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Good Vibes - HRV, Toolkit to improve HRV, Hair loss & treatments,100 days & more..

Good Vibes
Good Vibes - HRV, Toolkit to improve HRV, Hair loss & treatments,100 days & more..
By Sandeep Mall • Issue #21 • View online
Welcome 31 new and 2660 existing subscribers to the 21st issue of Good Vibes.
In this issue :
  • Everything you need to know about Heart rate variability
  • Toolkit to improve HRV
  • Understand Terminologies used in nutrition
  • Hair loss & Treatments
  • 100 Day Challenge
  • Tweet of the week
  • Recipe of the week
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Sandeep Mall

Heart rate variability
What is HRV?
  • HRV stands for heart rate variability
  • HRV measures the variation in time between heartbeats, and that’s measured in milliseconds (1,000 milliseconds is one second)
  • So if a person’s heart is beating 60 times per minute, you think there’s 1,000 milliseconds between every beat…but it turns out that it’s not really the case
  • Even if your heart is beating 60 times per minute (i.e., once per second) between the first beat and the second beat, it might be 1,010 milliseconds
  • And between that second beat and the third beat, it might be 960 milliseconds
  • And between that beat and the beat thereafter, it might be 1,027 milliseconds.
  • In other words, there is actually some variability
  • If you has ever seen an EKG, you will recognize that there is a very big spike for each of those beats (known as the spike in the R wave)
  • If you now measure the distance between the Rs—the RR interval—and you take the RMSSD (The Root Mean Square of Successive Differences between normal heartbeats)…that means you calculate the time difference between each RR interval
  • The RMSSD is obtained by first calculating each successive time difference between heartbeats (RR intervals) in ms.
  • Then, each of the values is squared and the result is averaged before the square root of the total is obtained.
  • So RMSSD is reported in milliseconds
  • If using wearables that calculate HRV while you’re sleeping, you’ll notice it gives you a number in milliseconds
What can it tell us, possibly?
  • HRV provides a snapshot into how your body is balancing between the two branches of your autonomic nervous system: sympathetic (“fight-or-flight”), and parasympathetic (“rest-and-digest”).
  • The heart is not a metronome – it’s actually erratic
  • A healthy nervous system has a balanced but strong push and pull between Sympathetic and Parasympathetic causing high Heart Rate Variability
  • It turns out that that variability is heavily influenced by which of the autonomic nervous systems is most dominant
What is the autonomic system, and what’s the difference between sympathetic and parasympathetic?
  • The Autonomic system handles the unconscious processes (and even effects conscious behavior)
  • Autonomic contains two branches – the Parasympathetic and the Sympathetic
Sympathetic is activated in times of stress
  • Fight or Flight
  • Sacrifice long term to get through the short term
  • Flood energy, dilate pupils, slow digestion/peristalsis, increase heart rate
  • It’s slowing digestion and peristalsis, meaning it’s slowing down anything that’s not essential, and it’s increasing heart rate
Parasympathetic is activated in times of recovery
  • Rest and digest
  • Conserves energy, constricts pupils, aids digestion, slows heart rate
What does this have to do with HRV?
  • when the sympathetic system is revved up, HRV goes down
  • when the parasympathetic system is in control HRV goes up
  • As the heart rate speeds up, which is what’s happening under sympathetic tone, there’s less variability between the beats
  • When the heart rate slows down, when the body is relaxing, there’s more variability between beats.
  • High HRV means you’re getting both strong “on” and “off” outputs and your body is highly responsive to your environment. It can quickly shift its energy from “fight or flight” to “rest and digest” to easily match its surroundings. 
  • Low HRV is sympathetic dominant and means the body is under some form of stress.
NOTE: comparing your HRV to another person’s HRV might not be the most helpful thing in the world, but knowing how your HRV, your heart rate, your respiratory rate, your body temperature change over time, and assimilating all of that data is probably a more useful biomarker. 
Factors that lower HRV
  • Alcohol – I’ve never seen anything that lowers my HRV as much as alcohol does.
  • stress
  • when you go to bed and you’re stressed out
  • Smoking
  • lack of physical activity
  • lousy diet
  • caffeine consumption in the evening
  • high blood pressure
  • high triglycerides
  • metabolic syndrome
  • apparently even air pollution can lower a person’s HRV
Things that raise HRV
  • endurance exercise
  • yoga 
  • meditation
  • Biofeedback
  • Good sleep hygiene
The Gold standard in measuring HRV is EKG but now a days many wearables also show your HRV.
What’s a good HRV?
Science still does not have a specific answer to this. HRV declines with age so whenever you talk about HRV, you have to talk about it in the context of age.
Middle 50% of HRV by age
Middle 50% of HRV by age
You’ll notice it’s actually quite a steep drop with age. The most important thing to be thinking about is how do you stack up to yourself over time. Don’t compare your HRV to others.
(Excerpts from Peter Attias Podcast )s
Toolkit to improve HRV
1. Stay active. One of the most effective ways to lower your resting heart rate and increase your HRV is staying active. Regular exercise a few times per week can lead to improved HRV at any age and is one of the most effective, established ways to make progress for more sedentary individuals. If you’re already very active, rather than aiming for a higher HRV score, focus on incorporating HRV monitoring into your training routine and watch how your HRV consistency changes. This approach can lead to improved performance.. 
2. Get good sleep. Good sleep is just as important as exercise. Several studies have shown how sleep deprivation, or simply lower sleep quality, is associated with reduced HRV [5]. So, especially when something like a new exercise regimen or work-related stress begins to add strain to your day — recovery becomes essential.
3. Eat well. Activity, sleep, and diet are the three pillars of a healthy lifestyle. What we eat and when we eat can have a significant impact on our sleep and resting physiology (heart rate and HRV). While individual needs can vary, try avoiding processed foods and late, large meals, as these have been shown to reduce HRV.
4. Breathe. Deep breathing techniques (everything from yoga, mindfulness, meditation, or biofeedback) can effectively strengthen the parasympathetic system (your “rest and digest” network), resulting in improved HRV. 
5. Listen To Your Body And Better Manage Stress.  The previous four tips are all key to improving our HRV, but stress will still play a significant role in our lives for a variety of reasons. On days when your HRV is a bit lower than usual, try to prioritize recovery, reduce training intensity, and take extra care of yourself. 
Understanding Terminologies which you hear when we talk health
We regularly use many terminologies when we talk nutrition, science and health. What exactly do they mean or define. Read here a comprehensive list with their definitions.
Hair Loss & Treatments
by Dr. Divya Sharma, MD
Hair loss and hair fall are particularly distressing conditions where you feel that your once thick, beautiful mane is thinning day by day. Most people associate hair loss with menopause or old age but it can occur at any time in a person’s life- even during puberty! 
There are various types of hair loss and treatments for different causes. 
What are the different types of hair fall?
First, we need to understand the type of hair fall before deciding on treatment options. In the previous issue we learnt about different stages of haircycle. Every person has three types of hairs on their head - anagen (growing), catogent (resting) and telogen (shedding). 
What is Telogen Effluvium (TE)?
Telogen effluvium occurs when there is a sudden increase in resting hairs over growing ones, leading to less body volume or ponytail size. This may sometimes lead to less hair volume at temple regions in females. 
How does TE get triggered? This condition may be triggered by nutritional deficiency, illness, major surgery or childbirth among many other stressful events which adversely impact the dermal papilla or hair root. 
What is the suggested treatment for TE? Your Dermatologist may prescribe Procapil, Capixyl or Biomimetic peptides, which increase the circulation around the hair root. They also enhance nutritional delivery to the hair follicle. One can use them for a longer period to see a visible improvement in Hair volume as well. Due to the slow hair cycle, it takes longer for hair to see a definite increase in volume especially in females.
Most importantly, one should be assured that telogen effluvium will not lead to baldness or permanent hair loss if treated well in time.
Pre-mature hair loss in Men
It is natural for men to experience hair loss as they age, but sometimes baldness can occur prematurely or more severely. Most often men notice the recession of that hairline near the temple area or thinning of hair near the vertex or crown of the head. 
What is Male pattern baldness or Androgenic Alopecia? 
We all understand that post puberty, men have increased levels of Dihydrotestosterone (DHT). DHT causes miniaturization of the hair follicle which leads to recession of hairline to some extent. Roughly when the recession reaches beyond an imaginary line between the two ears, we label it as Male pattern baldness or Androgenetic alopecia (AGA). 
Dermatologists use Hamilton Norwood Classification to grade the baldness and start you on treatment to avoid progression at Stage 3 and above. 
How do we control the progression of hair loss? There are two main approaches to control the progression - the first is to revert miniaturization and to reduce DHT activity. 
Minoxidil is one of the most commonly used FDA approved treatments. It is usually prescribed as a solution or foam in strengths of 2 %, 5% and even 10%. It is now available in oral tablet form as well. It works on potassium channels and enhances scalp circulation. It prevents further miniaturization to a certain extent. It is effective as long as it is applied. 
Regarding side effects, it may cause irritation, flakiness of the scalp and even allergic reactions in very few people. The allergic reaction is actually triggered by a preservative used in minoxidil preparations. It is approved as a 2% solution to be applied twice a day for women or 5% once a day. Men can use 5% twice a day and in few cases, even 10% is used. The oral tablet is being increasingly used by the Dermatologists but certain cardiac side effects are reported. 
Regenerative medicine and its role in hair regrowth
One of the key challenges that I come across in my practice is the limited hair regrowth achieved by the topical solution, here in comes the role of hair regenerative medicine where increasingly we are trying to harvest the growth potential of the stem cells in the hair bulge region. Procedures like Platelet rich plasma (PRP) or Platelet rich Fibrin (PRF) help to achieve hair regrowth in certain patients. 
Other non-surgical treatment options -Microneedling and Mesotherapy where external hair growth factors are injected near the hair root to increase the hair diameter. 
Finasteride is used in oral and topical form to reduce the activity of 5 alpha reductase enzyme which converts Testosterone into Dihydrotestosterone. It may have potential side effects like erectile dysfunction, lack of libido or depression. Though in practice, we seldom see any side effects but one has to be investigated thoroughly before the treatment. Hair Transplant is a surgical option and I am keeping it outside the purview of today’s article and should be a separate discussion and write-up in a later issue.
Consistency, Compliance and Overall health:
Though treatment for hair loss remains the same, what makes the difference is the consistency of treatment, compliance with treatment and the impact of the overall healthy lifestyle. Dyslipidemia, smoking and nutritional deficiency may need to be worked up as well. 
Key to effective hairloss/hairfall treatment is that it should be initiated early to see better results. 
Dr Divya Sharma is a renowned dermatologist and trichologist based out of Bengaluru. She is on the scientific committee of various national regional dermatology congresses and is often invited as faculty to Indian Academy of Dermatologists, Venerologists and leprologists (IADVL), Association of cutaneous surgeons of India (ACSICON) national conferences. A member of IADVL special interest group (SIG) -Aesthetics. She runs her own practice Dr Divya’s Skin and Hair solutions at Bengaluru 
You can find her on twitter @divya_sharmaMD
100 Day challenge
I bet most of us enjoyed the Holi vibes and didn’t miss a chance to indulge in the festive treats and it’s absolutely ok to do so if we balanced it with maintaining fitness regime. 
The last wild card challenge and women’s day bonus point activity received great response! Participating in wildcard challenges is a great way to give a kick to your total points. Keep it up! 
Starting tomorrow, March 21, we bring you another opportunity to up your point tally. Here comes the fourth wildcard challenge - Plank for a minute.
Plank option 1 - for 15 points 
Plank Option 1
Plank Option 1
Plank option 2 with 10kg weight - for 25 points
Plank Option 2
Plank Option 2
Do plank for a minute, record your video, upload on Twitter/Instagram with hashtags #wildcardchallenge and #AdmireYourself and share the link using the data dashboard. Choose the appropriate option of WildCard Challenge 4 from the list, add the link of your social media post and submit. If you are not on social media, you may upload your video directly but the video size shouldn’t exceed 10MB. 
Leadership Board
Here are the lists of top 50 in both categories at the end of 56 days of 100 Day Challenge (as on March 19)
40 & Below
40 & Below
Above 40
Above 40
Shopping Fest
Today is the last day of the shopping fest (upto 25% off) by our sponsors. Exclusive discounts for you, only for today. Details, links and coupons codes are here - https://sandeepmall.com/shopping-fest/
Shop and show some love to the businesses that support the 100 Day Challenge.
Tweet thread of the week
Sharing an interesting and motivating thread that came on my timeline by Shubho Sengupta
This post is for young friends who think they are in the ‘wrong job’ and that they deserved better.
Albert Einstein could not get a job for two years after graduation because his professors refused to give him a recommendation letter (he used to interrupt their math equations with the final answer, which they did not like).
Out of pity, a friend’s father offered him a job as a third-class clerk at the Swiss Patent Office. Though he initially found the work dull and uninspiring, he quickly realised some of the best scientific ideas in Europe passed through his ‘lectern’ (see pic).
For example, synchronizing the clocks at train stations using electrical signals - this was a hot idea at the time, and passed through Einstein’s lectern (he stood and worked). He eventually found a job as a professor, after seven years of the Swiss Patent Office.
By then, he had written four groundbreaking papers, on the photoelectric effect, Brownian motion, special relativity, and the equivalence of mass and energy.He was not even 26 when he left the patent office, as Europe’s scientific establishment applauded his four papers.
He later referred to the patent office as “that worldly cloister where I hatched my most beautiful ideas”. So, you’re in your early 20 and bored with your job?
Book I am reading
All over the world, our ability to pay attention is collapsing. In the US, college students now focus on one task for only 65 seconds, and office workers on average manage only three minutes. New York Times best-selling author Johann Hari went on an epic journey across the world to meet the leading scientists and experts investigating why this is happening to us – and discovered that everything we think we know on this subject is wrong.
We think our inability to focus is a personal failing – a flaw in each one of us. It is not. This has been done to us – by powerful external forces. Our focus has been stolen. Johann discovered there are twelve deep cases of this crisis, all of which have robbed some of our attention. He shows how he learned this in a thrilling journey that takes him from Silicon Valley dissidents who figured out how to hack human attention, to veterinarians who diagnose dogs with ADHD; from a favela in Rio where everyone lost their attention in a particularly surreal way, to an office in New Zealand that discovered a remarkable technique to restore their workers’ attention.
Crucially, he learned how – as individuals, and as a society – we can get our focus back, if we are determined to fight for it. The answers will surprise and thrill you. This is a book about our attention crisis unlike any you’ve read before.
About the author
Johann Hari is the author of three New York Times best-selling books and the Executive Producer of an Oscar-nominated movie and an eight-part series starring Samuel L. Jackson. His books have been translated into 38 languages. Johann’s first book, ‘Chasing the Scream: the First and Last Days of the War on Drugs’, was adapted into the Oscar-nominated film ‘The United States Vs Billie Holiday’. His His second book was ‘Lost Connections: Uncovering The Real Causes of Depression – and the Unexpected Solutions’ 
Recipe of the week
Spirulina Crunch Bar
Improves: Glucose, cortisol, hsCRP, DHEAS, testosterone
Prep: 15 mins Cook: 10 mins
INGREDIENTS
  •  3 tbsp pumpkin seeds
  •  3 tbsp sunflower seeds
  •  ½ banana, mashed
  •  3 tbsp coconut flakes
  •  1 tbsp almond butter
  •  ½ tsp spirulina seaweed
RECIPE DIRECTIONS AND SERVING SIZE
Preheat oven to 350F.
In a food processor pulse pumpkin seeds and sunflower seeds until chopped to small, uniform pieces. Add in remaining ingredients and pulse for about 1 minute until well-combined.
Form crunch bar mixture into desired shape and then place on a baking sheet lined with tin foil. Bake 5 to 10 minutes, or until bar is firm and slightly golden on the outer edges.
Quote of the week
“Solitude is the strength of being alone. It’s where we become our best company.”- Jay Shetty
The ability to enjoy one’s own company is one of the greatest gifts life has to offer. Learning to turn my thoughts away from all my responsibilities at the day’s end and take my mind into a state of peace and benevolence enables me to carry greater and greater loads without feeling the burden. When my inner landscape is full of beautiful thoughts, everything I do is a pleasure. Gently, I calm down in chaotic situations and offer solace to troubled mind.
Disclaimer
The information provided in this newsletter is not medical advice, nor it should be taken as a replacement for medical advice. I am not a medical Doctor so I don’t prescribe anything. Most of the tools suggested are based out of scientific research and my experiments with them. Your healthcare, your wellbeing is your responsibility. Anything we suggest here, please filter it through that responsibility. 
Did you enjoy this issue?
Sandeep Mall

Helping people achieve deep health and balance in life is my passion. This weekly newsletter is about things I am passionate about, tools I use and experiences I love to share. Connect at me@Sandeepmall.com

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