Male Malady: Tight Ties May Impair Vision

Times Staff Writer

It's no secret to men that close-fitting shirt collars and tightly tied neckties are one of the most nettlesome--if trivial--inconveniences associated with being male. Now, researchers at the Cornell University College of Human Ecology say these dress habits may harm vision too.

In a study involving measurement of the tightness of shirt collars and ties and vision clarity in several groups of men, researchers found that neckties tied so tightly that they reduced the natural circumference of the neck measurably cut visual acuity for such tasks as reading.

The study, reported in the journal Human Factors, speculated that the relationship between necktie tightness and vision may be traced to reduction in blood flow through the carotid arteries, which supply the brain and run up the neck fairly close to the skin. Researchers said 67% of the men studied were wearing shirts or ties that were too tight. The tie was at fault far more often than the shirt collar.

An obvious preventive step: Unfasten the top button of your shirt and loosen the knot of your tie.

Dietary Fat, Cholesterol

There's no shortage of research on the effects of blood cholesterol levels on the risk of heart disease for men, but for women--especially pre-menopausal women--it remains a field in which few studies have been done and in which conclusions about men are presumed to hold true for women.

It came as something of a surprise, then, that in a new project examining the relationship of fat in the diet and cholesterol in the blood of young, healthy women, a 50% reduction in dietary fat had almost no effect on cholesterol.

What this may mean is unclear, but the leader of the National Cancer Institute team that conducted the study said the results emphasize that a great deal remains unknown about the precise relationship between fat consumed in food and levels of fatty chemicals in the bloodstream.

The researcher, D. Yvonne Jones, reported that while she continues to believe men and women alike should reduce dietary fat intake, the finding about the ineffectiveness of fat reduction in influencing cholesterol in women took her by surprise.

She said noted that most research studies on the subject focus on men--in whom the dietary fat-cholesterol interrelationship appears to be more clear cut.

Jones' new study was published in the American Journal of Clinical Nutrition. It focused on a total of 31 women in their late 20s whose cholesterol levels to begin with were well within healthful guidelines. The key subgroup of 15 women in whom dietary intervention was tried had an average total cholesterol reading of 180 milligrams--well below the 200 level generally accepted as indicative of good health.

At first, the women were given diets in which 40% of total calories were fat. Then the diets were changed, cutting the fat to 20%. All of the diets included items from all the traditional food groups and were considered normal in the context of U.S. nutrition. But the reduction in fat, the Jones team found, was accompanied by just a 12% decline in cholesterol--a change the researchers found to be insignificant.

"I really expected that there would be more of an effect of such a drastic drop in fat," Jones said from Bethesda, Md. Whether women whose cholesterol levels were higher than the healthy group studied would experience the same insignificant dietary reduction is not known. Jones said she is following the study up to see if women after menopause have changes in the diet-cholesterol relationship.

Exercise and Osteoporosis

Today's women are increasingly aware of the hazards and risks of osteoporosis--and they are equally interested in ways they can minimize their risk of sustaining the sometimes-debilitating bone loss associated with the disease.

Highly promoted risk-assessment clinics and the dispute over whether taking calcium supplements has any preventive effect are two early entries on the list of controversies as osteoporosis awareness increases.

Now, a new question has been raised about yet another of the tenets of the osteoporisis-prevention faith: Can regular exercise in pre-menopausal adulthood can avert later damage to the spine from the disease?

Writing in an editorial in the Journal of the American Medical Assn., four UC San Francisco researchers have cautioned that while the idea that exercise can prevent osteoporosis is still an inviting concept, proof that this belief is valid is still lacking.

The researchers said regular exercise is, beyond question, still a good idea--to maintain overall health and to speed recovery from injuries that may be suffered in a fall. And they say it may well turn out to be true that exercise--especially load-bearing exercise--is an osteoporosis prevention. The four scientists reviewed several dozen studies of the relationship between exercise and osteoporosis.

The problem, they said is that serious flaws have marred the few studies published thus far that have observed the exercise/bone-deterioration-prevention link. It is a classic case of how results that seem to reach an inviting conclusion may lead to enthusiasm over changes in behavior that may be, at best, premature. The researchers urged design of new investigations.

"But until the results of these and other studies are made available," they said, "we must refrain from indiscriminately counseling individuals to undertake programs of exercise with the hope of preventing osteoporosis."

German Measles at Work

The development of a German measles vaccine in 1969 brought about dramatic declines in the incidence of the disease, but outbreaks have continued--focusing new attention on the need to reach non-immunized pockets of the population. To reduce gaps in protection, moreover, a team of New York City researchers has suggested a special focus on workplace immunization campaigns tailored to reach women of childbearing age.

Employee health departments, the researchers from the New York City Department of Health said, may be in a unique position to identify working women who have not been vaccinated. The urging for greater workplace German measles (also called rubella) vaccination came after an investigation of five New York workplace outbreaks in 1983-85.

If a pregnant woman gets German measles, her child may eventually suffer from varied serious handicaps. Vaccine protection is highly effective. In 1969, there were nearly 58,000 U.S. cases of rubella. In 1985, the figure was 604. In the first 22 weeks of 1987, there were just 170.

A study of the New York outbreaks, published in the American Journal of Public Health, concluded that rubella incidents at the workplace were solely responsible for the first, slight reversal in the downward trend of German measles since the vaccine was introduced.

One single outbreak in the Wall Street financial district in 1983 involved 86 rubella cases and exacted a financial toll in lost wages, treatment and vaccine costs and health worker services of more than $85,000.

"Workplace outbreaks--which result in infection of pregnant women, disruption of the work site and loss of working staff time--can be prevented by assuring immunity of all employees," the health researchers concluded.

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