Norman Knight: Bristling at the latest health guidelines

<p>Well, it happened again. What I thought I knew, what I thought was true turns out to be wrong.</p><p>I believed I was doing a good thing, a healthy thing. Heck, I was following doctors’ advice by taking a low-dose aspirin every day. Now the experts say this is not a good plan. They tell me not only is this routine not useful, it could even be detrimental to my health.</p><p>An article in the New York Times explains that after years of recommending older adults take 75 to 100 milligrams of aspirin daily to prevent cardiovascular problems, the most recent guidelines from the American College of Cardiology and the American Heart Association cite studies stating this regime does not help those older Americans who do not have cardiovascular disease. (I love how they dwell on the word “older.”)</p><p>One of the authors of the study, Dr. Erin Michos, emphasized in an interview the new guidelines are meant for people “with no clinical signs of heart disease or stroke.” She cautioned that people who have had heart attacks or have stents should continue to take aspirin on their doctors’ orders.</p><p>The new guidelines recommend that instead of aspirin, we “older” people who are not at risk should institute changes in our lifestyles. We should maintain a healthy weight, avoid smoking, regularly exercise and eat a diet tilted toward vegetables, fruits and nuts, whole grains and fish. Sound familiar? Aren’t those the standard recommendations for just about everything?</p><p>Well, I guess I can rest in the knowledge that at least some things stay the same — at least for now.</p><p>As if this re-assessed aspirin information is not enough to rock my “older” worldview, I am now told I am probably putting too much paste on my brush as I stand sleepily in front of the bathroom mirror cleaning my teeth.</p><p>The Centers for Disease Control and Prevention recently issued a recommendation that a person should use no more than a pea-sized amount of toothpaste when he or she brushes.</p><p>This recommendation is especially directed to those 6 years old or younger. For children 2 to 3 years old, a rice grain-sized daub should be placed on the brush. (Or, better, have Mom or Dad do it.) Furthermore, the American Academy of Pediatrics recommends that baby teeth should be “brushed with a smear of fluoride toothpaste as soon as teeth erupt.” No special recommendations were issued for older Americans, so I guess the pea-sized amount goes for us, too.</p><p>I know where I and probably others got the idea that we should put lots of toothpaste on our brush: from TV commercials. These television ads were interspersed with our favorite Saturday morning shows. Bucky Beaver or some cartoon character would show a close-up of toothbrush bristles as a thick glop of toothpaste, sometimes with stripes and sometimes not, would be squeezed slow-motion, curving back on itself across the entire length of the bristle area.</p><p>These commercial messages are how I established my truth about the world of tooth-brushing.</p><p>Of course, commercials are made to sell things, and if you are pitching a product, the more you can sell, the better. I understand this is different than information presented by those in scientific research. Today, daily low-dose aspirin is good for you; tomorrow, after more extensive research, maybe not so good. Next year, it could be good again. It reminds me of what we know or think we know about the health risks of coffee or eggs or butter: Studies show the product does harm; later studies shown it to have positive effects. Things change as new information is gathered. That’s science for you.</p><p>The next time I am in for a checkup, I’ll ask my doctor what he thinks about low-dose aspirin. And I will try to remember not load my toothbrush with too much paste no matter what those cartoon characters say.</p>