On Your Mind... ETFs, Dark Chocolate, and Bad CPR

Readers amaze me...

I've said before that our greatest resource for information and research is you.

Thanks to you, we have thousands of experts at our fingertips... people who constantly send us their research (and challenge ours). Our readers are from all over the world with different backgrounds and experiences.

Every day, our inbox is jam-packed with questions, topic suggestions, and the occasional criticism. And my team and I appreciate every single e-mail. Each week, we cover topics ranging from investing to personal finance to getting healthier to (more recently) how to get your money's worth with your car.

I've got a smart team of folks working with me who are all experts in their fields. They spend all their time reading and researching. But despite the many hours we work on Health & Wealth Bulletin each week, there's only so much we can do on our own.

So we want to hear from you... What topics do you want to see us cover? What questions do you have for my team of experts? How can we help you improve your health and wealth this year? Send your thoughts our way... [email protected].

Now, let's get into some of the things you've had on your minds this week...

Q: I have a question about ETFs that I hope you can explain. If an ETF can issue shares as demand dictates, my question is how the price appreciates? Thanks in advance. – P.H.

A: For readers who aren't familiar with exchange-traded funds ("ETFs"), the concept behind ETFs is simple: A large group of investors pool their money by buying shares. Then a professional money manager invests that pool of money into a variety of stocks and bonds. He collects a fee for his services. And the investors get a diversified basket of investments through one single purchase.

Buying an ETF is just like buying a normal stock. There are no special steps to take – just give your broker the fund's ticker symbol instead of an individual stock's. The price of an ETF goes up and down throughout the day as investors buy and sell, just like a normal stock would. An ETF will move up or down depending on the value of its holdings as well.

You're correct that ETFs can issue shares when demand starts pushing the share price higher than the net asset value. This usually happens in blocks of 50,000 shares. In other words, the ETF's share issuance is linked to the value of the new shares it purchases. (Similarly, if demand drops, it can sell a portion of its holdings and liquidate some of its shares.)

Just to be clear, though... the best feature of an ETF isn't its price appreciation. Your gains are higher if you pick and choose individual stocks, leaving out the fund's holdings that you think will fare worse – if you choose the right stocks.

Rather, we recommend ETFs as a way to diversify your portfolio in a cost-effective way. They won't rise as high as their best-performing holding, but they won't fall as far as their worst performer either.

ETFs can meet different financial needs, investing styles, and risk levels... from international funds, to industry-specific funds, to fixed-income funds. Some ETFs even track a specific index. For example, the SPDR S&P 500 Fund (SPY) follows the S&P 500 Index. So you can – without too much money or effort – own a basket of dozens of stocks and collect any income from dividends. Just don't count on the highest possible price appreciation.

Q: The February 2023 edition of Consumer Reports reported finding traces of lead and cadmium in many dark chocolates. Should we be concerned about this? My wife and I each consume about a half-ounce of dark chocolate per day.

Many thanks for your great daily bulletin and all the work that goes into it. – P.H.

A: Thanks for the kudos, P.H. I hope you enjoy reading Health & Wealth Bulletin as much as the team and I love publishing it!

Last December, the news was abuzz with frightening talk of heavy metals – specifically cadmium and lead – being present in chocolate.

I often roll my eyes at scary headlines, but this had some teeth to it. In fact, lots of foods have trace amounts of naturally occurring heavy metals. So do air, water, some of the products we buy, and also various industrial materials.

Cadmium and lead are common in the environment. It turns out that during chocolate production, cocoa beans sit for days in cadmium- and lead-contaminated dirt while drying out in the sun.

Cadmium toxicity is associated with lung, kidney, liver, skeletal, reproductive, and cardiovascular dysfunction, as well as cancer. And lead toxicity can cause neurological and blood dysfunction, kidney and liver damage, and reproductive disorders.

You don't have to panic, though... Not many people will eat so much chocolate that they'll poison themselves. But if you're concerned, you can do these three things:

First, think of chocolate as a treat... something for special occasions rather than an everyday indulgence. Moderation is key with sweets even when there isn't a risk of cadmium or lead contamination.

Second, you can be more selective about the chocolate you eat. Consumer Reports tested 28 dark chocolate bars, finding that five particular chocolates had the lowest concentrations of cadmium and lead. If you'll be guzzling chocolate, consider one of these:

Lastly, you can eat certain foods that will bind to toxic metals (specifically cadmium and lead) and help usher them out of your body.

Studies have shown that foods and beverages high in essential metals like zinc, calcium, and iron... vitamins B1, B6, C, and E... and protective phytochemicals like quercetin, catechin, anthocyanin, and curcumin help protect you from cadmium and lead buildup. These foods include berries, ginger, green tea, lemon water, and turmeric.

Q: Is it true that bad CPR is better than no CPR? Should I bother getting certified? – C.M.

A: To best answer your questions, we tracked down the best expert we know: a nurse with more than two decades of experience in emergency medicine and nearly a decade of teaching cardiopulmonary resuscitation ("CPR") at one of the most prestigious hospitals in the world...

Generally this is true, but it depends on how bad the CPR is. When someone goes into cardiopulmonary arrest (when the heart stops beating), their chances of survival drop exponentially for every minute their brain and heart go without blood flow. If a bystander begins chest compressions immediately and maintains a depth of about 2 to 2.4 inches and a compression rate of about 100 to 120 times a minute, they're giving the victim the best chance of survival.

As you move further away from those numbers, the chances of survival start to go down but are still higher than if no CPR was done at all. My rule would be this: If I do nothing, this person will probably die. If I help, they may still die, but I'm giving them the best chance of survival.

The real negative consequence of bad CPR is that the victim probably won't survive, or if they do survive, they'll be less likely to make a full recovery.

A CPR certification is nice to have but not necessary if you don't work somewhere that requires you to have a CPR card. The American Heart Association ("AHA") offers a Family & Friends CPR course that teaches hands-only CPR and AED use, as well as managing a choking victim for adults and children. For the vast majority of people, this is what I would recommend they take. I'd suggest taking a CPR class once a year as these are "if you don't use it, you lose it" skills and are always good to freshen up on once you've learned them.

You can use this page from the AHA to find a Family & Friends CPR class near you.

I also strongly suggest that everyone take a few minutes to watch the videos on this page to learn about hands-only CPR.

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
February 10, 2023