On questions of diet, there's an almost automatic assumption that if a little virtue is good, a lot of virtue is better. This presumption has brought fame and fortune to more than a few diet gurus.
But that assumption may not necessarily be valid. Weeks after the American Heart Assn. introduced new dietary guidelines (among other things, total fat of not more than 30%) that seemed almost permissive when compared to the strictures of, say, Nathan Pritikin, a research team at the University of Texas Health Science Center in Dallas has concluded that the heart association approach is at least as good and maybe better than more austere diets.
Their report in the Journal of the American Medical Assn. was full of cautions about such things as the comparatively small size of its sample of patients (just nine men). Yet the Texas team was confident enough of its findings to conclude that the AHA diet--lower in fat than more stringent diets but still austere compared to the normal American diet--has as good or better abilities to lower cholesterol levels in the blood as other diets that may be even more unpalatable.
The AHA program relies on strict limitation of salt intake, restrictions on both total fat and saturated fat (total fat includes even fats that are thought to be healthful while saturated fats are those linked to such diseases as hardening of the arteries), minimum levels of protein in the total diet (15% of all calories) and reduction of alcohol consumption to not more than two drinks a day--whether it's liquor, beer or wine.
In what could be called a tempest in an armpit, a small Los Angeles medical equipment company has reacted with rage and dismay after an electrical anti-sweating device it is marketing was rated no better than a can of spray deodorant by a leading medical publication.
The device, called the Drionic, is a battery-powered gadget whose technology is based on the ability of electric current to inhibit perspiration. The Drionic came on the market last year, was approved by the U.S. Food and Drug Administration and billed as an alternative to sprays, roll-ons and other conventional antiperspirants for people with a condition called hyperhidrosis--excess sweating--of the hands, feet and armpits. It is produced by General Medical Co. and sells for $100.
To use the Drionic, a person places its electrode pads on the affected part of the body and turns on the battery current 30 minutes every other day for about two weeks--a treatment that is said to produce six weeks of reduced perspiration. Continuing regular use is claimed to keep perspiration under control.
On Nov. 7, however, the Medical Letter, a prominent publication that assesses drugs and medical devices, panned the Drionic, concluding that it is "not very effective for treating (excessive sweating) of the hands, feet or (armpits)," and suggesting to physicians that "topical antiperspirants are preferred."
General Medical responded that it will demand a retraction from the Medical Letter and noted that the publicity may harm sales. Moreover, General Medical's president, Robert Tapper, offered two letters from researchers who have concluded studies of the Drionic and who say the machine is effective. The researchers--Dr. Richard Dobson of the Medical University of South Carolina, and Dr. Mervyn Elgart of George Washington University Medical Center in Washington--have written the medical journal expressing disagreement.
MISCELLANEA MEDICA: Echoing cautions voiced since President Reagan's colon cancer surgery focused public attention on early detection of intestinal cancer, the Medical Letter warns that some commercial tests for detection of hidden blood in the stool may be "unreliable" and concludes that the effectiveness of such tests in preventing death from colon cancer "has not been established." . . . A new study published in the journal Physician and Sports Medicine questions the ability of increasingly popular lateral knee braces to prevent athletic injuries, noting that so far, there is little proof the heavily marketed braces have extensive value in injury prevention and concluding that "serious doubts" cloud the reputation of the brace. . . .
A letter to the editor in the New England Journal of Medicine reports on the case of a 10-year-old boy who suffered face burns when he opened a bag of freshly heated microwave popcorn. The letter speculates that existing warnings ("Handle the bag carefully--It's hot!") aren't strong enough. . . . A Chicago firm is selling a special dart board, called "A Second Opinion," to be hung in doctors' waiting rooms. Diagnosis or treatment depends on where the dart lands on the board with the bull's eye being "take a cruise" and other possibilities including "put ice on it" and "bypass the bypass."
DOCTOR'S LEXICON: You may think that the operation called coronary artery bypass surgery involves substitution of new vessels (taken from veins in the leg) for the large, water pipe-like arteries that carry the body's blood supply to and from the heart. In fact, these arteries aren't involved in bypass surgery at all. Instead, the vessels that are bypassed are the so-called coronary arteries , offshoots of a pair of pencil-thick branches of the arterial system that nourish the heart muscle itself with blood and permit the beating pattern to occur.