Correlation Health Dictionary

A LIPID that is an important constituent of body cells and so widely distributed throughout the body. It is especially abundant in the brain, nervous tissue, adrenal glands and skin. It is also found in egg yolk and gall-stones (see GALLBLADDER, DISEASES OF). Cholesterol plays an important role in the body, being essential for the production of the sex hormones as well as for the repair of membranes. It is also the source from which BILE acids are manufactured. The total amount in the body of a man weighing 70 kilograms (10 stones) is around 140 grams, and the amount present in the blood is 3·6–7·8 mmol per litre or 150–250 milligrams per 100 millilitres.

A high blood-cholesterol level – that is, one over 6 mmol per litre or 238 mg per 100 ml – is undesirable as there appears to be a correlation between a high blood cholesterol and ATHEROMA, the form of arterial degenerative disease associated with coronary thrombosis and high blood pressure. This is well exempli?ed in DIABETES MELLITUS and HYPOTHYROIDISM, two diseases in which there is a high blood cholesterol, sometimes going as high as 20 mmol per litre; patients with these diseases are known to be particularly prone to arterial disease. There is also a familial disease known as hypercholesterolaemia, in which members of affected families have a blood cholesterol of around 18 mmol per litre or more, and are particularly liable to premature degenerative disease of the arteries. Many experts believe that there is no ‘safe level’ and that everybody should attempt to keep their cholesterol level as low as possible.

Cholesterol exists in three forms in the blood: high-density lipoproteins (HDLs) which are believed to protect against arterial disease, and a low-density version (LDLs) and very low-density type (VLDLs), these latter two being risk factors.

The rising incidence of arterial disease in western countries in recent years has drawn attention to this relationship between high levels of cholesterol in the blood and arterial disease. The available evidence indicates that there is a relationship between blood-cholesterol levels and the amount of fat consumed; however, the blood-cholesterol level bears little relationship to the amount of cholesterol consumed, most of the cholesterol in the body being produced by the body itself.

On the other hand, diets high in saturated fatty acids – chie?y animal fats such as red meat, butter and dripping – tend to raise the blood-cholesterol level; while foods high in unsaturated fatty acids – chie?y vegetable products such as olive and sun?ower oils, and oily ?sh such as mackerel and herring – tend to lower it. There is a tendency in western society to eat too much animal fat, and current health recommendations are for everyone to decrease saturated-fat intake, increase unsaturated-fat intake, increase daily exercise, and avoid obesity. This advice is particulary important for people with high blood-cholesterol levels, with diabetes mellitus, or with a history of coronary thrombosis (see HEART, DISEASES OF). As well as a low-cholesterol diet, people with high cholesterol values or arterial disease may be given cholesterol-reducing drugs such as STATINS, but this treatment requires full clinical assessment and ongoing medical monitoring. Recent research involving the world’s largest trial into the effects of treatment to lower concentrations of cholesterol in the blood showed that routine use of drugs such as statins reduced the incidence of heart attacks and strokes by one-third, even in people with normal levels of cholesterol. The research also showed that statins bene?ted women and the over-70s.... cholesterol

A substance which is insoluble in water, but soluble in fat solvents such as alcohol and ether. The main lipid groups are the triglycerides, phospholipids, and glycolipids. They play an important role in nutrition, health (particularly in the functioning of the cell membranes, and the immune response), and disease (notably cardiovascular disease). There is a strong correlation between the concentration of CHOLESTEROL in the blood (transported as lipoproteins) and the risk of developing ATHEROMA and coronary heart disease (see HEART, DISEASES OF). Lipoproteins are classi?ed by their density and mobility, the chief groups being low-density (LDL) and high-density (HDL). High SERUM concentrations of LDL increase the risk of cardiovascular disease, while HDL is thought to protect the vessel wall by removing cholesterol, and has an inverse relationship to risk. The various serum lipid abnormalities have been classi?ed into ?ve groups, according to the cause and particular lipoprotein raised. Most important are type II (increased LDL, genetically determined) and type IV (increased VLDL, associated with obesity, diabetes, and excess alcohol). Various lipid-lowering drugs are available, but any drug treatment must be combined with a strict diet, reduction of blood pressure, and cessation of smoking.... lipid

an area of *cerebral cortex that lies away from the main areas that are concerned with the reception of sensory impulses and the start of motor impulses but is linked to them by many neurons known as association fibres. The areas of association are thought to be responsible for the elaboration of the information received by the primary sensory areas and its correlation with the information fed in from memory and from other brain areas. They are thus responsible for the maintenance of many higher mental activities. See also body image.... association area

n. the situation in which an apparent association between two *variables is in fact explained by a third variable that correlates with one or both of the variables under investigation. If confounding is not recognized, it can lead to the false assumption that two variables are directly related, known as a spurious correlation.... confounding

diagonal creases across the ear lobes, which have a statistically significant correlation with coronary atheroma. The reason is unknown.... ear-lobe creases

see correlation.... multivariate analysis

n. the branch of medicine concerned with the psychiatric effects of disorders of neurological function or structure. Increasingly, the correlation is being drawn between demonstrable brain changes and the resulting effects on the mind. It is the function of the growing specialty of neuropsychiatry to investigate this relationship.... neuropsychiatry

Charts relating height to age have been devised, and give an indication of the normal rate of growth. (See APPENDIX 6: MEASUREMENTS IN MEDICINE for more details.) The wide variation in normal children is immediately apparent on studying such charts. Deviations from the mean of this wide range are called percentiles. Centile or percentile charts describe the distribution of a characteristic in a population. They are obtained by measuring a speci?c characteristic in a large population of at least 1,000 of each sex at each age. For each age there will be a height, above and below which 50 per cent of the population lies: this is called the 50th centile. The 50th centile thus indicates the mean height at a particular age. Such tables are less reliable around the age of PUBERTY, because of variation in age of onset.

Minor variations from the mean do not warrant investigation, but if the height of an individual falls below the third centile (3 per cent of normal children have a height that falls below the third centile) or above the 97th centile, investigation is required. Changes in the rate of growth are also important, and skeletal proportions may provide useful information. There are many children who are normal but who are small in relation to their parents; the problem is merely growth delay. These children take longer to reach maturity and there is also a proportional delay in their skeletal maturation – so that the actual height must always be assessed in relation to maturity. The change in skeletal proportions is one manifestation of maturity, but other features include the maturing of facial features with the growth of nose and jaw, and dental development. Maturity of bone can readily be measured by the radiological bone age.

Failure to gain weight is of more signi?cance. Whilst this may be due to some underlying disease, the most common cause is a diet containing inadequate calories (see CALORIE). Over the last six decades or so there has been quite a striking increase in the heights and weights of European children, with manufacturers of children’s clothing, shoes and furniture having to increase the size of their products. Growth is now completed at 20–21 years, compared with 25 at the turn of the century. It has been suggested that this increase, and earlier maturation, have been due to a combination of genetic mixing as a result of population movements, with the whole range of improvement in environmental hygiene – and not merely to better nutrition.

In the case of adults, views have changed in recent years concerning ‘ideal’ weight. Life-insurance statistics have shown that maximal life expectancy is obtained if the average weight at 25–30 years is maintained throughout the rest of life. These insurance statistics also suggest that it is of advantage to be slightly over the average weight before the age of 30 years; to be of average weight after the age of 40; and to be underweight from ages 30–40. In the past it has been usual, in assessing the signi?cance of an adult’s weight, to allow a 10 per cent range on either side of normal for variations in body-build. A closer correlation has been found between thoracic and abdominal measurements and weight.... weight and height

(in statistics) see correlation.... scatter diagram

n. (in statistics) any characteristic (e.g. age, lifestyle, or habit) relating to an individual or group that can take a number of different values. Categorical or qualitative variables are descriptive characteristics, such as sex, race, or occupation; quantitative variables relate to a numerical scale and are subdivided into discrete variables, found only at fixed points (e.g. number of children), and continuous variables, found at any point on a scale (e.g. weight). See also confounding; correlation.... variable

Arises from premalignant adenoma. About one in ten adenomatous polyps develop into a carcinoma. Simple excision of polyps with in situ carcinoma sometimes leads to complete cure.

Symptoms: bleeding, with alteration of bowel habit. Common in diverticular disease where large polyps may be undetected. Early detection by flexible sigmoidoscopy at hospital is essential to accurate diagnosis. Sudden episodes of unexplained diarrhoea and constipation.

The term refers to cancers of the ascending colon, caecum, transverse colon, hepatic flexure, descending colon, splenic flexure, sigmoid colon and rectum. The large bowel tumours are almost wholly adeno-carcinoma.

Common causes: ulcerative colitis, Crohn’s disease, necrotic changes in polyps. The colon is at risk from cancer on a diet high in protein, fat and alcohol and which is low in fibre. An exception is the average diet in Finland where a high fat intake is present with a low incidence of cancer. Strong evidence advanced, includes the heavy consumption of yoghurt (acidophylus lacto bacillus) by the population.

A study of 8006 Japanese men living in Hawaii revealed the close relationship between cancer of the rectum and alcohol consumption. A family history of pernicious anaemia predisposes.

A 19-year prospective study of middle-aged men employed by a Chicago electric company reveals a strong correlation between colorectal cancer and Vitamin D and calcium deficiency. Results “support the suggestion that Vitamin D and calcium may reduce the risk of colorectal cancer”. (Lancet, 1985, Feb 9, i, 307)

Patients with ulcerative colitis of more than 10 years standing carry the increased risk of developing colorectal cancer. There is evidence that malignancy in the bowel may be reduced by saponins. Alternatives of possible value. Inoperable lesions may respond to: Bayberry, Goldenseal, Echinacea, Wild Yam, Stone root, Black root, Mistletoe, Clivers, Marshmallow root, Violet leaves, Chickweed, Red Clover, Thuja.

Tea. Equal parts: Red Clover, Gotu Kola, Violet leaves. 2-3 teaspoons to each cup boiling water; infuse 15 minutes. Freely, as tolerated.

Tablets/capsules. Echinacea, Goldenseal, Wild Yam.

Formula. Echinacea 2; Bayberry 1; Wild Yam 1; Stone root 1; Goldenseal half; Liquorice quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily and at bedtime.

Mistletoe: Injections of fresh plant (Iscador). (Dr Rudolph Steiner Institute, Switzerland)

Violet leaves: Daily irrigations of strong infusion.

Chickweed: Bathe rectum with strong infusion. Follow with Chickweed ointment.

Chinese Herbalism. (1) Tea – Pan-chih-lien (Scutellaria barbarta), 2 liang. (2) Tea. Feng-wei ts’ao (Pteris multifida) 1 liang, and po-chi (water chestnut) 2 liang. (3) Concoction of suitable amount of ts’ang-erh ts’ao, for bathing affected area. (Barefoot Doctor’s Manual)

Diagnosis. Exploration of proctosigmoidoscope to confirm.

Diet. Special emphasis on yoghurt which is conducive to bowel health; orally and by enema. A vegan uncooked raw food diet has been shown to reduce the body’s production of toxins linked with colon cancer. A switch from conventional Western cooked diet to an uncooked vegan diet reduced harmful enzymes produced by gut bacteria. (Journal of Nutrition)

A substance has been found in fish oil believed to prevent cancer of the colon. Mackerel, herring and sardines are among fish with this ingredient. Bowel cancer and additives. See: CROHN’S DISEASE (Note).

Preventive care. All 55-year-olds with this predisposing condition should be screened by sigmoidoscopy. Regular faecal occult blood tests advised.

Regular exercise helps prevent development of bowel cancer. (Nottingham University researchers) Treatment by general medical practitioner or oncologist. ... cancer-colorectal