Monday, March 19, 2007

Cholesterol: You can't win

LOW Cholesterol seems to be bad for your brain

While a high total cholesterol level in middle age is a risk factor for developing dementia later in life, a drop in cholesterol after middle age may also be a sign of later cognitive problems, a study shows. It hints that falling total cholesterol levels after middle age may point to an ongoing disease processes in the brain, and could be a marker for risk of late-life cognitive impairment.

Dr. Miia Kivipelto, from the Aging Research Center at the Karolinska Institute in Stockholm, Sweden, and colleagues investigated changes in total cholesterol levels in relation to cognitive functioning in late-life. The study involved some 2000 people who had their cholesterol level measured in midlife, and were re-examined an average of 21 years later. The team focused on 70 people who developed mild cognitive impairment during follow-up, 48 who developed Alzheimer's disease and a "control" group of 1,203 people who remained mentally intact. "Mid-life total cholesterol represented a risk factor for more severe cognitive impairment later in life," the researchers found, with significant differences between the controls, those with mild cognitive impairment, and those with dementia. On the other hand, a moderate drop in total cholesterol from mid-life to late-life "was significantly associated with the risk of a more impaired late-life cognitive status," the investigators report in the medical journal Neurology.

These findings remained unchanged after adjusting for factors that might influence brain function, including age, sex, education and even the presence APOE-4 gene, which is known to predispose people to develop Alzheimer's disease. Kivipelto and colleagues believe that declining cholesterol after middle age may "reflect ongoing pathological processes in the brain." Nonetheless, they say the relationship between cholesterol and dementia is "controversial," and meanwhile, they point out, high cholesterol "carries risk even in old age, and results from clinical trials in vascular diseases support the benefit of lipid-lowering treatment in elderly patients."


US approves quicker test for meningitis

US health officials have approved a quicker test for meningitis that aims to help doctors more quickly diagnose and treat patients with the potentially fatal infection. The test, made by Cepheid Inc.'s, can determine within 3 hours whether a patient has the viral form of the condition rather than the more dangerous type caused by bacteria, the US Food and Drug Administration said. Other products can take as long as a week. While those with viral meningitis can usually recover within weeks without medical help, those with the bacterial version need urgent treatment with antibiotics to prevent brain damage and possible death, according to the agency. "Because this test is significantly faster than existing methods for diagnosing meningitis, it could minimize delays in treating patients," said Dr. Daniel Schultz, director of FDA's Center for Devices and Radiological Health. "Swift recognition of the cause and appropriate treatment is critical to patient recovery."

Meningitis, an infection of fluid in the spinal cord and around the brain, can cause fever headaches and neck pain, according to the Centers for Disease Control and Prevention. Those younger than two may seem inactive or irritable as well as experience vomiting. There are also several vaccines to help prevent the condition. Although wide outbreaks of meningitis are not seen in the United States, some data has shown it can occur more frequently among college students living in dorms. It is also seen more often overseas.

Dr. David Persing, Cepheid's chief medical and technology officer, said one million tests are conducted nationwide each year for the viral infection. Shares of the company closed more than 9 percent higher at $9.44 on Nasdaq. Cepheid's test is designed to work with its GeneXpert system, which can also diagnose Group B streptococcal infections in pregnant women. Other tests are also being developed for the system, Persing told Reuters. "We think a lot of labs are going to buy a GeneXpert just for this test," he said, referring to meningitis. The disposable cartridges that hold spinal fluid samples cost $69 each and come in packs of 10, Persing said. The system to test the samples can cost between $25,000 and $125,000. The test can identify infections from a class of viruses called enterovirus, which make up about 90 percent of all viral meningitis cases, the FDA said.

A study of the product using samples from 255 patients, found 96 percent of those who tested positive had viral meningitis, while 97 percent of those who tested negative did not have it, it added.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.