Modern Medicine: Cholesterol control - is it really the answer?

by Dr Iain Corness, Consultant

Sometimes I find it amazing that there are still folk out there who are not convinced that diet and cholesterol are the key factors in heart disease. However, I should not be too hard on these people, after all, it took the medical world 81 years to accept that fact.

The cholesterol story began in 1913 with a Russian pathologist called Anitschkow and his pet rabbits. (No, I am not making this up!) Way back in the days of button-up boots and before the advent of ballpoint pens and cling wrap, Anitschkow demonstrated that raised cholesterol levels produced hardening of the arteries supplying the heart muscle (the coronary arteries). That really was 1913 and Anitschkow’s work was done on his bunny rabbits, but medical science was not convinced that what happened to Bugs Bunny would actually happen to us. After all, we are not really large rabbits!

However, his work was not in vain, because 47 years later a huge study was done in America (the Framingham Study by a Dr. Kanel) and the initial results were published in 1960. This appeared to show that cholesterol and heart disease were intimately connected. But the medical world is notoriously slow to react to change, I’m afraid, and Kanel’s words fell onto some stony ground. But there were a few believers. (I actually met Dr. Kanel in the early 1970’s and I am glad to say he convinced me.)

The believers continued the research and it was in 1994 that the Scandinavian 4S study proved the concept and the need to lower cholesterol, to in turn reduce heart disease, became universally accepted. That’s 81 years after Anitschkow pointed the scientific finger at cholesterol.

Since the 4S study, the world has been looking at different ways of reducing cholesterol, from diet all the way through to some special drugs called ‘statins’. Now considering that all drugs have a certain ‘risk’ attached to them, for my simple mind, we should at least start with dietary measures. Non-dangerous stuff! I have given you the 10 Dietary Commandments before (from Australian Cardiologist, David Colquhoun). Cut out this article and laminate and stick on the refrigerator!

1. Eat bread every day, preferably multigrain.

2. Eat some fruit every day.

3. Never eat cream or butter again.

4. Eat more fish and eat less meat.

5. Use olive oil every day.

6. Eat some vegetables every day.

7. Eat a handful of nuts every day.

8. Use more fresh herbs and garlic.

9. Have a glass of wine with food every day.

10. Eat in a relaxed way and enjoy your food.

Now all that looks fairly easy and the glass of wine with it all suits me down to the ground, I must say. However, note that that was a glass of wine, not a bottle of wine! It is also a diet that is very easy to follow in Pattaya, where fish and fruit abounds. Just look at Thai food and how it fits in - herbs, garlic, vegetables, little meat, more fish, no dairy products, substitute rice for multigrain and you have a wonderful recipe for a healthy cholesterol reducing diet.

So what’s your cholesterol level? Do you have to do something about it? Until you know your level, you won’t know what your relative risk is. Have it checked!

Heart to Heart with Hillary

A Slice of Thai History: The Japanese invasion of Thailand 8 December 1941 (part two)

by Duncan Stearn

The invasion of Thailand began with the Fifth Division launching amphibious landings - covered by a destroyer squadron - at Songkhla, Thepa, and Pattani just after 1:00 a.m. These landings were unopposed, unlike the earlier assault against the British in Kota Bahru which was vigorously resisted. By mid-morning the Japanese had around 60 aircraft, mainly fighters, on the ground at the strategically important Songkhla airfield.

However, further Japanese landings near the mouth of the Chumphon River, Nakhon Sri Thammarat, and Prachuap Khiri Khan were opposed by Thai military forces as was an invasion of eastern Thailand from Battambang Province in Cambodia and an air assault against Don Muang airfield, on the outskirts of Bangkok. Thai air force planes flew against the superior Japanese forces, but six fighters were shot down.

At Prachuap Khiri Khan some 120 air force personnel battled with nearly 2,000 Japanese troops for control of the vital airfield. The battle began at around 4:00 a.m. and continued for the next 30 hours until a telegram from the prime minister arrived ordering them to surrender. By that time, the morning of 9 December, they had lost 42 killed, including two women. Japanese losses were estimated at around 400 dead.

At around 7:30 a.m. Pibulsongkram re-appeared in Bangkok and immediately ordered a ceasefire. For the prime minister the tactics of a brief resistance meant he could later claim the Thais had defended their territory against the Japanese but he had reluctantly ordered a ceasefire in order to save the country from destruction.

Although ‘Operation Matador’ could not be implemented, the British had a back-up plan entitled ‘Operation Krohcol’ and at 11:00 a.m. permission was granted by the commander-in-chief to push troops into Thailand to harass the Japanese.

At 3:00 p.m. (other sources say 5:30 p.m.) ‘Operation Krohcol’ commenced when two companies of the Indian 11th Division crossed the Thai border with the aim of blocking the Japanese advance from Songkhla. It had been hoped the Thais would at least be neutral, but they resisted the British advance, sniping at it all the way. The Indian troops moved on to Sadao and at dusk dug in and waited for the Japanese.

At the same time an armoured train advanced into Thailand from Pedang Besar, aiming to interdict any Japanese move from Pattani. They destroyed an important bridge and then withdrew.

Around 9:30 p.m. an advance column of Japanese ran into the Indian troops dug in around Sadao, forcing them to retreat back across the Malayan border. The British destroyed a couple of bridges as they went but by midnight the Japanese were crossing the border.

Personal Directions: Yes we can. No we can’t. Well, maybe we can...

by Christina Dodd,
founder and managing director of Asia Training Associates

“Yes we can, but - wait a second - we need to put it to the committee and let you know once they’ve come up with a decision.”

“When will that be?”

“I’m not sure, perhaps next week. Someone will get in touch with you...”

Heard any of this before? What does it tell you?

Loads of indecision and huge doses of its equally disruptive partner - procrastination - exist in many businesses today, despite the fact that we all realize and acknowledge how difficult it is do business with these negative and counter-productive characteristics at play.

The simple fact of the matter is that many of us find it difficult to be decisive and to make a decision! No matter whether it is a simple decision or a more complicated one. This behavior can literally “drive people up the wall” if they are on the receiving end of it and it is the kind of behavior that can lead many customers to “make a decision” to change to another supplier or another bank or another gas station!

A rare quality indeed is the one where a decision can be well thought out and delivered in a timely fashion with confidence and commitment. An even rarer quality is the one where a decision can be made in a short space of time, to a deadline and under stress, and be a decision that hits the spot and gets the task at hand completed. Phew! Where are these decision makers? They do exist - I have actually met some - and those companies who are fortunate enough to have them on staff have an invaluable resource to say the least!

The all-too-common scenario of not being able to make a decision or of procrastinating until you “drive people to murder”, is nothing new and you might ask, why should we draw point to it? Well, to my mind attention needs to be drawn to it so that we can understand the important part it plays in forming the “mark of a business”, as to how that business operates and whether or not that business achieves. It is the basis of good business that leads to successful business.

On a personal level, it forms the mark of a capable individual, someone who has got it together and is able to cope with all sorts of situations that may arise. By the way, it is okay to go to pieces sometimes, as we are only human, but there are times when having someone around who can cope with making tough decisions in awkward moments is an absolute Godsend.

So many people I know have lost precious time and precious money waiting for decisions to be made. Most of us I’m sure have quite literally agonized over a situation where no decision has been forthcoming and we’ve lost sleep, worried ourselves sick, lost tempers with loved-ones, cancelled other engagements because the decision might come through at the same time and what if you were unable to take the call! We have all been affected by indecision or a lack of decision-making at some time or another and so we all know first-hand the frustration that comes with it.

A few weeks ago I was taking a group of rather senior managers through a workshop and the time came to form groups. Fifty percent of them had no problems with this basic task, but the other fifty percent took much longer in making the decisions of who would go where - and this was despite the fact that certain conditions had been set to make the task simple. As we proceeded, having eventually formed groups, the time came to select a group leader to represent them for the duration of the program. Well, this was a real adventure for some and the looks of exasperation on their faces was quite surprising. It was almost as if they were begging me to choose their leader for them. To decide their leader would involve making another decision!

It is extraordinary how we behave when it comes to making a decision - to being put on the spot and having to come up with something.

What goes on inside our minds when a decision has to be made? How strong and accurate are our powers of being able to analyse a situation and to measure it accordingly to produce the correct response, or an acceptable response? What is the real issue here?

I think a lot of our problems with decision-making lie in the fact that a lot of us are afraid of the acceptance factor. Will the decision be accepted by those whom it will affect? If we know someone is going to be pleased to receive something from us, then we are very happy to go about our way to make sure they get it. We have no fear of rejection. The task is easy and causes no anguish, poses no threat. But if we know that someone is not going to like what we are about to give them, then this opens up a whole different set of emotions which may cause us to hesitate and procrastinate because we are afraid that the outcome will not be accepted.

In the simple activity of forming groups, those participants who found it difficult to decide which group they would be in were probably afraid that their colleagues might not accept or like the choices they were about to make. When it came to selecting a leader, this emotion also raised its head and fuelled the fire of indecision. The acceptance factor is hard for some people to come to terms with and to overcome, and needs to be dealt with on an individual level.

Some people believe that you have either got it or you haven’t when it comes to ability and when it comes to having the ability to make decisions. I believe that there are a great many things that we are capable of learning, a great many abilities that we have but just don’t know how to use. Through coaching and personal and professional development, humans can astonish and amaze each other with their skills - it is all the desire to achieve and perform better, and the method and level of application.

For more information on this and other subjects of personal and professional development, please contact me at [email protected]

Until next time have a wonderful week.

Women’s World: You are what you eat

by Lesley Warner

Firstly this week I would like to say a sad goodbye to a friend that was brutally murdered in his home; let this be a word of caution to those that trust a stranger’s smile.

Lately I’ve been observing the enormous amount of enormous people in the fast food restaurants. These now include the Thais, as a surprising number now go in for this fast food diet, feeding it to their children with a total disregard to the size of the child. While I was waiting for a friend the other day I watched a Thai child walk out of a restaurant; the child was totally naked so I presumed it lived there. He must have be about 3 years old, and I can honestly say I have never seen such a fat child of this age anywhere. As I observed, his mother came out and gave him a large bag of goodies, which he greedily grabbed as she looked at him adoringly.

I have noticed several fat Thai children - they do seem to have the propensity for overweight even more than farangs. Maybe the fact that they are generally of a smaller stature than Western children it is more obvious. It’s quite sad because in the 20 years that I have been visiting Thailand I never remember seeing this before. When I first came to Bangkok I can remember feeling huge and ungainly next to the petite Thai ladies. I no longer feel this, as a good percentage of them are far bigger than me and they even have cellulite!

It makes you wonder if there is some kind of drug in fast food to make us want to eat it. I mean, quite honestly, what can be attractive in a reconstituted piece of fried chicken that’s been cooked for at least 30 minutes and left on a warming plate? Then it’s rammed into a cardboard box with some excuse for french-fries shoveled into another cardboard box and all stuck into a plastic/paper bag. If you decide to eat in the restaurant you are then expected to clear away the tray with your cardboard boxes yourself.

What you eat does affect how you look today, and in later life. There are certain nutrients the body needs for glowing healthy skin. I have compiled a list that will help everyone; next week I’ll concentrate on us ladies again:

Vitamin A - The best sources are egg yolks, oysters and nonfat milk. You can also get vitamin A from foods rich in beta-carotene, which the body can convert into vitamin A. This fat-soluble vitamin is essential for the maintenance and healing of epithelial tissues, with skin being the largest expanse of epithelial tissue you’ve got!

Carrots - Researchers have found that a serving of carrots, sweet potatoes, tomatoes, watermelon, papaya, broccoli or spinach a day can help reduce the redness and inflammation associated with sunburn.

B vitamins - Help convert calories into energy for skin metabolism and are components of enzymes that maintain normal skin function (including functioning of the oil-producing glands, which keep skin moist and smooth). That’s why poor intake of almost any B vitamin can cause dry or scaly skin. Best sources are poultry, red meat, fish, bananas, whole grains, brewer’s yeast, peanut butter and eggs.

Vitamin C - When taken internally, this vitamin helps maintain collagen - the underlying supporting structure of skin. But sun exposure (and stress) can drain vitamin C from the skin, leaving it vulnerable to damage from the environment. Best sources are citrus fruits and juices, kiwi, cantaloupe, strawberries, tomatoes, sweet peppers and green peas.

Vitamin E - This antioxidant helps slow the aging of skin cells by reducing the production of an enzyme called collagenase, which breaks down collagen, causing the skin to sag and wrinkle. Sun exposure can deplete vitamin E from the skin, making it more vulnerable to sun damage (this is why vitamin E is found in skin-care products from moisturizers to body washes). Best sources are salmon, extra-lean meat, almonds, leafy vegetables, and olive and sesame oils.

Zinc - This trace mineral helps maintain collagen and elastin fibers that give skin its firmness, helping to prevent sagging and wrinkles. Best sources are seafood, turkey, pork, soybeans and mushrooms.

Nothing replaces a well balanced diet and proper calorie intake, but a vitamin supplement can provide a means to obtaining essential nutrients missing in most of our diets. Vitamins are involved in all metabolic processes and are essential to life.