What's Good About Swimming

Swimming is good exercise (that's obvious). Swimming is a lifetime sport that benefits the body and the whole person! But what is it that makes swimming good, specifically? That depends on what you are trying to accomplish.
Swimming is a healthy activity that can be continued for a lifetime - and the health benefits swimming offers for a lifetime are worth the effort it takes to get to the swimming pool. It works practically all of the muscles in the body (if you do a variety of strokes). Swimming can develop a swimmer's general strength, cardiovascular fitness and endurance. It does not help with bone density - you need to weight bearing exercise for that - but that is about all that is missing from what swimming could do for your fitness.
Why do you swim? For the health benefits to your heart and lungs? For the chance to be with some of your friends at the pool? Because, in your case, running everyday hurts? Because you like the feeling of floating and sliding through the water? Or is it something else? If you are looking for a break from the heat of the summer, then a dip in the water is exactly what you need; swimming is a way for you to cool off. It fills a wonderful recreational need for individuals and families, from beach and pool fun to water parks.
Maybe you are a runner, training on a regular basis, and want to find an activity that keeps your heart rate up but takes some of the impact stress off of your body. Perhaps you have been doing some other form of land exercise, and now an injury prevents you from putting weight on a knee or ankle. Swimming can help you. Kicking workouts, water aerobics, pool running, or a regular swimming workout can all give you a great exercise session without the weight of your body pounding you with each move.
Regular swimming builds endurance, muscle strength and cardio-vascular fitness. It can serve as a cross-training element to your regular workouts. Before a land workout, you can use the pool for a warm-up session. Swimming with increasing effort to gradually increase your heart rate and stimulate your muscle activity is easily accomplished in the water. After a land workout, swimming a few laps can help you cool-down, move blood through your muscles to help them recover, and help you relax as you glide through the water.

Swimming does burn calories at a rate of about 3 calories a mile per pound of body weight. If you weigh 150 lbs. and it takes you 30 minutes to swim one mile (1,760 yards or 1,609 meters), then you will be using about 900 calories in one hour. However, many swimmers do not swim that quickly, and many cannot swim for that distance or duration.
Spending time in a group workout, whether water aerobics or a master's swim practice, is a great social outlet. Exchanging stories, challenging each other, and sharing in the hard work make swimming with others a rewarding experience.
There are other psychological benefit to swimming, if you allow it to occur. Relax and swim with a very low effort. Let your mind wander, focusing on nothing but the rhythm of your stroke. This form of meditation can help you gain a feeling of well-being, leaving your water session refreshed and ready to go on with the rest of your day. Many swimmers find an in-direct benefit form swimming. They develop life skills such as sportsmanship, time-management, self-discipline, goal-setting, and an increased sense of self-worth through their participation in the sport. Swimmers seem to do better in school, in general terms, than non-swimmers as a group.
One thing swimming is not good for is losing a lot of weight. The on-line Merck Manual explains that swimming is not the best way to lose weight due to the cooling effects of being in the water. While you do use a lot of calories swimming, once you get out of the pool much of that calorie burning stops. Doing land based exercise like running or cycling may use about the same amount of calorie per hour as swimming, but once you stop exercising the land-based workout usually leads to continued increase in calorie use for as long as 18 hours after the workout. Why? Because when you are in the pool you don't heat up as much as you do on land, and your body does not have to work to cool you down as much once the exercise session concludes. Swimming does exercise almost the entire body - heart, lungs, and muscles - with very little joint strain. It is great for general fitness, just not a great way to drop excess pounds.

Drinking Water to Maintain Good Health

Water - The Beverage Your Body Needs Most

Drinking water is so important for good health. When you were a kid in school, you learned that each molecule of water is made up of two hydrogen atoms and one oxygen atom. You may also have learned that it was great fun to fill up your squirt guns with water, at least until the principal caught you. What you may not have learned, however, was how much water you needed in order to be a healthy human being.

Why You Need to Drink Water

Your body is estimated to be about 60 to 70 percent water. Blood is mostly water, and your muscles, lungs, and brain all contain a lot of water. Your body needs water to regulate body temperature and to provide the means for nutrients to travel to all your organs. Water also transports oxygen to your cells, removes waste, and protects your joints and organs.

Signs of Dehydration

You lose water through urination, respiration, and by sweating. If you are very active, you lose more water than if you are sedentary. Diuretics such as caffeine pills and alcohol result in the need to drink more water because they trick your body into thinking you have more water than we need.

Symptoms of mild dehydration include chronic pains in joints and muscles, lower back pain, headaches and constipation. A strong odor to your urine, along with a yellow or amber color indicates that you may not be getting enough water. Note that riboflavin, a B Vitamin, will make your urine bright yellow. Thirst is an obvious sign of dehydration and in fact, you need water long before you feel thirsty.

How Much Water do you need to drink?

A good estimate is to take your body weight in pounds and divide that number in half. That gives you the number of ounces of water per day that you need to drink. For example, if you weigh 160 pounds, you should drink at least 80 ounces of water per day. If you exercise you should drink another eight ounce glass of water for every 20 minutes you are active. If you drink alcohol, you should drink at least an equal amount of water. When you are traveling on an airplane, it is good to drink eight ounces of water for every hour you are on board the plane. If you live in an arid climate, you should add another two servings per day. As you can see, your daily need for water can add up to quite a lot.

Twenty percent of your water need will come from the foods you eat. The rest of your water need should come from the beverages you drink. Water is the best choice. Sodas have a lot of sugar in them, so if you drink sodas, you may take in more calories than you need. Herbal teas that aren't diuretic are fine. Sports drinks contain electrolytes and may be beneficial, just look out for added sugar and calories that you don't need. Juices are good because they have vitamins and nutrients.

Caffeinated beverages will also add to your daily water need. Even though caffeine is a diuretic, if you regularly consume caffeine, your body will regulate itself to that diuretic effect.

Drink Enough Water

It may be difficult to drink enough water on a busy day. Be sure you have water handy at all times by keeping a bottle for water with you when you are working, traveling, or exercising. If you get bored with plain water, add a bit of lemon or lime for a touch of flavor. There are some brands of flavored water available, but watch for extra calories.

Benefits of Yoga - Why Yoga Exercise is Good for You

Yoga books tell us that Yoga, as we all know, is aimed to unite the mind, the body, and the spirit. Yogis view that the mind and the body are one, and that if it is given the right yoga kitand tools and taken to the right environment, it can find harmony and heal itself. Yoga therefore is considered therapeutic. It helps you become more aware of your body's posture, alignment and patterns of movement. It makes the body more flexible and helps you relax even in the midst of a stress stricken environment. This is one of the foremost reasons why people want to start Practicing Yoga - to feel fitter, be more energetic, be happier and peaceful.

Yoga is a science that has been practiced for thousands of years. It is consists of Ancient Theories, observations and principles about the mind and body connection which is now being proven by modern medicine. Substantial research has been conducted to look at the Health Benefits of Yoga - from the Yoga Postures (Asanas), Yoga Breathing (Pranayama), and Meditation. The information on Yoga Poses & Benefits are grouped into three categories-physiological, psychological, biochemical effects. Furthermore, scientists have laid these results against the benefits of regular exercise.

Physiological Benefits of Yoga

• Stable autonomic nervous system equilibrium
• Pulse rate decreases
• Respiratory rate decreases
• Blood Pressure decreases (of special significance for hyporeactors)
• Galvanic Skin Response (GSR) increases
• EEG - alpha waves increase (theta, delta, and beta waves also increase during various stages of meditation)
• EMG activity decreases
• Cardiovascular efficiency increases
• Respiratory efficiency increases
• Gastrointestinal function normalizes
• Endocrine function normalizes
• Excretory functions improve
• Musculoskeletal flexibility and joint range of motion increase
• Breath-holding time increases
• Joint range of motion increase
• Grip strength increases
• Eye-hand coordination improves
• Dexterity skills improve
• Reaction time improves
• Posture improves
• Strength and resiliency increase
• Endurance increases
• Energy level increases
• Weight normalizes
• Sleep improves
• Immunity increases
• Pain decreases
• Steadiness improves
• Depth perception improves
• Balance improves
• Integrated functioning of body parts improves

Psychological Benefits of Yoga

• Somatic and kinesthetic awareness increase
• Mood improves and subjective well-being increases
• Self-acceptance and self-actualization increase
• Social adjustment increases
• Anxiety and Depression decrease
• Hostility decreases
• Concentration improves
• Memory improves
• Attention improves
• Learning efficiency improves
• Mood improves
• Self-actualization increase
• Social skills increases
• Well-being increases
• Somatic and kinesthetic awareness increase
• Self-acceptance increase
• Attention improves
• Concentration improves
• Memory improves
• Learning efficiency improves
• Symbol coding improves
• Depth perception improves
• Flicker fusion frequency improves

 Biochemical Benefits of Yoga

•  Glucose decreases
•  Sodium decreases
•  Total cholesterol decreases
•  Triglycerides decrease
•  HDL cholesterol increases
•  LDL cholesterol decreases
•  VLDL cholesterol decreases
•  Cholinesterase increases
•  Catecholamines decrease
•  ATPase increases
•  Hematocrit increases
•  Hemoglobin increases
•  Lymphocyte count increases
•  Total white blood cell count decreases
•  Thyroxin increases
•  Vitamin C increases
•  Total serum protein increases

Yoga Health Benefits versus Exercise Benefits

Yoga Benefits

• ParasympatheticNervous Systemdominates
• Subcortical regions of brain dominate
• Slow dynamic and static movements
• Normalization of muscle tone
• Low risk of injuring muscles and ligaments
• Low caloric consumption
• Effort is minimized, relaxed
• Energizing (breathing is natural or controlled)
• Balanced activity of opposing muscle groups
• Noncompetitive, process-oriented
• Awareness is internal (focus is on breath and the infinite)
• Limitless possibilities for growth in self-awareness

Exercise Benefits
• Sympathetic Nervous System dominates
• Cortical regions of brain dominate
• Rapid forceful movements
• Increased muscle tension
• Higher risk of injury
• Moderate to high caloric consumption
• Effort is maximized
• Fatiguing (breathing is taxed)
• Imbalance activity of opposing groups
• Competitive, goal-oriented
• Awareness is external (focus is on reaching the toes, reaching the finish line, etc.)
• Boredom factor

Food source of antioxidant - health benefits of antioxidants

Green tea, blueberries or whey – be informed about antioxidants and their properties.

Our bodies are constantly utilizing oxygen for a range of vital functions. In the process appears chemicals known as free radicals that have unpaired electrons which traveling inside the body are trying to steal electrons from other molecules. This process is known as oxidation and there are a lot of antioxidants that are the remedy to this problem. Antioxidants have the function to neutralize free radicals; some of the antioxidants have proven to have anti-inflammatory properties.

Antioxidants benefits

Antioxidants are substances that may protect cells from the damage caused by unstable molecules known as free radicals. Free radical damage may lead to cancer. Antioxidants interact with and stabilize free radicals and may prevent some of the damage free radicals might otherwise cause.

Examples of antioxidants include beta-carotene, lycopene, vitamins C, E, and A, and other substances.

Extras of the green tea: It contains phenols – substances that have anti-inflammatory and antioxidant properties. The experiments proved that green tea decrease the redness and other effects of sunburns; decrease the level of skin irritation, caused by different surface-active substances of washing materials.

Milk Thistle Extract: Milk thistle is a plant native to the Mediterranean. It usually grows in dry, sunny areas. The active ingredient is called silymarin. Consisting of a group of compounds known as flavonolignans, silymarin helps repair liver cells that have been damaged by alcohol and other toxins. Silymarin also has potent antioxidant and anti-inflammatory effects. Most milk thistle based products are standardized to contain 70-80% silymarin.

Blueberries: Much research has shown that blueberries provide health benefits in the areas of anti-aging, antioxidant action, disease prevention, treatment of urinary tract infection, improving eyesight and controlling cholesterol. Blueberries are powerful antioxidants. Anthocyanin, which is the pigment that makes the blueberry blue, is the key antioxidant responsible for these benefits. Researchers believe that the phytochemicals in blueberries may reduce inflammatory processes in tissues by increasing cells membranes ability to allow vital nutrients and chemical signals to pass in and out of the cell.

Whey: The low-molecular proteins fraction of the whey represents the most active factor, because it contains amino acids, growth factors and antibodies. Whey also contains the amino acid called glutamylcysteine which is necessary for the synthesis of glutathione – one of the main antioxidants.

Mexican Red Beans: The flavonoids that give Mexican Red Beans their bright-red colour are extremely powerful antioxidants. These beans are also a good source of fibre, folic acid, and carbohydrates.


Grapes antioxidants: They have the property to render harmless the radicals which are formed during inflammations, thus, preventing the skin irritation.

Prunes: Or dried plum, contain an unusually high concentration of unique phytonutrients called neochlorogenic and chlorogenic acid. These substances found in prunes and plums are classified as phenols, and their function as antioxidants has been well documented. They are especially good at neutralizing a particularly dangerous oxygen radical called superoxide anion radical, and they have also been shown to help prevent oxygen-based damage to fats.
The ability of prunes to fight free radicals is boosted by beta-carotene. Beta-carotene acts as a fat-soluble antioxidant, eliminating free radicals that would otherwise cause a lot of damage to our cells and cell membranes.

What do you choose? Junk food or healthy products? Whatever your choice will be you have to know about antioxidants and the products that contain the biggest amount of antioxidants.

Best sources of antioxidants – best foods with antioxidants
A USDA study analyzed the antioxidant content of commonly consumed foods. Researchers tested over 100 foods. Here is a ranked list of the top 20 fruits, vegetables and nuts:
1. Small red bean (dried), 1/2 cup
2. Wild blueberry, 1 cup
3. Red kidney bean (dried), 1/2 cup[br[
4. Pinto bean, 1/2 cup
5. Blueberry (cultivated), 1 cup
6. Cranberry, 1 cup (whole)
7. Artichoke (cooked hearts), 1 cup
8. Blackberry, 1 cup
9. Prune, 1/2 cup
10. Raspberry, 1 cup
11. Strawberry, 1 cup
12. Red delicious apple, 1
13. Granny Smith apple, 1
14. Pecan, 1 ounce
15. Sweet cherry, 1 cup
16. Black plum, 1
17. Russet potato, 1 cooked
18. Black bean (dried), 1/2 cup
19. Plum, 1
20. Gala apple, 1

Test Your Eye with Eye Charts

Snellen Chart, Landolt C, Lea Test

I wonder if I see things as clear as others do, or I do more, or I do less....!?

Eye charts are a great help to the objectivity of my assessment of myvisual acuity.

They are of various different kinds, each one designed and made with a different kind of purpose in mind.

Various kinds of symbols have been designed for these charts, facilitating identification by illiterates and children alike. Some of them are the capital block letter "E" turned in different orientations, the "broken ring" chart with different segments missing called Landolt C, eye charts comprisingsimple pictures called Lea Test, et cetera et cetera.

These charts comprise different rows of test symbols in different sizes.

Snellen Eye Chart

You start with the row comprising the largest test symbols and go on identifying them in the next and next rows till you are comfortably able to do so.

Once you face a difficulty in identifying in a particular row, you stop there and your vision is calculated according to its power as being able to identify upto the previous row only.

The calculation part is very easy. The rows are supposed to be identifiedfrom a distance of 200 feet (for the largest one) to 4 feet (for the smallest).

If you can identify the symbols in the 4 feet row from a distance of 4feet, your vision is said to be 4/4 or 20/20 or 6/6.

If you can identify the symbols in the 7 feet row from a distance of 7feet, your vision is said to be 7/7 or 20/20 or 6/6.

If you can identify the symbols in the 10 feet row from a distance of 10feet, your vision is said to be 10/10 or 20/20 or 6/6.

But if you can only identify the 15 feet row (supposed to be identified from 15 feet) from a distance of 10 feet, your vision is said to be 10/15or 20/30 or 6/9.

And If you can identify the symbols in the 20 feet row from a distance of20 feet, your vision is said to be 20/20 or 6/6.

Snellen Eye Chart

If you can only identify the 30 feet row (supposed to be identified from 30feet) from a distance of 10 feet, your vision is said to be 10/30 or 20/60or 6/18.

If you can only identify the 40 feet row (supposed to be identified from 40feet) from a distance of 10 feet, your vision is said to be 10/40 or 20/80or 6/24.

If you can only identify the 50 feet row (supposed to be identified from 50feet) from a distance of 10 feet, your vision is said to be 10/50 or20/100 or 6/30.

If you can only identify the 60 feet row (supposed to be identified from 60feet) from a distance of 10 feet, your vision is said to be 10/60 or20/120 or 6/36.

If you can only identify the 70 feet row (supposed to be identified from 70feet) from a distance of 10 feet, your vision is said to be 10/70 or20/140 or 6/42.

If you can only identify the 100 feet row (supposed to be identified from100 feet) from a distance of 10 feet, your vision is said to be 10/100 or20/200 or 6/60.

If you can only identify the 200 feet row (supposed to be identified from200 feet) from a distance of 10 feet, your vision is said to be 10/200 or20/400 or 6/120 that comes under the purview of legal blindness.

Tibetan monks also created Tibetan eye charts. These eye charts are said to train the muscles and nerves of the optical system, correcting visual problems along with measuring visual acuity.

Vision therapy does the same thing, i.e., correct vision, but only with the benefit that it is instantaneously done through third eye opening.

About Cholesterol

Certain people should have a cholesterol blood test as part of a 'cardiovascular risk assessment'. These include: all people aged 40 or more, people at any age with a strong family history of early heart disease or stroke, and people at any age with a family history of a hereditary lipid (cholesterol) disorder. If you are found to have a high risk of developing heart disease or stroke then you will usually be advised to take a statin drug to lower your cholesterol level. As a rule, no matter what your cholesterol level is, lowering the level reduces your risk. Lifestyle factors that also reduce the risk include: not smoking, choosing healthy foods, a low salt intake, regular physical activity, keeping your weight and waist size down, and drinking alcohol in moderation. Your blood pressure is also important.

What is cholesterol?

Cholesterol is a lipid (fat chemical) that is made in the liver from fatty foods that we eat. A certain amount of cholesterol is present in the bloodstream. You need some cholesterol to keep healthy. Cholesterol is carried in the blood as part of particles called lipoproteins. There are different types of lipoproteins, but the most relevant to cholesterol are:

• Low density lipoproteins carrying cholesterol - LDL cholesterol. This is often referred to as 'bad cholesterol' as it is the one mainly involved in forming atheroma. Atheroma is the main underlying cause of various cardiovascular diseases (see below). Usually, about 70% of cholesterol in the blood is LDL cholesterol, but the percentage can vary from person to person.

• High density lipoproteins carrying cholesterol - HDL cholesterol. This is often referred to as 'good cholesterol' as it may actually prevent atheroma formation.

What are atheroma and cardiovascular diseases?

Patches of atheroma are like small fatty lumps that develop within the inside lining of arteries (blood vessels). Atheroma is also known as atherosclerosis and 'hardening of the arteries'. Patches of atheroma are often called plaques of atheroma.

Over months or years, patches of atheroma can become larger and thicker. So, in time, a patch of atheroma can make an artery narrower. This can reduce the blood flow through the artery. For example, narrowing of the coronary (heart) arteries with atheroma is the cause of angina.

Sometimes, a blood clot (thrombosis) forms over a patch of atheroma and completely blocks the blood flow. Depending on the artery affected, this can cause a heart attack, a stroke, or other serious problems.

Cardiovascular diseases are diseases of the heart (cardiac muscle) or blood vessels (vasculature). However, in practice, when doctors use the term 'cardiovascular disease' they usually mean diseases of the heart or blood vessels that are caused by atheroma.

In summary, cardiovascular diseases caused by atheroma include: angina, heart attack, stroke, transient ischaemic attack (TIA), and peripheral vascular disease. In the UK, cardiovascular diseases are a major cause of poor health, and the biggest cause of death.

What factors affect the blood level of cholesterol?

In most people, your cholesterol level reflects the amount of fat that you eat. This is not the full story as different people who eat the same amount of fat can make different amounts of cholesterol. However, in general, if you eat less fat your cholesterol level is likely to go down.

In some people, a high cholesterol level is due to another condition. For example, an underactive thyroid gland, obesity, drinking a lot of alcohol, and some rare kidney and liver disorders can raise the cholesterol level.

In some people, a very high level of cholesterol runs in the family due to an inherited genetic problem with the way cholesterol is made. One example is called familial hypercholesterolaemia.

Risk factors

Everybody has some risk of developing atheroma which then may cause one or more cardiovascular diseases. However, certain risk factors increase the risk. Risk factors include:

• Lifestyle risk factors that can be prevented or changed:

o Smoking.

o Lack of physical activity (a sedentary lifestyle).

o Obesity.

o An unhealthy diet - including eating too much salt.

o Excess alcohol.

• Treatable or partly treatable risk factors:

o Hypertension (high blood pressure).

o High cholesterol blood level.

o High triglyceride (fat) blood level.

o Diabetes.

o Kidney diseases that affect kidney function.

• Fixed risk factors - ones that you cannot alter:

o A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65.

o Being male.

o An early menopause in women.

o Age. The older you become, the more likely you are to develop atheroma.

o Ethnic group. For example, people who live in the UK with ancestry from India, Pakistan, Bangladesh, or Sri Lanka have an increased risk.

However, if you have a fixed risk factor, you may want to make extra effort to tackle any lifestyle risk factors that can be changed.

Note: some risk factors are more 'risky' than others. For example, smoking and a high cholesterol level probably cause a greater risk to health than obesity. Also, risk factors interact. So, if you have two or more risk factors, your health risk is much more increased than if you just have one. For example, a middle aged male smoker who has high blood pressure and a high cholesterol level has a high risk of developing a cardiovascular disease such as a heart attack before the age of 60.

What is a high cholesterol level?

The following levels are generally regarded as desirable:

• Total cholesterol (TC) - 5.0 mmol/l or less. However, about 2 in 3 adults in the UK have a total cholesterol level of 5.0 mmol/l or above.

• Low-density lipoprotein (LDL) cholesterol after an overnight fast: 3.0 mmol/l or less.

• High-density lipoprotein (HDL) cholesterol: 1.2 mmol/l or more.

• TC/HDL ratio: 4.5 or less. That is, your total cholesterol divided by your HDL cholesterol. This reflects the fact that for any given total cholesterol level, the more HDL, the better.

As a rule, the higher the LDL cholesterol level, the greater the risk to health.

However, your level of cholesterol has to be viewed as part of your overall cardiovascular health risk. The cardiovascular health risk from any given level of cholesterol can vary, depending on the level of your HDL cholesterol, and on other health risk factors that you may have.

Assessing (calculating) your cardiovascular health risk

A risk factor calculator is commonly used by doctors and nurses. This can assess your cardiovascular health risk. A score is calculated which takes into account all your risk factors such as age, sex, smoking status, blood pressure, cholesterol level, etc.

The calculator has been devised after a lot of research that monitored thousands of people over a number of years. The score gives a fairly accurate indication of your risk of developing a cardiovascular disease over the next 10 years. If you want to know your score, see your practice nurse or GP.

Who should have their cardiovascular health risk assessed?

Current UK guidelines advise that the following people should be assessed to find their cardiovascular health risk:

• All adults aged 40 or more.

• Adults of any age who have:

o A strong family history of early cardiovascular disease. This means if you have a father or brother who developed heart disease or a stroke before they were 55, or in a mother or sister before they were 65.

o A first degree relative (parent, brother, sister, child) with a serious hereditary lipid disorder. For example, familial hypercholesterolaemia or familial combined hyperlipidaemia. These diseases are uncommon.

If you already have a cardiovascular disease or diabetes then your risk does not need to be assessed. This is because you are already known to be in the high risk group.

What does the assessment involve?

A doctor or nurse will:

• Do a blood test to check your cholesterol and glucose (sugar) level.

• Measure your blood pressure and your weight.

• Ask you if you smoke.

• Ask if there is a history of cardiovascular diseases in your family (your blood relations). If so, at what age the diseases started in the affected family members.

A score is calculated based on these factors plus your age and your sex. An adjustment to the score is made for certain other factors such as strong family history and ethnic origin.

What does the assessment score mean?

You are given a score as a percentage chance. So, for example, if your score is 30% this means that you have a 30% chance of developing a cardiovascular disease within the next 10 years. This is the same as saying a 30 in 100 chance (or a 3 in 10 chance). In other words, in this example, 3 in 10 people with the same score that you have will develop a cardiovascular disease within the next 10 years. Note: the score cannot say if you will be one of the three. It cannot predict what will happen to each individual person. It just gives you the odds.

You are said to have a:

• High risk - if your score is 20% or more. That is, a 2 in 10 chance or more of developing a cardiovascular disease within the next 10 years.

• Moderate risk - if your score is 10-20%. That is, between a 1 in 10 and 2 in 10 chance.

• Low risk - if your score is less than 10%. That is, less than a 1 in 10 chance.

Who should be treated to reduce their cardiovascular health risk?

Treatment to reduce the risk of developing a cardiovascular disease is usually offered to people with a high risk. That is:

• People with a risk assessment score of 20% or more. That is, if you have a 2 in 10 chance or more of developing a cardiovascular disease within the next 10 years.

• People with an existing cardiovascular disease (to lower the chance of it getting worse, or of developing a further disease).

• People with diabetes. If you have diabetes, the time that treatment is started to reduce cardiovascular risk depends on factors such as: your age, how long you have had diabetes, your blood pressure and if you have any complications of diabetes.

• People with certain kidney disorders.

The following people should also have drug treatment to lower their cholesterol level, regardless of any calculated risk. The risk calculator may not necessarily take these people into account who have a high risk of developing atheroma.

• People with a total cholesterol to high density lipoprotein ratio of 6 or more (TC/HDL = 6 or more).

• People with familial (hereditary) lipid disorders.

What treatments are available to reduce the risk?

If you are at high risk of developing a cardiovascular disease then drug treatment is usually advised along with advice to tackle any lifestyle issues. This usually means:

• Drug treatment to lower your cholesterol level, usually with a statin drug. No matter what your current cholesterol level, drug treatment is advised. There are several brands of statin drug. They work by blocking an enzyme (chemical) which is needed to make cholesterol in the liver. See leaflet called 'Statins' for details.

• There is no actual target level for people who do not already have cardiovascular disease. However, for those who do have a cardiovascular disease the aim, if possible, is to reduce total cholesterol to less than 4.0 mmol/l and LDL cholesterol to less than 2.0 mmol/l.

• Drug treatment to lower blood pressure if it is high. This is even if your blood pressure is just mildly high. See leaflet called 'High Blood Pressure' for details.

In addition, if you already have cardiovascular disease, a daily low dose of aspirin is also usually advised . Aspirin helps to prevent blood clots from forming on patches of atheroma. See leaflet called 'Aspirin and Other Antiplatelet Drugs' for details.

In addition, everyone should aim to tackle lifestyle risk factors. This means to:

• Stop smoking if you smoke.

• Eat a healthy diet.

• Keep your salt intake to under 6 g a day.

• Keep your weight and waist in check.

• Take regular physical activity.

• Cut back if you drink a lot of alcohol.

If available, and if required, you may be offered a referral to a specialist service. For example, to a dietician to help you to lose weight and eat a healthy diet, to a specialist 'stop smoking clinic', or to a supervised exercise programme.

Can diet lower my cholesterol level?

Changing from an unhealthy diet to a healthy diet can reduce a cholesterol level. However, dietary changes alone rarely lower a cholesterol level enough to change a person's risk of cardiovascular disease from a high risk category to a lower risk. However, any extra reduction in cholesterol due to diet will help. A healthy diet has other benefits too apart from reducing the level of cholesterol.

Briefly, a healthy diet means:

• AT LEAST five portions, and ideally 7-9 portions, of a variety of fruit and vegetables per day.

• THE BULK OF MOST MEALS should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.

• NOT MUCH fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low fat, mono-, or poly-unsaturated spreads.

• INCLUDE 2-3 portions of fish per week. At least one of which should be 'oily' (but if you are pregnant you should not have more than two portions of oily fish a week).

• LIMIT SALT to no more than 6 g a day (and less for children).

• If you eat meat it is best to eat lean meat, or poultry such as chicken.

• If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive oil.

Foods that contain plant sterols or stanols can reduce total blood cholesterol level and LDL cholesterol by about 10%. There does not seem to be much evidence however that this has an effect on preventing cardiovascular disease. The National Institute of Clinical Excellence (NICE) therefore does not recommend that these products are used routinely until more information is available.

How much benefit do I get if my cholesterol level is reduced?

If you have a high risk of developing a cardiovascular disease, or you already have a cardiovascular disease, lowering your cholesterol level reduces your risk of developing future cardiovascular problems. For details on exactly how much risk is reduced by lowering and treating risk factors, see the guidance produced by the Clinical Knowledge Services called 'Cardiovascular risk assessment and management ' -www.cks.nhs.uk/cvd_risk_assessment_and_management

What if I am at moderate or low risk?

Statin drugs are available on prescription and funded by the NHS if your risk is high. If your risk is moderate to low, it should be enough to concentrate on the lifestyle changes mentioned above. However, some people prefer to buy a low dose statin as well. If you do decide to do this, make sure your doctor knows so this can be put on your medical record.

Further help and information

Heart UK

7 North Road, Maidenhead, Berkshire, SL6 1PE

Helpline: 0845 450 5988 Web: www.heartuk.org.uk

Provides information on heart disease and its management by lifestyle and drugs. Aims to help anyone at high risk of heart disease especially families with inherited high cholesterol.

British Heart Foundation

14 Fitzhardinge Street, London, W1H 6DH

Tel (Heart Information Line): 0300 330 3311 Web: www.bhf.org.uk

British Nutrition Foundation

Web: www.nutrition.org.uk

Their website provides healthy eating information

Women Breast Cancer

Breast Canser

Breast cancer (malignant breast neoplasm) is cancers originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ducal carcinomas; those originating from lobules are known as lobular carcinomas. There are many different types of breast cancer, with different stages (spread), aggressiveness, and genetic makeup; survival varies greatly depending on those factors.Computerized models are available to predict survival. With best treatment and dependent on staging, 10-year disease-free survival varies from 98% to 10%. Treatment includes surgery, drugs (hormonal therapy and chemotherapy), and radiation.

Worldwide, breast cancer comprises 10.4% of all cancer incidence among women, making it the most common type of non-skin cancer in women and the fifth most common cause of cancer death. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths).Breast cancer is about 100 times more common in women than in men, although males tend to have poorer outcomes due to delays in diagnosis.

Some breast cancers require the hormones estrogen and progesterone to grow, and have receptors for those hormones. After surgery those cancers are treated with drugs that interfere with those hormones, usually tamoxifen, and with drugs that shut off the production of estrogen in the ovaries or elsewhere; this may damage the ovaries and end fertility. After surgery, low-risk, hormone-sensitive breast cancers may be treated with hormone therapy and radiation alone. Breast cancers without hormone receptors, or which have spread to the lymph nodes in the armpits, or which express certain genetic characteristics, are higher-risk, and are treated more aggressively. One standard regimen, popular in the U.S., is cyclophosphamide plus doxorubicin (Adriamycin), known as CA; these drugs damage DNA in the cancer, but also in fast-growing normal cells where they cause serious side effects. Sometimes a taxane drug, such as docetaxel, is added, and the regime is then known as CAT; taxane attacks the microtubules in cancer cells. An equivalent treatment, popular in Europe, is cyclophosphamide, methotrexate, and fluorouracil (CMF). Monoclonal antibodies, such as trastuzumab (Herceptin), are used for cancer cells that have the HER2 mutation. Radiation is usually added to the surgical bed to control cancer cells that were missed by the surgery, which usually extends survival, although radiation exposure to the heart may cause damage and heart failure in the following years.

Breast cancer Treatment

The mainstay of breast cancer treatment is surgery when the tumor is localized, followed by chemotherapy (when indicated), radiotherapy and adjuvant hormonal therapy for ER positive tumours (with tamoxifen or an aromatase inhibitor). Management of breast cancer is undertaken by a multidisciplinary team based on national and international guidelines. Depending on clinical criteria (age, type of cancer, size, metastasis) patients are roughly divided to high risk and low risk cases, with each risk category following different rules for therapy. Treatment possibilities include radiation therapy, chemotherapy, hormone therapy, and immune therapy.

A patient must first go through the staging process to see if s/he can benefit local treatment. It makes use of Clinical, imaging and pathological assessment to make a best guess by the physician. If the cancer has spread beyond the Breast and the lymph nodes then it is classified as Stage 4 or metastaic cancer and requires mostly systemic treatment.

Live tissue samples for testing

Recently live tissue samples from surgery are tested with various chemotherapy agents to derive probabilities of which ones may work better and specially the ones which would not work (Cell-death assays). The companies need the sample within 24 hours of surgical excision. This is specially useful for early stage cancers were a response for the therapy cannot be determined once the wole cancer is taken out during the surgery and the chemotherepy is given in an adjuciant setting. However, the benefits of such tests have not yet been established in clinical trials and is not mainstream.