Cheers!

This is High on Health, your weekly rhythm of health wisdom, pulsing with insights and updates to keep your heart beating strong and your health at its peak!

I want to extend my warmest wishes to all those celebrating Thanksgiving with their loved ones.

As someone who has lived in the US, I have grown to love this holiday, which has become my favorite. While some may argue that the celebration is controversial, for me, it's all about cherishing precious moments spent with family and friends, expressing gratitude, and having a good time. We are organizing a special "Friendsgiving" dinner at work!

It was another busy week for me, with important events happening every day. I spent a lot of time traveling by air, rail, and road. But amidst all the rush, I also had the opportunity to enjoy some wonderful meals with my teams, colleagues, clients, and friends. When I reflect on my week, I realize that what stands out the most are the interactions, honest conversations, and connections I make with people. As we celebrate Thanks-/Friendsgiving, I want to take a moment to thank everyone who makes my life richer by spending time with me. It truly means a lot!

In terms of my personal life, the washing machine is still broken. Unfortunately, we're stuck in a frustrating situation where the insurance company and the service repair team are in a catch-22. The service center is willing to dispatch their team and provide the final report, but only after they receive confirmation from the insurance company. Meanwhile, the insurance company insists that they will decide to cover the service claim only after the repair is completed and a final report is filed. It's a bit of a stand-off at the moment (and, in case you are thinking, “That must have been solved a million times before.”… Yes, I assume so. 😭 😭 😭). As you may recall from my previous newsletter, I spoke about the concept of the growth mindset. Well, we're certainly putting it into practice in this situation.

Thanks for asking, but am I sensing some stress? Well, maybe. Let’s have a look. Like many of you, I am carrying around a device that apparently can indicate my stress level.

It's possible that we can determine our stress levels by using a smart device, such as the Oura Ring, Whoop Band, Apple Watch, Garmin devices, and others. These devices are designed to track our heart rate variability (HRV), which is the variance in the time between each beat of our heart and changes in response to stress. HRV variables can be affected by various stress-inducing methods¹ .

If you are wearing any such device and haven’t fully leveraged HRV yet, I did some deep diving this week for you!

Keep your cool, do your breathwork, and oooommmmm…

Take care!

Andre 🤔💡👨‍⚕️

¹  Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature

An Overview of Heart Rate Variability Metrics and Norms

Explaining HRV Numbers and Age — What’s Normal, Good and Bad?

Heart Rate Variability – A Historical Perspective

HRV - the Morse code of your heart?

When I typed HRV into the search bar, Google suggested the following questions: what is a good HRV rate, what should my HRV be for my age, and what is an unhealthy HRV? So, what is HRV all about?

📚 A Peek into HRV History

Rewind to 1965 – that's when the story of HRV began. Picture this: researchers discover that tiny changes in the time between heartbeats could signal distress in unborn babies. Fast forward to the 1970s and 1980s, and HRV started showing its potential. It became a beacon of hope for detecting heart issues in diabetics and even predicting the increased risk of death after heart attacks. Now, let's leap into our era of smart gadgets and digital ECG recorders. HRV has gone high-tech, offering us deeper insights into our health than ever before. It's like having a health detective right on your wrist!

🔍 What Exactly is HRV?

HRV isn't about how fast your heart beats but rather the subtle dance between each heartbeat. Imagine your heart beating at 60 beats per minute. It's not a metronome, with each beat spaced exactly a second apart. Instead, there's a bit of freestyle! Some beats might be just shy of a second, others a smidge over. This variation is totally normal – in fact, it's a sign of a happy, healthy heart!

📈 Measuring the Beat

Capturing these tiny differences, as small as milliseconds, requires some nifty gadgets. But without a dash of physiological know-how and some clever analysis, these numbers are just a meaningless jumble. Enter RMSSD¹ – a cool statistical tool that helps us make sense of HRV. It's like the DeepL for your heartbeat, translating those subtle timing changes into insights about your body's response to stress, exercise, and relaxation.

🏋️‍♂️ Why Should You Care?

Physiologists, fitness gurus, and life coaches are all over this! They use HRV to examine how your body deals with workout strains and chill-out times. It's not just about pushing harder; it's about training smarter and giving your body the rest it deserves.

What HRV reveals about you

🤔 HRV: Your Body's Inner Balance Sheet

HRV is like a daily log of your autonomic nervous system, the behind-the-scenes powerbroker managing your blood pressure, breathing, and more. It's all about balancing your sympathetic nervous system (SNS) - your body's 'fight or flight' response - and the parasympathetic nervous system (PNS), which is like your built-in 'rest and digest' mode. HRV is the story of their ongoing balancing act.

📉 Interpreting the HRV Story

Low HRV for an extended period? It might mean your SNS is in overdrive, possibly more than necessary. On the other hand, a higher HRV indicates that your PNS is bringing more calm and control to your heart, which is generally a good sign for your health.

🔄 Comparing HRV: Your Personal Health Tracker

Your HRV isn't just a number; it's a personal health tracker. If it's higher than your average over a day, you might be on the right track health-wise. A lower HRV, however, could suggest that your lifestyle or heart health needs a closer look. But: HRV is influenced by many factors, making it a complex but insightful marker of your overall well-being.

🧘‍♀️ Lifestyle Factors: The HRV Influencers

As we age, our HRV naturally tends to decrease. But it's not just about getting older. Stress, dehydration, excessive alcohol, unhealthy eating habits, a sedentary lifestyle, and poor sleep can all contribute to lowering your HRV. Conversely, managing stress, making healthier food choices, staying active, drinking enough water, moderating alcohol intake, and getting quality sleep can help in maintaining or improving your HRV.

Tracking Your Heart's Rhythms: The How-To of HRV

🔍 The Gold Standard: Continuous EKG

Regarding accuracy in tracking HRV, nothing beats a continuous electrocardiogram (EKG). This is like a heart diary, recording every little electrical whisper from your heart. Cardiologists might suggest wearing a Holter monitor or a patch for a detailed report – it's like having a heart detective attached to you, even on the move!

⌚ Smart devices: Your Wrist's or Finger’s Take on HRV

Now, what about your trusty smart device? These gadgets measure HRV based on the pulse they detect on your wrist. While super convenient, they might not be as spot-on as an EKG, which listens directly to your heart's story from the chest. But don't dismiss your smart device's HRV reading just yet! It's still a valuable piece of info, especially if you notice significant changes over time. Remember, it's not the full story, so there's no need to panic if the numbers look slightly off.

🤔 HRV: How Much Should You Care?

While leading a healthy lifestyle is great, don't get too hung up on using HRV as your ultimate health barometer. HRV can be influenced by a myriad of factors, and it can be quite the task to tweak every aspect of your life just to see your HRV numbers dance to a different tune. Sometimes, it's more rewarding to measure the impact of healthy habits through other means, like how energized you feel or how your stress levels are doing.

🤖 Got a Smart device?

If you've got a smart device that tracks HRV and you notice a trend over time, it's still a good idea to chat about it with your healthcare provider. It can be a starting point for a conversation about your overall health and might even bring you some peace of mind.

So, keep tracking, stay curious, and remember to focus on the big picture of health and well-being!

Do you want to know how I’m doing?

This is my HRV status measured with my Garmin watch over the last 4 weeks:

My HRV was well in the green and, luckily, not low. However, it recently increased out of range and got labeled “unbalanced”. As some may recall, I’m trying to transform myself into an endurance athlete. This includes now 5 running sessions per week (and occasional cross-training with rowing or cycling).

The recent unusual spike in my tracking app, marked by orange boxes, made me wonder what my body might be trying to tell me. After some research, I found out that this high HRV could be a sign of intense recovery mode, possibly due to accumulated stress.

When we push our limits in training or face significant stressors, our HRV might initially dip as our bodies strive to manage. However, a sudden and sharp increase in HRV, like what I observed, suggests that my body might be shifting gears into a deep recovery phase. This could be its way of saying, "Hey, let's take a break and recuperate."

Such a spike in HRV might also align with other changes, such as mild illness (it’s cold season, and I’m surrounded by kids with running noses), the obvious alterations in my workout routine, or shifts in my sleep patterns (which is true; I try to be more strict about getting consistent and enough sleep). It's fascinating to realize how sensitive our bodies are to these changes and how they communicate through metrics like HRV.

This experience has been a valuable reminder for me about the importance of listening to my body. Interrupting this natural recovery process can lead to issues like overtraining and not fully recovering from the underlying stress, which can affect both immediate and long-term health. Witnessing this unusual HRV spike has made me more mindful of my body's recovery needs and the delicate balance it maintains daily.

Who else is tracking HRV or other metrics?

I would love to get your thoughts and comments!

¹ RMSSD (root mean square of successive differences), the square root of the mean of the squares of the successive differences between adjacent NNs.

While enjoying a glass, we rarely think about the science behind a wine-induced headache. It's not just about the alcohol; there's more to the story. Recent findings suggest that red wine might trigger headaches more than other alcoholic drinks, but the exact reason has been elusive. Various studies have pointed fingers at culprits like sulfites, tannins, and phenolic compounds, but a concrete explanation remained out of reach.

The spotlight now turns to quercetin, a flavonoid found in grapes (and hence, in wine). Scientists discovered that at certain concentrations, quercetin can significantly inhibit the enzyme responsible for breaking down a toxic byproduct of alcohol metabolism. This inhibition could potentially lead to headache-inducing effects. However, the real-world implications of this finding are still unclear. For instance, quercetin is more abundant in other foods like red onions and capers, yet they aren't notorious for causing headaches like red wine.

This leads to interesting questions about the actual impact of quercetin on our bodies and its role in wine-related headaches. While the hypothesis is intriguing, it's far from being a closed case. The next step? Human studies to see how different levels of quercetin in wine affect us. And I'm all in for being a volunteer in such a study – for science, of course!

Saga, by Brian K. Vaughan (Author), Fiona Staples (Artist)

I'm sure you already know about my love for red wine, but there are many other things that I enjoy and would like to share with you. To be honest, I was a bit skeptical about graphic novels at first. However, when I heard about Saga winning 12 Eisner Awards (which is like the Oscars for comic books), I became interested and decided to give it a try.

Let's dive into the unique and captivating world of "Saga," a graphic novel series that transcends the typical boundaries of love and war. Created by Brian K. Vaughan and Fiona Staples, this epic sci-fi opera weaves a tale that’s part "Star Wars," part "Game of Thrones," and a dash of "Romeo and Juliet." Here, the star-crossed lovers, Marko and Alana, don't meet a tragic end; instead, they start a family, with their daughter Hazel narrating their extraordinary journey.

At its heart, "Saga" is the story of Marko and Alana, from rival factions of an interstellar war, who defy all odds to be together. Their life is a thrilling escape from bounty hunters, set against the backdrop of a galactic conflict. Along their journey, they encounter a universe filled with bizarre yet fascinating elements – from robot royalty and flying sharks to surreal battles.

What truly sets "Saga" apart is its depiction of Alana and Marko's relationship. It's a deeply emotional and authentic portrayal, full of highs and lows that are beautifully narrated by Hazel. Their story is a testament to the power of love to grow, adapt, and overcome the bleakest of circumstances.

Beyond the romance, "Saga" mirrors some of the darkest aspects of our society, such as drug abuse and child slavery, against the backdrop of an unending war. This contrast makes moments of love and connection between characters all the more poignant and significant.

In this universe where despair is rampant, "Saga" presents an intriguing notion: the true antithesis of war is not peace, but the intimacy and vibrancy of love and life. The story navigates through a spectrum of emotions, ultimately offering a message of hope and resilience in the face of adversity.

If you're ready for an emotional, thought-provoking journey through a universe where love is both the greatest challenge and the most profound rebellion, then "Saga" is a must-read.

I am a huge fan and have pre-ordered Volume 11.

DISCLAIMER: None of this (such as text, graphics, images, and other materials) is medical or health advice. This newsletter is strictly for informational, educational, and entertaining purposes only. While I’m a medical doctor and a dentist by training, I’m not your doctor. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on High on Health! Please be careful and do your own research.