the community’s “pesco-vegetarians who ate up to one serving of fish a day lived longer than their vegans,” Buettner writes.
On the Nicoya Peninsula, the “big secret,” according to Buettner, is the “three sisters of Meso-American agriculture: beans, corn and squash”—plus a list of local fruits and vegetables.
The city of Fort Worth, Texas, has communicated directly with the town of Seulo and blue zone experts about becoming a blue zone. Of U.S. communities signing up to participate in the “Blue Zones Project,” dozens have been “certified” to date by blue zone teams who help community leaders follow a “menu” of 20 policies to make their communities healthier—although there has been some pushback against “social engineering” overtones.
At the October 10, 2017, National Geographic event, Dan Buettner and a panel of experts will discuss the science-based strategies that communities, businesses and individuals can use to cultivate greater joy, deeper meaning and increased satisfaction, and design a life of fulfillment and well-being. The evening’s event, moderated by Susan Goldberg, editor-in-chief of National Geographic magazine, is at 7:30pm. For tickets, click here.
—Mary Carpenter Read more well-being posts right here.
“ALTERED STATES” of consciousness can change an individual’s personality (thought to remain relatively fixed after age 30) and have “tremendous healing power,” according to psychiatrist Stanislav Grof, 1960s researcher of LSD as a therapeutic tool, at Johns Hopkins and elsewhere.
In the years since LSD became illegal, Grof created “Holotropic Breathwork”—holotropic from the Greek, meaning moving toward wholeness. The technique involves deep, fast breathing accompanied by music of specific vibrations, as a route to what Grof calls “non-ordinary states of consciousness.” Breathwork usually takes place in three-hour sessions, offered in day-long workshops around the country. The music changes for different phases of the session.
The technique is trademarked and can be facilitated only by those certified by Grof Transpersonal Training, although instructions for DIY breathwork abound. Reasons for starting out with an experienced guide include risks, such as panic attacks brought on by rapid breathing; and tetany, in which excess oxygenation causes muscles of the body to tighten up. Also, people starting out can feel uneasy and disoriented. (Those with lung conditions like asthma should check with a doctor.)
Altered states have been explored by ingesting drugs like LSD, psilocybin and the recently popular ayahuasca (which involves vomiting) and with an “extended” meditation practice, which can take months or years to develop; also for some through sensory deprivation, lucid dreaming and other “natural” means.
The healing powers of altered states are traced to slowing or redirecting blood flow away from brain structures responsible for rigid habitual thinking, obsessions and addictions —as well as from thoughts focused on the self and daydreaming, which arise as background chatter when the brain is “at rest.”
Known as the brain’s “default mode network,” these structures make up what’s known as the “emotional brain,” responsible for feelings, behavior, motivation and long-term memory. Located in the frontal and pre-frontal cortex and the limbic system, these structures, including the amygdala and hippocampus, have been implicated in everything from depression to creativity.
“Whether or not your default activity is helpful or harmful depends on where your mind automatically tends to go,” Scott Barry Kaufman, scientific director at the University of Pennsylvania’s Imagination Institute, told New York Magazine. “Our greatest source of suffering isn’t the default mode, but when we get stuck in the default mode:” a disturbed default mode network (DMN) is a mechanism in depression.
Bypassing the DMN puts the ego out of commission by dissolving boundaries between self and the world, according to John Hopkins psychologist Matthew Johnson, who researches the effects of psilocybin (magic mushrooms). What Johnson calls a “primary mystical experience” includes “a transcendence of time and space, a sense of unity and sacredness and a deeply felt positive mood” that is highly correlated with successful therapeutic outcomes.
Personality change—becoming more open-minded, tolerant, and interested in fantasy and imagination—was experienced by most of the healthy volunteers in Johnson’s two psilocybin studies, in 2006 and 2011, and confirmed in interviews with their family members, friends and colleagues. In the earlier study, 1/3 of participants rated their psilocybin session the most spiritually significant experience of their lives, ahead of the birth of a child or death of a parent.
“Early results suggest that when used by people without a family history or risk of psychological problems, psychedelics can make us kinder, calmer and better at our jobs…more open-minded and generous,” according to a Washington Post story.
Maybe most significant, the effects persisted in follow-up interviews at one year or longer —“an unprecedented finding” for a drug taken only once, New York University psychiatrist Stephen Ross told The New Yorker. Ross noted “incredible results” in a number of studies testing psilocybin in the treatment of depression, addiction, obsessive-compulsive disorder and other mental problems.
While psychedelics might provide what some call a “cheat code to enlightenment,” risks associated with illegality and unpleasant physical and mental experiences have turned some “psychonauts” toward different kinds of breathing —such as mindful breathing, coherent breathing and yoga breathing.
Examination of natural breathing rhythms has linked electrical activity in the brain that enhances emotional judgment and memory recall to different kinds of breath: inhaling and exhaling and breathing through the nose and the mouth. Recall was better for images viewed while inhaling, for example, in research by Northwestern University neurology professor Christine Zelano, who notes: “When you inhale you are in a sense synchronizing brain oscillations across the limbic network.”
—Mary Carpenter For more of Mary Carpenter’s well-being posts, click here.
OMEGA-3 FATTY ACIDS have been touted for a wide range of benefits—many traceable to reducing inflammation—for conditions that include cancer, mood disorders, arthritis and dementia. To date, the most impressive data concerns heart disease: a 2016 meta-analysis of data from almost 46,000 participants in 19 trials in 16 countries found increased omega-3 levels in the body’s cells associated with a lower incidence of fatal coronary heart disease.
Questions concerning omega-3s remain, however, about how much is enough and the best way to get that. Omega-3s in diet—from familiar sources including fatty fish like salmon and green leafy vegetables like spinach—are more “bio-available” than that from supplements, though adding these can help.
But when focusing on diet, the most important consideration is not simply increasing omega-3 consumption by eating greens, fish and grass-fed animals, but being vigilant about the ratio of omega 3s to omega 6s—the two major classes of polyunsaturated fatty acids.
“Omega-3s and omega-6s compete for positions in our cells,” according to Susan Allport in “The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them.” Thus, a diet rich in omega-6s means that fewer omega 3s can be absorbed—even when eating fish for every meal.
Anthropological evidence suggests that the ratio during much of human evolution was closer to 1:1, according to neurobiologist Stephan Guyenet, author of “The Hungry Brain: Outsmarting the Instincts That Make Us Overeat,” who has studied ratios in non-industrial populations.
While a healthy balance might be closer to 4:1, Americans consume about 10 times as much omega-6 as they do omega-3—in processed foods, in farmed fish fed corn and soy, and in all hydrogenated oils.
Reducing consumption of those pesky omega 6s requires limiting processed foods—specifically the oils used in those foods (see chart). The worst ratio is found in corn oil: 1% omega-3s (alpha-linolenic acid) to 57% omega-6s (linoleic acid). Oils considered “neutral” —with negligible effect either way on the body’s consumption ratio—are olive oil (1% to 9%), and coconut (7% to 2%).
Oils with the “healthiest balance”—that can be used to improve one’s daily ratio—are canola (11% to 21%) and flaxseed oil (57% to 18%). Allport adds flax to her food whenever possible: flaxseed oil along with olive oil in salad dressing; and ground flax seed to oatmeal or any cereal with insufficient omega-3s, and to replace up to one-quarter of the flour used in baking.
The best-balanced foods are meat, poultry and fish that are raised or farmed on grass or vegetable-based diets instead of corn; the dairy products, especially butter, that come from those cows; and the eggs that come from that poultry.
Allport recommends finding an egg “whose taste you enjoy” with as close to 300 milligrams of omega-3s and/or 100 milligrams of DHA as you can afford. Eggs from chickens fed a diet of corn and soy might have as little as 18 mg of DHA. (Key omega-3 fatty acids are DHA and EPA.) Because all eggs have some omega-3s, Allport warns: “Don’t be fooled by those…that don’t have more than 200 mg omega-3s/egg.”
Two high-level omega-3 brands are Christopher Eggs and Meijer Brand eggs with 660 mg. per egg (100 mg. of EPA and DHA)—as much as 13 times more than that of regular eggs. To show the power of one good egg, the comparative amount of omega-3s in eight ounces of one DHA-fortified “organic” milk is 32 mg.
While grass-fed products are usually more expensive, Allport believes the difference is more than made up in lower medical bills. By careful eating, she can keep the ratio of omega-6s and omega-3s in her tissues at a good level without the help of supplements. (Anyone wanting to know their personal ratio numbers can have their tissue levels of omega-3s and -6s evaluated, although such assessments reflect only recent dietary intake.)
For many people, however, even those working hard to reduce dietary omega-6, omega-3 supplements can make a difference. Supplements made from fish or krill are the most popular but have potential drawbacks: containing impurities (PCBs from plastics) and heavy metals; causing overfishing; and risking oxidation during production or shipping that can destroy healthy omega 3s.
While levels of impurities are considered too low to affect the general population, supplements made from algae avoid these risks and are a good option for several groups including pregnant women and infants (in formula), anyone taking large quantities of supplements—such as anyone with a recent head injury, and anyone who is especially concerned about contaminants.
While using flax seed and oil can help create a better balance, these products need to be kept cool and must be discarded at the first hint of rancidity; also, some people object to the taste.
Those of us not ready for supplements or added flax can keep making an effort to eat less processed food and more fish and leafy greens, and to follow any of the multitude of other suggestions—exercise, stress-reduction, diet, more exercise—with the goal of improving brain and body health.
—Mary Carpenter To read more well-being posts, click here.
“Whole grain is not the same as fiber, because fiber doesn’t always include the whole grain,” explains 
