Reflections...Volume 20 No 20 June 2002....Health & Wellbeing.....Cholesterol Alert

Volume 20 No 20 June 2002

Issues and Views

Micellaneous

Cholesterol Alert
By Shahida Nisar

Should you be taking drugs to lower your cholesterol? For millions of people who never dreamed they had a heart condition, the answer to that question changed abruptly last week. Impressed by mounting evidence that aggressive treatment can significantly reduce death from heart disease, a panel of experts from the U.S. National Heart, Lung and Blood Institute issued new guidelines for treating high cholesterol. In one stroke, the panel nearly tripled, from 13 million to 36 million, the number of adult Americans who should be taking daily doses to powerful cholesterol-lowering drugs. They also raised by 25% from 52 million to 65 million, the number who should go on a cholesterol-lowering diet.
Think of it as a remake of a Hollywood movie starring a cast of familiar characters: the good cholesterol (HDL), the bad (LDL) and the ugly (heart disease). The heroes are diet, exercise and a class of drugs called statins that cut cholesterol levels sharply by blocking a liver enzyme involved in cholesterol production.
What should you do? The first step is to get tested, early and often. Beginning at age 20 and every five years thereafter, all adults even if they don’t show signs of disease, should have their blood screened to get a lipoprotein profile (HDL, LDL, total cholesterol and triglycerides).

The last time guidelines were issued was eight years ago; since then we’ve learned a great deal about the role of HDL, the “good” cholesterol. A level of 60 or more is still considered to be protective against heart disease, but now we know low levels can also be dangerous. Before, doctors believed we should have a minimum level of 35. Now the bar has been raised to 40.
LDL has always played the heavy, the bad guy behind the buildup of fatty plaque in the arteries. The revised recommendations draw new lines in the sand. The optimal level is 100. Levels above 190 are off the charts. But even borderline (101 to 129), high borderline (130 to 159) and high levels (160 to 189) can benefit from treatment.
Triglycerides, free-floating molecules that circulate in our blood transporting fats for storage and metabolism, were given short shrift eight years ago. But recent studies show that elevated triglyceride levels significantly increase risk of heart disease. It’s now recommended that even borderline-high triglyceride levels (150 to 199) be treated through weight control and physical activity and, in extreme cases, with drugs.
How do you find out where you stand? Once you have your test results, calculating your level of risk is fairly straightforward. The U.S. National Institutes of Health has devised a formula that weighs the factors and tells you how likely you are to have a heart attack in the next 10 years. Easy-to-use computerized versions of this formula can be found at various websites, including Stime.com.
If you fall in a needs treatment category, your doctor can tell you whether you are a candidate for cholesterol-lowering drugs. Aggressive treatment does not mean drugs alone. You may also need to increase your physical activity, eat more fiber-rich foods and cut back on saturated fats and cholesterol. These are familiar recommendations, but now they apply to a lot more people.

Child's Neurons Different

Q: Why are Moms and Dads such hopeless punching bags when they go up against their kids at computer games?
A: Punching bags? Listen, kids, maybe the reason you're so much faster is your nerve impulses don't even bother taking the time to visit your little brain, counters Rutgers psychologist Leonard Hamilton. "Or maybe it's because Mom and Dad don't spend 24/7 zoned out in front of a computer screen. Or maybe..." OK, just kidding. For all us "old timers," it is certainly true brain cells change with age. The dendrites that transport information into the neurons get longer and more complex up to about age 30. We start out simpletons, so to speak, and become complextons -- great for subtle multi-factorial life decision-making but deadly for rapid-fire two-dimensional reflex-driven computer games. Children will kick rump at tasks such as "Touch the red circle as quickly as possible when it appears on the screen," or "Explode the alien battle cruiser before it explodes you." They're wired and primed to do these. But change the task to "Press the red circle when a red and green circle appear but press the green circle when a blue and green circle appear," and the results will be very different. "Now complexton Mom and Dad will rule, and the simpleton kids will be the punching bags. Hah!"
Q: Steel yourself for a hard question: When a diamond and a steel knife blade collide, which breaks?
A: While diamond is extremely hard, it is also brittle and more easily broken, says Louis A. Bloomfield in "How Things Work: The Physics of Everyday Life." "Steel" blade is actually imprecise, as there are many iron-based steels, mixing varying amounts of carbon. A good modern steel blade should undo a diamond, just as a good knife can "cut" a cheap knife.
A knife's blade must be both tough and flexible, with cutting edge hard but not brittle, requiring different steels for the two jobs. Samurai sword-smiths knew this well centuries ago, hammering together varying steels for a razor-sharp cutting edge supported by a durable sword body.