Report holds keys to longer Life Expectancy

[Guest guest]

This is a follow up article to one I posted last week.

Adding Years means examining realistically what can be changed:

http://www.washingtonpost.com/wp-dyn/articles/A54858-2002Nov1.html

In the article:

For example, fortification of food with iron (in

cereal flours or noodles), zinc (in wheat products)

and vitamin A (in sugar) is cost-effective even for

the poorest countries, because it would greatly

reduce death from diarrhea, malaria, measles and

pneumonia in children. Recommended

population-wide interventions, however, aren't

limited to micronutrients or the diseases of the poor.

Dietary salt contributes to high blood pressure, a

top-10 risk factor for early death everywhere in

the world. Regional strategies to reduce salt in

processed food have been tried in Australia.

Studies show that when guidelines for food

manufacturers are voluntary, dietary sodium intake falls

about 15 percent. When they are mandatory, it falls

about 30 percent.

Similarly, mass marketing campaigns to reduce

dietary fat lead to about a 2 percent reduction in

average cholesterol level over a decade. For an

individual that's a small change, but in a population it

leads to a significant drop in cardiovascular

mortality. That's because in most places, nearly

everyone has cholesterol above the truly " safe "

level. Consequently, when a population's average

cholesterol falls, it means that nearly everyone

has cut his risk, not just the people with the highest

levels.

The more common prevention strategy in the

developed world, however, is to look for people with

increased risk, and aim preventive measures only at

them. The WHO team found this also works.

High blood pressure is enough of a problem, it

noted, that screening adults for hypertension and

treating everyone with a systolic blood pressure

over 160 with a cheap diuretic drug is cost-effective

even in the poorest countries.

A third way, however, may offer the best approach

to cardiovascular disease, which is the leading

cause of death in rich countries and an important

one everywhere else. It combines aspects of both

population-wide and individually targeted

prevention.

Every individual's risk would be evaluated on the

basis of age, sex, a few facts of personal medical

history, a blood pressure measurement and possibly

also a cholesterol measurement. If the profile

revealed risk above a specified threshold -- say,

that a person had a 25 percent chance of suffering a

heart attack or stroke in the ensuing decade -- he

or she would then be prescribed a one-size-fits-all

treatment.