By 1992, Americans were doing better, dropping to 16th worldwide, behind Germany, England, Argentina, and a dozen other countries in CVD risks. (The Russian Federation was now number one.) This 23-year drop in CVD death rates was due to a number of things. Better education, improved surgical techniques, clot-busting drugs, and sophisticated emergency and health care system factors were instrumental. Individually, important behavior changes, including reductions in smoking and consumption of dietary fat, increased exercise, and defensive techniques such as cardiopulmonary resuscitation (CPR) also contributed to lower rates.

Despite these early encouraging signs, we still have a long way to go. In 2000, several databases indicated that Americans were more prone to obesity than ever before and led more sedentary lifestyles. Also, the epidemic of obesity was getting worse among our nation’s youth. Dietary excesses, particularly high-fat diets, and large portions, appeared to make a comeback.

Today, CVD continues to be the leading single cause of death around the world. In the United States, death rates from cardiovascular disease in men (ages 35-50) are three times greater than in women of the same age, but in later years (65-74) the incidence is about the same. In 1999, CVD accounted for over 41 percent of all deaths, or nearly 1 out of every 2.5 deaths. This is nearly 3 times the rate of the second leading killer, cancer, and more than the number of deaths caused by all other diseases combined. Of the nearly 2 million deaths per year in the United States, CVD was listed as a primary or contributing cause of death on about 1.4 million death certificates. CVD has been the number one killer in the United States since 1900, in every year but one -1918, when another killer, a particularly virulent strain of influenza (the flu), struck with blinding force. To help clarify just how serious CVD is to Americans, consider the following points:

- More than 2,600 Americans die of CVD each day, an average of 1 every 33 seconds. That’s more than 950,000 per year.

- Many of these deaths are sudden cardiac deaths, meaning that these Americans die from sudden, abrupt loss of heart function (cardiac arrest), either instantly or shortly after symptoms occur. Most of these deaths result from coronary heart disease (CHD); in fact, over 220,000 people, nearly half of all victims of heart attack, die from CHD before they get to a hospital.

- People who attempt to save such victims through cardiac resuscitation are sometimes riddled with guilt when they fail to save a life. However, many such deaths are due to sudden heart stoppage or slowing that even the most heroic efforts cannot prevent.

- CVD claims nearly 11,000 more lives each year than the next 6 leading causes of death combined.

- More than 150,000 Americans killed by CVD are under age 65.

- The 1998 death rates from CVD were 419.3 for white males and 532.0 for black males; for white females 294.9 and for black females 400.7 (rate is per 110,000 of population).

- From 1988 to 1998, death rates from CVD declined by 20.4 percent. However, due to increases in the total population, the decline in actual numbers of deaths was only about 3 percent.

- According to the most recent CDC/NCHS calculations, if all forms of major CVD were eliminated, life expectancy would rise by almost 7 years.

The probability at birth of eventually dying of CVD is 47 percent; of dying from cancer, 22 percent; from accidents, 3 percent; from diabetes, 2 percent; and 0.7 percent from HIV

Though these statistics seem grave enough, they do not include the effects of CVD experienced by the untold numbers who live with the ravages of the disease. Today, nearly 61 million Americans live with one of the major categories of CVD. Many do not know they have a serious problem. Nearly 13 million of these people have a history of heart attack, angina pectoris (chest pain), or both. In spite of major improvements in medication, surgery, and other health care procedures, the prognosis for many of these individuals is not good:

- Twenty-five percent of women and 38 percent of men will die within 1 year after having an initial heart attack.

- People who survive the acute stages of a heart attack have a chance of illness and death that is 1.5-15 times higher than that of the general population, depending on their sex and clinical outcomes. The risk of another heart attack, sudden death, angina pectoris, heart failure, and stroke – for both men and women – is substantial.

- Within six years after a recognized heart attack, 18 percent of men and 35 percent of women will have another heart attack; 7 percent of men and 6 percent of women will experience sudden death; about 22 percent of men and 46 percent of women will be disabled with heart failure about two thirds of heart attack patients won’t make a complete recovery, but 88 percent of those under age 65 will be able to return to their usual work

- CHD will permanently disable 19 percent of the U.S. labor force.

You can reduce your risk for CVD by taking steps to change certain behaviors. For example, controlling high blood pressure and reducing intake of saturated fats and cholesterol are two things you can do to lower your chances of heart attack. By maintaining your weight, decreasing your intake of sodium, exercising, not smoking, and changing your lifestyle to reduce stress, you can lower your blood pressure. You can also monitor the levels of fat and cholesterol in your blood and adjust your diet to prevent arteries from becoming clogged. Having combinations of risk factors seems to increase overall risk by a factor greater than those of the combined risks. Happily, the converse is also true. Reducing several risk factors can have a dramatic effect.

Understanding how your cardiovascular system works will help you understand risks to cardiovascular health and reduce them.

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Theories abound concerning the mechanisms that regulate food intake. Some sources indicate that the hypothalamus (the part of the brain that regulates appetite) closely monitors levels of certain nutrients in the blood. When these levels begin to fall, the brain signals us to eat. In the obese person, it is possible that the monitoring system does not work properly and that the cues to eat are more frequent and intense than they are in people of normal weight.

Other sources indicate that thin people may send more effective messages to the hypothalamus. This concept, known as adaptive thermogenesis, states that thin people can often consume large amounts of food without gaining weight because the appetite center of their brains speeds up metabolic activity to compensate for the increased consumption. Older studies have indicated the possibility that specialized types of fat cells, called brown fat cells, may send signals to the brain, which controls the thermogenesis response.

The hypothesis that food tastes better to obese people thus causing them to eat more has largely been refuted. Scientists do distinguish, however, between hunger, an inborn physiological response to nutritional needs, and appetite, a learned response to food that is tied to an emotional or psychological craving for food often unrelated to nutritional need. Obese people may be more likely than thin people to satisfy their appetite and eat for reasons other than nutrition.

In some instances, the problem with overconsumption may be more related to satiety than to appetite or hunger. People generally feel satiated, or full, when they have satisfied their nutritional needs and their stomach signals “no more”. For undetermined reasons, obese people may not feel full until much later than thin people. The leptin and GLP-1 studies seem to add credence to this theory.

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Now let’s turn to some specific skin infections. Lately I have noticed a gradual increase in Impetigo. The lesions of this contagious skin infection are characterised by thin, rolled vesicles or pustules, in a thick superficial crust, often caused by haemolytic streptococcus and staphylococcus influences. To my mind impetigo is caused more often nowadays by a faulty diet than by poor hygienic management. In hot climates impetigo problems seem to be becoming more common and there I think the causes lie in diet and hygiene in equal importance. Fortunately, impetigo can be cleared relatively easily, as long as the right measures are taken.

With children in particular, one should look at the child’s constitutional condition and likely causes will be malnutrition or a poorly balanced diet. Introduce plenty of fruit and vegetables into the diet and consider substituting cow’s milk with goat’s milk. Try to make the child eat raw food, such as salads, although I admit that this may not be so easy in younger cildren. Added to this, bathing in Epsom Salts baths and the use of Echinaforce, Violaforce and Urticalcin, makes a very good all-round treatment to clear impetigo.

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