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Miscellaneous information

In the course of putting together this site I came across various pieces of information of interest which didn't seem strictly relevant to the focus of this site but which seemed worth profiling from a general health perspective so I created this tab as a home for the information:




  • Superfoods

  • Turmeric (Curcumin)
    • For an overview about turmeric see the following link:

  • Ginger
    • The spicy heat in ginger is derived from the Gingerols it contains and different varieties contain different amounts. The drying and aging of ginger leads to the Gingerols being converted to Shogaols which provide greater spicy heat. So for the hottest spicy ginger you should seek out dried, well aged varieties which had a high Gingerol content when harvested however the latter two variables are difficult to find out.
      • Cooking ginger reduces the spicy heat. 
      • A great way to make a spicy ginger drink is to pour boiling water over dried chopped ginger in a french press coffee pot.



    • All-cause mortality risk according to tertiles of virgin olive oil consumption by body mass index, physical activity, and adherence to Mediterranean diet categories, in the ENRICA study = 12,161.
                      • Subgroup analyses were performed for total mortality, stratifying the population by possible effect modifiers such as sex, BMI (≤ or >26.3 kg/m2), total physical activity (≤ or >61.5 METs-hour/week) and adherence to the Mediterranean diet (≤ or >score 3). P for interaction was obtained for each subgroup analysis using the likelihood ratio test of models with and without the interaction term. Two items, alcohol and the ratio of monounsaturated/saturated fats were not included for the calculation of the Mediterranean Diet Score, thus the range in this modified score was from 0 (lowest adherence) to 7 (highest). The graph displays the hazard ratios (95% CI) for total mortality comparing the highest consumption of virgin olive oil (19 ± 12 g/day) with the lowest (<1 1="" activity="" adjusted="" age="" alcohol="" and="" bmi="" consumption="" continuous="" current="" day="" diet="" education="" educational="" energy="" excluding="" fats="" fiber="" for="" formal="" former="" g="" higher="" hours="" household="" in="" intake="" kcal="" kg="" leisure-time="" level="" m2="" medications="" mediterranean="" mets-hour="" monounsaturated="" never="" no="" number="" of="" or="" primary="" ratio="" saturated="" score="" secondary="" seven-point="" sex="" smoker="" smoking="" status="" total="" tv="" week="">3), hypertriglyceridemia (yes/no), hypercholesterolemia (yes/no), hypertension (yes/no), diabetes (yes/no), number of self-reported chronic conditions (0,1, and ≥2), and common olive oil consumption (g/day). The multiplicative interaction term between virgin olive oil consumption and the subgroup variable were for age (P value = 0.5132), for sex (P value = 0.596), for BMI (P value = 0.333), for total physical activity (P value = 0.045), and for adherence to Mediterranean Diet (P value = 0.129). Source:








  • Flavonoids (a type of Polyphenol which are also often referred to as antioxidants [probably because this is a property that is often measured and used as a proxy for "potency"])
    • Flavonoids appear to have health benefits although how exactly they work appears to be unclear, for a video about this see the following link:
    • For an overview about flavonoids see the following link:
    •  For a meta-analysis of prospective cohort studies which quantitatively assessed the association between flavonoid intake and mortality from cardiovascular disease and all-causes see the following link:
      • https://clinicalnutritionespen.com/article/S2405-4577(16)30271-6/fulltext
        • The conclusions indicate that a high intake of flavonoids is associated with reduced risk of mortality from  cardiovascular disease and all causes in men and women. The results support recommendations of high fruit and vegetables intake as a part of a healthy diet.
          • Sensitivity analysis that excluded one study at a time and estimated the pooled risk ratio with the remaining studies showed that the pooled risk ratios ranged from 0.84 (95% CI: 0.71, 0.98) to 0.88 (95% CI: 0.78, 0.99), which indicated robust results of the analysis of the highest flavonoid intake versus lowest from the studies examined.
          • Subgroup analysis by class of flavonoids showed significant associations for most classes (flavan-3-ols, flavones, flavanones, anthocyanidins and proan-thocyanidins), except for two classes (flavonols and isoflavones) that showed non-significant associations.
          • A significant risk reduction up to a daily flavonoid intake of about 170 mg was reported.
            • The flavonoid overview link given above provides summary tables of flavonoid classes and foods that contain them with amounts of each flavonoid per 100g of the food. However determining what would be an optimal combination of foods and amounts is non straightforward which is why I would guess this study simply supports the recommendation of a high fruit and vegetable intake. The following link to a scientific review article supports this guess:




      • Sulforaphane
        • Broccoli calabrese
          • Broccoli is a good source of sulforaphane a which a lot of research suggests is very beneficial polyphenol (more in the head than the stems). Sulforaphane is relatively unstable and is produced when two chemicals in broccoli interact (glucoraphanin and myrosinase) when broccoli is broken up (e.g. by chewing). Myrosinase content is reduced by cooking which reduces the amount of sulforaphane available. This can be countered to an extent by sprinkling with ground brown mustard seed (a source of Myrosinase) to the cooked broccoli and lightly cooking it or alternatively eating it raw. However much greater sulforaphane is available from sprouted broccoli seeds. See the following links for a video about growing broccoli sprouts and an informative FAQs page about sulforaphane in general:


        • Moringa oleifera leaf
          • The leaf of this tree which is available dried / powdered is also a good source of sulforaphane. See the following link to research about the properties of the leaf associated with different means of consumption:




      • Cocoa / chocolate
        • The most effective form, from a maximum and unaltered flavonoid content perspective, is non "dutched" cocoa powder (the addition of alkalis, to reduce bitterness and improve solubility, is often added in processing and is termed dutching). For a scientific article about this see the following link:
        • Cocoa is produced from cocoa beans by fermenting them, then roasting them, grinding them and then heating the grind to give a cocoa liquor (as a result of the fat melting) which is then usually pressed to separate the solids from the fat to produce cocoa powder and cocoa fat/butter respectively. Both these products can be referred to as cocoa mass/solids. These products may be further processed such as adding alkali to the cocoa powder as mentioned above. Chocolate is produced using one or more of these products and combining with other ingredients such as sugar, fat, flavourings and emulsifiers. The stated amount of cocoa mass/solids quoted on product label is therefore relatively meaningless from a flavonoid content perspective as this is determined primarily by the amount and quality of unprocessed cocoa powder in the chocolate which is rarely detailed on product labels. White chocolate does not typically contain any cocoa powder.
        • For a video about this subject see the following link:
        • For a video about consuming chocolate and what makes a good quality chocolate is see the following link:

      • Green tea
        • If you don't particularly like the flavour of green tea but do like the flavour of mint try Moroccan mint tea which is a blend of mint and green tea leafs.
          • The taste also works after brushing teeth with mint based toothpastes and when unsweetened its' antibacterial properties may provide dental hygiene benefits. 
        • For a video about the possible health benefits and risks of green tea see the following link:



        • Port wine
          • Port is made by the fermentation of grapes that contain naturally occurring sugar in the form of glucose and fructose. The fermentation utilises the glucose first but then it is stopped by the addition of distilled alcohol in the production process to fortify the drink leaving the fructose in the port which provides the sweetness (fructose is relatively significantly sweeter than glucose and also has a flavour profile typically preferred over glucose by most consumers). As a consequence it is a drink relatively high in both alcohol and fructose. It also often has a lot of sediment in it that contains the dead yeast killed when the alcohol was added which contains purines derived from the yeast DNA. The metabolism of purine (derivation; pure urine), alcohol and fructose all produce uric acid (aka urate) via different metabolic pathways. Uric acid is mostly removed from the blood by the kidneys which passes it out of the body in urine. If the kidneys are unable to remove enough uric acid from the blood high levels can build up. High levels of uric acid in the blood (aka hyperuricemia) can have health consequences  such as contributing/leading to inflammatory arthritis (gout).



                        • Changes in circulating levels of UA after the 6-month intervention. Forty-seven subjects were randomised to consume 1 l of SSSD (regular cola), semi-skimmed milk, diet cola or water daily for 6 months. A post hoc pair-wise comparison of the four groups using an unpaired t-test was performed and data are displayed as relative changes in plasma levels of UA for the four test beverages in relation to baseline values. Data are displayed as mean±s.e.m, *P=0.02, **P=0.009 and ***P=0.002 as compared with the relative change in UA in the SSSD group.

              • For a (long) video about uric acid and its impact on health see the following link:
                • https://youtu.be/QZ6jPCcFNa8
                  • Even in the normal range, having higher serum urate could be a risk for hypertension, dyslipidemia, and CKD. The optimal serum urate range, which conferred the lowest risk for developing cardiometabolic diseases, could be less than 5 mg/dL for men and 2–4 mg/dL for women in a generally healthy population. These findings suggest that routine screening of serum urate is useful as a predictor for cardiometabolic diseases in primary care settings. Source:


  • Vitamin and supplement product testing
    • For a website that provides information about vitamin and supplement products derived from laboratory testing see the following link:



      • Dose-response curves for serum 25(OH)D concentrations and all-cause and cardiovascular mortality. Hazard ratios (blue lines) and 95% confidence intervals (light blue shade) were adjusted for age (continuous), sex (male, female), and ethnicity (White, mixed, Asian, Black, Chinese, others, or unknown), education (college or university, vocational qualification, upper secondary, lower secondary, others, or unknown), Townsend deprivation index (in quintiles), household income (<18 18="" 31="" 52="">1,00,000 £, or unknown), smoking status (never smoker, former smoker, current smoker, or unknown), alcohol consumption (0, 0.1–4.9, 5.0–14.9, 15.0–19.9, 20.0–29.9, ≥30.0 g/day, or unknown), physical activity (inactive group, insufficient group, active group, or unknown), healthy diet score (in quintiles), and BMI (<18 .5="" 1.0="" 1.73="" 18.5="" 23.0="" 25.0="" 30.0="" 5.0="" 60.0="" and="" antihypertensive="" bmi="" body="" c-reactive="" c="" cancer="" cardiovascular="" cholesterol="" creatinine="" cvd="" cystatin="" diabetes="" disease="" duration="" egfrcr-cys="" equation="" estimated="" filtration="" glomerular="" history="" hypertension="" in="" index="" insulin="" kg="" lowering="" m2="" mass="" medication="" min="" ml="" no="" none="" of="" only="" or="" oral="" per="" protein="" quintiles="" rate="" use="" years="" yes="">

    • The association of genetically predicted 25-(OH)D with all-cause mortality was L-shaped (P for nonlinearity < 0.001), and risk for death decreased steeply with increasing concentrations until 50 nmol/L. Evidence for an association was also seen in analyses of mortality from cancer, CVD, and respiratory diseases (P ≤ 0.033 for all outcomes). Odds of all-cause mortality in the genetic analysis were estimated to increase by 25% (odds ratio, 1.25 [95% CI, 1.16 to 1.35]) for participants with a measured 25-(OH)D concentration of 25 nmol/L compared with 50 nmol/L. Source:
      • https://www.acpjournals.org/doi/10.7326/M21-3324
        • The 35 SNPs used in the Vitamin D genetic score (detailed in the research Supplementary Data document) were:
          • rs6671730, rs35408430, rs7522116, rs7528419, rs1933064, rs76798800, rs6672758, rs727857, rs1047891, rs2012736, rs6782190, rs705117, rs1352846, rs78151190, rs75741381, rs12056768, rs77532868, rs12794714, rs61891388, rs1660839, rs12803256, rs12798050, rs72997623, rs1149605, rs10859995, rs8018720, rs261291, rs77924615, rs212100, rs10426, rs6123359, rs17216707, rs2585442, rs2762943, rs2074735.

    • For research about Vitamin D levels in traditionally living populations in East Africa see the following link:



  • Vitamin K2

    • For an article about Vitamin K including information on vitamin K2 see the following link:
    • For an article about Natto see the following link:
    • The relative risk (RR) of CHD mortality was reduced in the mid and upper tertiles of dietary menaquinone (Vitamin K2) compared to the lower tertile [RR = 0.73 (95% CI: 0.45, 1.17) and 0.43 (0.24, 0.77), respectively]. Intake of menaquinone was also inversely related to all-cause mortality [RR = 0.91 (0.75, 1.09) and 0.74 (0.59, 0.92), respectively] and severe aortic calcification [odds ratio of 0.71 (0.50, 1.00) and 0.48 (0.32, 0.71), respectively]. Phylloquinone (Vitamin K1) intake was not related to any of the outcomes. These findings suggest that an adequate intake of menaquinone could be important for CHD prevention. Source:
    • A salad of rocket and parmesan cheese should be a good source of Vitamin K1 and K2 and when combined with an olive oil and balsamic vinegar dressing makes a classic Italian salad.



    • Omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease

                • Relations between quintiles of the Omega-3 Index and hazard ratios (+95% confidence interval) for death from CVD (n = 58), cancer (n = 146), other causes (n = 128), and all causes (n = 350, including 18 of unknown causes). Data are from 2500 participants free of baseline CVD followed for a median of 7.3 years. Adjusted for all variables in Table 1. P-values for trend are shown above the columns. CVD, cardiovascular disease; CHD, coronary heart disease. Source:


  • Vitamin D3 / omega3s / simple exercise
    •  For a video about research into the taking vitamin D3, omega3s and simple exercise alone and in combinations to prevent cancer in 70 year and older adults see the following link:

                • Primary endpoint—effect of treatments on the prevention of any invasive cancer. Cox-proportional hazard model adjusted for history of cancer, sex, BMI, prior fall, age, and study center. The comparison group is always the group that does not have the respective treatment(s) of interest. For all three treatments, it is the group who received only the placebo. All verified new invasive cancer cases (n = 81) among all 2,157 participants. Abbreviation: SHEP, Simple home exercise program.



  • Vitamin B12




    • For an article that discusses multivitamins see the following link:
      • https://www.healthline.com/health-news/multivitamins-dont-provide-many-health-benefits-researchers-say
        • If you restrict your food intake on a low calorie diet taking a daily multivitamin tablet for the duration should mean that no deficiencies occur.
        • For a good value multivitamin product available in the UK that seems to be comprehensive and provide doses consistent with health guidance see the following link:
          • https://www.waitrose.com/ecom/products/waitrose-a-z-multivitamins/822149-236342-236343
            • Typical valuesper tablet
              Vitamin A800µg RE
              100% of NRV
              Vitamin D5µg
              100% of NRV
              Vitamin E12.0mg a-TE
              100% of NRV
              Vitamin K75.0µg
              100% of NRV
              Vitamin C80.0mg
              100% of NRV
              Thiamin1.1mg
              100% of NRV
              Riboflavin1.4mg
              100% of NRV
              Niacin16.0mg NE
              100% of NRV
              Vitamin B61.4mg
              100% of NRV
              Folic Acid200.0µg
              100% of NRV
              Vitamin B122.5µg
              100% of NRV
              Biotin50.0µg
              100% of NRV
              Pantothenic Acid6.0mg
              100% of NRV
              Calcium200.0mg
              25% of NRV
              Magnesium100.0mg
              27% of NRV
              Iron14.0mg
              100% of NRV
              Zinc10.0mg
              100% of NRV
              Copper1000.0µg
              100% of NRV
              Manganese2.0mg
              100% of NRV
              Selenium55.0µg
              100% of NRV
              Chromium40.0µg
              100% of NRV
              Molybdenum50.0µg
              100% of NRV
              Iodine150.0µg
              100% of NRV





  • Oats

    • If you eat oats for their potential health benefits you may wish to consider which processed form you consume. Oatmeal (pinhead / steel cut) and oat bran appear to offer the greatest health benefits but provide different nutrient profiles. See the following link for information about oat bran:



  • Optimal metabolic health biomarkers



  • Cholesterol
      • Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational Cardiovascular Risk Consortium (published in 2019).
        • Added value of this study
          • To our knowledge, our study provides the most comprehensive analysis of long-term risk for cardiovascular disease related to non-HDL cholesterol and offers an easily applicable tool to assess the long-term probabilities for cardiovascular disease events associated with non-HDL cholesterol. On the basis of a derivation and validation approach to risk prediction, our data provide robust multinational information. By using an up-to-date multinational population-based pooled cohort dataset, we provide a model that calculates the potential benefit of an early lipid-lowering strategy in individuals without prevalent cardiovascular disease across a range of non-HDL cholesterol categories.
        • Source:

        • Sex-specific linear association of non-HDL cholesterol and cardiovascular disease risk (winsorised at 1·6 and 8·5 mmol/L). The Cox model used is adjusted for age, sex, study cohort, smoking, diabetes, body-mass index, systolic blood pressure, and antihypertensive medication. Non-HDL cholesterol was modelled using cubic splines. An interaction between sex and non-HDL cholesterol was included in the model. Median follow-up was 12·8 (IQR 7·5–18·4) years.

 

        • Model of long-term cardiovascular disease risk prediction and the benefit of lipid reduction. Individual risk of fatal or non-fatal cardiovascular disease in women (A) and men (B) according to age, non-HDL cholesterol concentration, and the number of additional cardiovascular risk factors (daily smoking, arterial hypertension, diabetes, and obesity; white circle). The red circle represents the probability (%) of cardiovascular disease by the age of 75 years. The hypothetically achievable probability (%) for cardiovascular disease by the age of 75 years after 50% reduction of non-HDL cholesterol is given in the green circle.



      • For research about the comparison between a specific cholesterol reducing diet and a statin on  cholesterol see the following link:
        • https://academic.oup.com/ajcn/article/81/2/380/4607446?login=false
          • The cholesterol reducing diet (portfolio diet) was composed of:
            • Plant sterols (1.0 g/1000 kcal).
            • Soy-protein foods (including soy milks and soy burgers, 21.4 g/1000 kcal).
            • Almonds (14 g/1000 kcal).
            • Viscous fibers from oats, barley, psyllium, and the vegetables okra and eggplant (10 g/1000 kcal).


                          • Bubble plots for the association between statin use and all-cause mortality regressed against the percentage of men (A,B), mean age (C,D), year of publication (E,F), average follow-up (G,H), and number of deaths per 1000 patient-years (I,J). Plots on the left represent the primary meta-analysis, whereas plots on the right represent the meta-analysis after the exclusion of influential studies. Bubble size represents study weight.












                    • Salt intake and risk of death. Spline plot of all-cause mortality (log scales) against salt intake in the follow-up study of Trials of Hypertension Prevention. Data from 2974 participants who were not in the salt reduction group, followed up for 23–26 years post-trial, adjusted for age, sex, race/ethnicity, clinic, treatment assignment, education status, baseline weight, alcohol use, smoking, exercise, and family history of cardiovascular disease. Rug plots indicate the distribution of estimated salt intake. Source:





    • Higher sodium and lower potassium intakes, as measured in multiple 24-hour urine samples, were associated in a dose–response manner with a higher cardiovascular risk.


                  • Spline Plots for the Associations of 24-Hour Urinary Sodium and Potassium Excretion and Sodium-to-Potassium Ratio with Cardiovascular Risk:
                    • The spline analysis of pooled data supported a linear association over the range of sodium excretion (Panel A; 5th to 95th percentile, 1846 to 5520 mg) and potassium excretion (Panel B; 5th to 95th percentile, 1462 to 3961 mg) within the overall study population. The sodium-to-potassium ratio (Panel C) was assessed on the basis of the sodium and potassium excretion measured in millimoles. Hazard ratios were estimated from Cox models stratified according to study cohort with adjustment for age, sex, race, educational level, height, body-mass index, alcohol consumption, smoking status, physical activity, history of diabetes and elevated cholesterol status, family history of cardiovascular disease, and mutual adjustment for 24-hour urinary potassium and sodium excretions. Shaded areas indicate 95% confidence intervals, and the dashed line at 1.0 indicates the reference. Box plots at the bottom of the graphs show the distributions of the urinary biomarker. The vertical bar indicates the median, and the ends of the box the interquartile range; the whiskers (dashed lines) extend to values no farther than 1.5 times the interquartile range (which may be past the graphed area), and dots indicate values that are farther than 1.5 times the interquartile range. The 5th, 25th, 50th, 75th, and 95th percentiles (P5, P25, P50, P75, and P95, respectively) are shown at the bottom of each graph. Source:

    • Low sodium salt substitutes(LSSS): a tool for sodium reduction and cardiovascular health.
      • ...The Cochrane systematic review and meta‐analysis by Brand and colleagues examined the evidence regarding the use of LSSS on cardiovascular health in adults and children, and included blood pressure as a primary outcome. Importantly, the review also examined potential adverse effects including high levels of potassium in the blood (hyperkalaemia), which can cause potentially dangerous abnormal heart rhythms...
      • ...Meta‐analyses demonstrated a mean reduction in systolic blood pressure of 4.76 mmHg (95% confidence interval (CI) 3.50 lower to 6.01 lower) and diastolic blood pressure of 2.43 mmHg (95% CI 3.50 lower to 1.36 lower) with the use of LSSS. Meta‐analyses also showed small decreases in non‐fatal stroke (rate ratio 0.90, 95% CI 0.80 to 1.01), non‐fatal acute coronary syndrome (rate ratio 0.70 95% CI 0.52 to 0.94) and cardiovascular mortality (rate ratio 0.77 95% CI 0.60 to 1.00) in adults...
      • ...This review provides valuable evidence for policymakers in support of their efforts to reduce sodium intake. Although the review authors conclude that the 4.8 mmHg reduction in systolic blood pressure was not clinically meaningful (having prespecified a clinically meaningful reduction to be at least 10 mmHg), a reduction in blood pressure of this magnitude is consistent with reductions seen with the use of several classes of antihypertensive medications and is likely to be associated with substantial benefits at a population level. For example, a meta‐analysis of trials of antihypertensive drugs showed a mean reduction of systolic blood pressure using ACE inhibitors of 4 mmHg, which was associated with reductions in stroke (20%) heart failure (21%), acute coronary syndrome (13%) and major cardiovascular events (17%). Observational studies have demonstrated substantial reductions in CVD mortality with systolic blood pressure going down to 115 mmHg, and there is clear evidence that blood pressure reductions such as those demonstrated in this review are likely to have a positive impact on population cardiovascular health...
      • Source:


  • Blood pressure


    •  Home blood pressure (BP) monitoring (HBPM)
      • Home BP is the average of all BP readings performed with a semiautomatic, validated BP monitor, for at least 3 days and preferably for 6–7 consecutive days before each clinic visit, with readings in the morning and the evening, taken in a quiet room after 5 min of rest, with the patient seated with their back and arm supported. Two measurements should be taken at each measurement session, performed 1–2 min apart.(57) Compared with office BP, HBPM values are usually  lower, and the diagnostic threshold for hypertension is >_135/85 mmHg (equivalent to office BP >_140/90 mmHg) (Table 9) when considering the average of 3–6 days of home BP values. Compared with office BP, HBPM provides more reproducible BP data and is more closely related to HMOD, particularly LVH.(58) Recent meta-analyses of the few available prospective studies have further indicated that HBPM better predicts cardiovascular morbidity and mortality than office BP.(59) There is also evidence that patient self-monitoring may have a beneficial effect on medication adherence and BP control,(60,61) especially when combined with education and counselling.(62) Telemonitoring and smartphone applications may offer additional advantages,(63,64) such as an aid to memory to make BP measurements, and as a convenient way to store and review BP data in a digital diary and transmit them. We do not recommend the use of apps as a cuff-independent means of measuring BP.





      • Cuff on the left arm or right arm?
        • Blood pressure should be assessed in both arms and readings from the higher reading arm should be used.



      • Normal daily blood pressure variation



    • For research that suggests that the reduction of systolic blood pressure reduced the risk of major cardiovascular events irrespective of previous diagnoses of cardiovascular disease and even at normal or high-normal blood pressure values see the following link:
      • https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00590-0/fulltext
        • In this largest source of randomised evidence of blood pressure-lowering effects on cardiovascular disease and death, we found the proportional effects of blood pressure-lowering on cardiovascular outcomes to be similar in people with or without previous cardiovascular disease and across categories of baseline systolic blood pressure down to less than 120 mm Hg. On average, a 5 mm Hg reduction of systolic blood pressure reduced the risk of a major cardiovascular event by about 10%; the corresponding proportional risk reductions for stroke, heart failure, ischaemic heart disease, and cardiovascular death were 13%, 13%, 8%, and 5%, respectively.
      • For a lecture from one of the main authors of the above study see the following link:


    • For a video discussion about blood pressure (from 1 hour and 44 minutes in) with some key insights see the following link:



    • The relative impact of factors that impact blood pressure


    • The best nonpharmacological interventions that impact blood pressure


                  • *Type, dose, and expected impact on BP in adults with a normal BP and with hypertension.†In the United States, one “standard” drink contains roughly 14 g of pure alcohol, which is typically found in 12 oz of regular beer (usually about 5% alcohol), 5 oz of wine (usually about 12% alcohol), and 1.5 oz of distilled spirits (usually about 40% alcohol).
                  • Nonpharmacological interventions are effective in lowering BP, with the most important interventions being weight loss, the DASH (Dietary Approaches to Stop Hypertension) diet, sodium reduction, potassium supplementation, increased physical activity, and a reduction in alcohol consumption. Various other nonpharmacological interventions have been reported to lower BP, but the extent and/or quality of the supporting clinical trial experience is less persuasive. Such interventions include consumption of probiotics; increased intake of protein, fiber, flaxseed, or fish oil; supplementation with calcium or magnesium; and use of dietary patterns other than the DASH diet, including low-carbohydrate, vegetarian, and Mediterranean diets. Stress reduction is intuitively attractive but insufficiently proved, as are several other interventions, including consumption of garlic, dark chocolate, tea, or coffee. Behavioral therapies, including guided breathing, yoga, transcendental meditation, and biofeedback, lack strong evidence for their long-term BP-lowering effect. The best proven nonpharmacological measures to prevent and treat hypertension are summarized in the table above. Source:


    • Associations between height and blood pressure
                • Predicted brachial artery blood pressure differences (ΔBP, short–tall BP) between the 5th and 95th height (man, 161.8 and 188.1 cm, respectively; woman, 150.0 and 173.0 cm, respectively) percentiles for a representative adult male (BMI, 25 kg/m2; % body fat, 25) and female (BMI, 25 kg/m2; % body fat, 40) at 3 ages. A race × height interaction was present for female PP and the predicted ΔBP was derived using values for non-Hispanic White. Variations in predicted ΔBP values for women of other race/ethnic groups are given in Section 3. BMI = body mass index, BP = blood pressure, DBP = diastolic blood pressure, MBP = mean arterial blood pressure, PP = pulse pressure, SBP = systolic blood pressure. Source:

    • Blood pressure with aging
                • Multivariable-adjusted sex-specific trajectories of blood pressure (BP) with aging. The BP trajectories adjusted for multiple risk factors (body mass index, total cholesterol, diabetes, and smoking status). Although BP trajectories in both sexes were attenuated with multivariable adjustment, consistent with the known contributions of risk factors to age-related BP elevation, between-sex differences in all BP trajectories persisted. P values are for sex differences in the BP trajectories. DBP indicates diastolic blood pressure; SBP, systolic blood pressure. Source:


    • The effect of a dietary supplement of potassium chloride or potassium citrate on blood pressure.
      • WARNING: Too high a level of potassium in your blood is life threatening.



    • The effect of a reduction in alcohol consumption on blood pressure.
      • In people who drank (1 drink=12 g pure alcohol) two or fewer drinks per day, a reduction in alcohol was not associated with a significant reduction in blood pressure; however, in people who drank more than two drinks per day, a reduction in alcohol intake was associated with increased blood pressure reduction. Reduction in systolic blood pressure (mean difference −5·50 mm Hg, 95% CI −6·70 to −4·30) and diastolic blood pressure (–3·97, −4·70 to −3·25) was strongest in participants who drank six or more drinks per day if they reduced their intake by about 50%. Source:
    • Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies
      • Results: seven studies, with 19 548 participants and a median follow-up of 5.3 years (range, 4–12 years), were included in the analysis. We observed a substantially linear positive association between baseline alcohol intake and changes over time in SBP and DBP, with no suggestion of an exposure-effect threshold. Overall, average SBP was 1.25 and 4.90 mm Hg higher for 12 or 48 grams of daily alcohol consumption, compared with no consumption. The corresponding differences for DBP were 1.14 and 3.10 mm Hg. Subgroup analyses by sex showed an almost linear association between baseline alcohol intake and SBP changes in both men and women, and for DBP in men while in women we identified an inverted U-shaped association. Alcohol consumption was positively associated with blood pressure changes in both Asians and North Americans, apart from DBP in the latter group. Source:

    • The effect of different exercise modes on blood pressure.
      • Results: 270 randomised controlled trials were ultimately included in the final analysis, with a pooled sample size of 15 827 participants. Pairwise analyses demonstrated significant reductions in resting SBP and DBP following aerobic exercise training (−4.49/–2.53 mm Hg, p<0.001), dynamic resistance training (–4.55/–3.04 mm Hg, p<0.001), combined training (–6.04/–2.54 mm Hg, p<0.001), high-intensity interval training (–4.08/–2.50 mm Hg, p<0.001) and isometric exercise training (–8.24/–4.00 mm Hg, p<0.001). As shown in the network meta-analysis, the rank order of effectiveness based on the surface under the cumulative ranking curve (SUCRA) values for SBP were isometric exercise training (SUCRA: 98.3%), combined training (75.7%), dynamic resistance training (46.1%), aerobic exercise training (40.5%) and high-intensity interval training (39.4%). Secondary network meta-analyses revealed isometric wall squat and running as the most effective submodes for reducing SBP (90.4%) and DBP (91.3%), respectively. Source:



    • Reductions in systolic blood pressure achieved by hypertensives with three isometric training sessions per week are maintained with a single session per week.
      • Isometric handgrip or (wall) squat exercise performed three times per week produces reductions in systolic blood pressure (SBP) in adults with hypertension. We aimed to compare these interventions and the potential to retain benefits with one exercise session per week. We compared blood pressure changes following handgrip and squat isometric training interventions with controls in a randomized controlled multicentre trial in 77 unmedicated hypertensive (SBP ≥ 130 mmHg) adults. Exercise sessions were performed in the workplace and consisted of four repetitions—three sessions per week for the first 12 weeks (phase 1), and one session per week for the subsequent 12 weeks (phase 2). Office blood pressure (BP) was measured at baseline, post-phase 1 and post-phase 2. Post-phase 1, mean reductions in SBP were significantly greater in handgrip (–11.2 mmHg, n = 28) and squat (–12.9 mmHg, n = 27) groups than in controls (–.4 mmHg; n = 22) but changes in DBP were not. There were no significant within-group changes during phase 2 but SBP was 3.8 mmHg lower in the wall squat than the handgrip group—a small magnitude but clinically important difference. While both interventions produced significant SBP reductions, the wall squat appears to be more effective in maintaining benefits with a minimal training dose. The low time investment to achieve and retain clinically significant SBP reductions—42 and 12 min, respectively—and minimal cost, particularly of the wall squat, make it a promising intervention for delivery in public health settings. Source:
        • https://onlinelibrary.wiley.com/doi/full/10.1111/jch.14621
        • The wall squat group performed 4 repetitions of 2 min with 2 min rest between each repetition ultimately if able at a 95 degree angle (picture (A) below) progressing to it over many weeks incrementally from a higher angle (picture (B) below). Picture (C) shows the hand grip exercise also tested. 



    • The effect of endurance exercise on (ambulatory recorded) blood pressure.
      • Overall, endurance training induced a significant reduction in daytime SBP [-3.2 mmHg, 95% confidence interval (CI), -5.0 to-0.3] and daytime DBP (-2.7 mmHg, 95% CI, -3.9 to -1.5). No effect was observed on night-time BP. The findings from this meta-analysis suggest that aerobic endurance exercise significantly decreases daytime, but not night-time, ambulatory BP.

    • Effect of aerobic and resistance exercise training on high (ambulatory recorded) blood pressure.
      • We found that aerobic training and resistance training were well tolerated. Both aerobic training and resistance training reduced daytime systolic ABP (-7.2 +/-7.9 and -4.4 +/-5.8 mmHg; P < 0.05) and 24-h systolic ABP (-5.6 +/-6.2 and -3.2 +/-6.4 mmHg; P < 0.05). Aerobic training and resistance training both improved brachial artery flow-mediated dilation...  However, only aerobic training decreased markers of inflammation (C-reactive protein, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1 and lectin-like oxidized LDL receptor-1) and endothelin-1 and increased nitrite and nitrate levels (P < 0.05).
      • Healthcare providers should continue to emphasize aerobic training for hypertension management given the established role of nitric oxide, endothelin-1 and chronic low-level inflammation in the pathogenesis of cardiovascular disease. However, our study demonstrates that resistance training should also be encouraged for middle-aged hypertensive patients. Our results also suggest that even if patients are on antihypertensive medications, regular aerobic training and resistance training are beneficial for blood pressure control and cardiovascular disease risk reduction.
        • Participants assigned to aerobic training or resistance training completed three exercise sessions/week over 12 weeks at our institution’s exercise facilities under the direct supervision of an exercise physiologist. Exercise sessions were preferably scheduled on Monday, Wednesday and Friday. Unless there was a schedule conflict, participants completed all sessions at the same time on the planned days between 0700 h and 1900 h. Prior to the 12 week exercise intervention, 1 week was provided to familiarize participants with the equipment and exercise protocols. Aerobic training was performed on a treadmill using a progressive exercise intensity starting at 60% of heart rate (HR) reserve and increasing by increments of 10% every 4 weeks to 80% of HR reserve over the 12-week intervention. Exercise sessions consisted of 5 min treadmill walking at a self-selected intensity, 45–50 min treadmill exercise at the prescribed intensity and 5 min cool down (stretching). HR was monitored during each aerobic training session using telemetry (Polar Electro Oy, Kempele, Finland). Resistance training consisted of two to three sets of eight to 20 submaximal repetitions of bench press, leg press, lat pull down, leg extension, shoulder press, leg curl, bicep curl and triceps extension. Two sets were performed in the first 6 weeks and three sets in the last six weeks separated by 120s rest between sets. To prevent excessive BP increases, repetitions ranged from 15 to 20 in the first 4 weeks, 10–15 in weeks four through eight and eight to 12 in weeks eight through twelve. The maximum weight that participants could move with good technique (without concentric failure) was used. In addition, three sets of 15 repetitions of abdominal crunches were performed during each session.
        • Abstract source:

    • Effect of resistance exercise training on high blood pressure.
      • When comparing hypertension, the results of systolic blood pressure after strength training were significantly decreased by strength training compared to the baseline moment (mean difference = − 9.52; 95% CI − 12.89 to − 6.14; I2 = 90%; p < 0.00001...). ...significant associations between diastolic blood pressure and strength training (mean difference = − 5.19; 95% CI − 7.98 to − 2.39; I2 = 93%; p = 0.0003).
      • The strongest effect of strength training on decreasing blood pressure was observed in protocols with a moderate to vigorous load intensity (> 60% of one-repetition maximum-1RM), a frequency of at least 2 times per week, and a minimum duration of 8 weeks. We concluded that strength training interventions can be used as a non-drug treatment for arterial hypertension, as they promote significant decreases in blood pressure. Source:


    • For a comprehensive long video about blood pressure lowering (antihypertensive) medications see the following link:









    • For details of a wearable blood pressure monitoring device see the following link:







                  • Mortality hazard risk ratios with 95% confidence intervals by HbA1c group for those with/without diabetes (HbA1c 5%-5.6%, no diabetes diagnosis [green bar], as reference), NHANES 1988-2015.
                    • Low HbA1c Levels in People Without Diabetes
                      • Note the U-shaped curve above. In people without diabetes, there is no agreed lower cut-off point for HbA1c. However, with the widespread use of HbA1c testing, low HbA1c values are often detected. The definition of low HbA1c varies from study to study, with researchers using 4%, 4.5% or even 5% as the cut-off point.
                      • Several research studies have suggested that with HbA1c, it is not a case of “the lower the better.” There are many medical conditions that affect red blood cell turnover, which can cause low HbA1c levels. 

                  • In 2011, an expert group at the World Health Organization (WHO) agreed the HbA1c test could be used to diagnose diabetes and recommended 6.5% as the diagnostic cut-off point. However, a value of less than 6.5% does not exclude diabetes, and WHO’s group did not make any formal recommendations to interpret HbA1c levels below 6.5%. Consequently, the American Diabetes Association (ADA) and U.K. National Institute for Health and Care Excellence (NICE) have each defined its own cutoff points for pre-diabetes (see Table 2, below).


    • Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes

                    • Adjusted relative hazard of coronary heart disease in 1321 individuals without diabetes (A) and 1626 individuals with diabetes (B), adjusted for age, sex, and race and plotted on the log scale. All adjusted relative hazards are centered at hemoglobin A1c (HbA1c) = 5.2%, and the graphed lines are shown for the fifth to 95th percentiles of HbA1c level. The solid black line in A is from a single-knot linear spline model (knot at HbA1c = 4.6%). The dotted gray line is from a linear spline model with knots at the quintiles of HbA1c. In B, the solid black line is from a linear model; the gray dotted line is from a linear spline model with knots at the quintiles of HbA1c level. The normal range for HbA1c in persons without diabetes (4%-6%) is indicated by the dotted vertical lines in A. The current target for glycemic control in persons with diabetes (HbA1c = 7%) is indicated by the vertical dotted line in B. Source:

    • Sex-specific risks for cardiovascular disease across the glycaemic spectrum.

                • Sex-specific associations between glycated haemoglobin (HbA1c) and six cardiovascular diseases. Caption: ∗A composite measure of all examined outcomes. Notes: Sex-specific hazard ratios from Cox proportional hazards models, sequentially adjusted for age at study entry, socio-demographics (i.e., ethnicity and deprivation), lifestyle factors (i.e., smoking status, alcohol consumption, physical activity, body mass index, waist-hip ratio, processed meat and fruit and vegetable intake), and clinical characteristics (i.e., total cholesterol, estimated glomerular filtration rate, C-reactive protein, diagnosed hypertension, use of antihypertensive medication or statins, and family history of cardiovascular disease). Categories defined as follows: low-normal (<35 mmol/mol or <5.5%), pre-diabetes (42–47 mmol/mol or 6.0–6.4%), undiagnosed diabetes (≥48 mmol/mol or ≥6.5%), or diagnosed diabetes. Reference group: normal HbA1c (35–41 mmol/mol or 5.5–5.9%). Source:


                • Mean continuous IG trace obtained by the microdialysis technique in healthy volunteers after ingestion of meals with identical carbohydrate amount, but with different fiber, protein, and fat content. Mean interstitial glucose trace ± 2 SD (corresponding to the 95% range), n = 23; Cap. BG: capillary blood glucose values, used for calibration of the tissue glucose monitoring device; Ven. BG: venous blood glucose values. Meal 1: rice pudding with sugar and cinnamon; meal 2: toast, honey, jam, curd cheese, and orange juice; meal 3: kidney beans, wholemeal bread, salami, cheese; and meal 4: grilled salmon, broccoli, carrots, wild rice, and cream. (Right) Areas under the curve (above baseline) after intake of standardized meals. Mean AUC ± SEM: AUC 0-1, 1-2, 2-3, 3-4, and 4-5 hours after start of meal (n = 23); **P < 0.01, ***P < 0.001 versus AUC 0-1 hour.


      • Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range

      • If you think you have an excessive post meal glucose response this can be more rapidly brought down by undertaking some form of exercise such as a 45 to 60min walk or by exercising the soleus muscle in your calf if you need to remain more static, see the following link for the research on this:







    • Death rate by age group in England and Wales in 2015



                    • Sex-standardised cumulative incidence (%) of the top 50 diseases and all cancers between April 1, 2010, and March 31, 2015, for individuals aged 80 years or more on April 1, 2010. AKI=acute kidney injury. BPH=benign prostatic hyperplasia. CIN=cervical intraepithelial neoplasia. CKD=chronic kidney disease. COPD=chronic obstructive pulmonary disease. GORD=gastro-oesophageal reflux disease. HDLC=high-density lipoprotein cholesterol. IBS=irritable bowel syndrome. ID=infectious disease. LDLC=low-density lipoprotein cholesterol. LRTI=lower respiratory tract infection. PCOS=polycystic ovary syndrome. PID=pelvic inflammatory disease. T1D=type 1 diabetes. T2D=type 2 diabetes. TIA=transient ischaemic attack. URTI=upper respiratory tract infection. UTI=urinary tract infection.

    • What things are you most likely to die from and how to prevent them

    • Biomarker based biological age
      • Chronological age is the strongest risk factor for most chronic diseases. Developing a biomarker-based age and understanding its most important contributing biomarkers may shed light on the effects of age on later-life health and inform opportunities for disease prevention. The biomarker ages, from research source provided below, described 44.0% and 51.3% of the variation in chronological age for healthy men and women, respectively with the principal biomarker components from the research shown in the charts below:

                  • Top phenome-wide associations and closely related traits with genetically predicted height.

        • For information about UK biobank data including details of the biomarkers utilised in the above research see the following link:
          • https://biobank.ndph.ox.ac.uk/ukb/
          • Outside of the UK biobank research environment some of the  biomarkers may be difficult to measure if the aim is to compare against UK biobank data e.g. the Reaction time and the Pairs matching test as they were tested in a laboratory environment with specific testing equipment. For reaction time however research is available that has made the comparison and provides access to the online research tool used to undertake the research unfortunately the tool combines a Reaction time test followed by a similar Pairs matching test but only provides a single result so the Reaction time test result cannot be split from the overall test score result provided. See the following link to the research:


    • Phenotypic age biomarker based estimation

    • Blood biomarker profiles and exceptional longevity: comparison of centenarians and non-centenarians
      • In conclusion, already from age 65 onwards, a difference in commonly available biomarkers was observed between individuals who eventually became centenarians and those who did not. From a total of 12 blood-based biomarkers:
      • Higher levels of:
        • total cholesterol (TC) [metabolic status/function]
        • iron [anaemia]
      • Lower levels of:
        • glucose [metabolic status/function]
        • creatinine [kidney function]
        • uric acid [inflammation]
        • aspartate aminotransferase (ASAT) [liver function]
        • gamma-glutamyl transferase (GGT) [liver function]
        • alkaline phosphatase (ALP) [liver function]
        • total iron-binding capacity (TIBC) [anaemia]
        • lactate dehydrogenase (LD) [liver function]
        • were associated with a greater likelihood of becoming a centenarian. While chance likely plays a role for reaching age 100, the differences in biomarker values more than one decade prior death suggest that genetic and/or lifestyle factors, reflected in these biomarker levels may also play a role for exceptional longevity. Our work - to date the largest study on this topic also shows that centenarians had homogeneous biomarker profiles which underscores the importance of specific biomarker characteristics in research on exceptional longevity. Source:






    • Sparkling water







      • In addition to impeding the inhalation of pathogens wearing a mask also helps keep your nose at a higher temperature than without one which helps the body fight infection in the upper respiratory tract when one is acquired by providing a more hostile environment to the infecting pathogen(s).





    • HEPA14 air filtration
      • Airborne severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in a coronavirus disease 19 (COVID-19) ward before activation of HEPA-air filtration but not during filter operation; SARS-CoV-2 was again detected following filter deactivation. Airborne SARS-CoV-2 was infrequently detected in a COVID-19 intensive care unit.
        Bioaerosol was also effectively filtered. Source:




    • Solid fuel stoves
      • It appears that even the use of even modern wood and coal burning residential stoves can create high levels of indoor Particulate Matter air pollution well above World Health Organisation guideline safe levels. Research indicates that people inside homes with a residential stove are at risk of exposure to high intensities of particulate matter of sizes PM2.5 and PM1. The research reports that this can occur within a short period of time through normal use with the opening of the stove door to refuel being the primary mechanism for introducing PM into the home. See the following link to the research:
        • https://www.mdpi.com/2073-4433/11/12/1326/htm
        • The World Health Organisation guidelines for maximum mean Particulate Matter concentrations over 24 hours are:
          • PM10 = 50 ug/m3
          • PM2.5 = 25 ug/m3
            • United States and western Europe background concentration, estimated at 3 – 5 ug/m3.
          • PM1 = No guidance as, "While there is considerable toxico-logical evidence of potential detrimental effects of ultrafine particles on human health, the existing body of epidemiological evidence is insufficient to reach a conclusion on the exposure–response relationship to ultrafine particles."
          • See the following link for the guidance:
          • Particulate matter air content can be easily measured using a consumer air quality particulate matter monitor.
            • You'll want to make sure there are no other sources of particulate matter air pollution in the room when taking readings (e.g. burning incense, candles, etc).
          • For a video about particulate matter air pollution in general but which also covers cars see the following link:





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