Wednesday, April 23, 2008

HIGH blood pressure

Personal Health

Hypertension: In Retreat, but Hardly Vanquished

Published: April 22, 2008

As with cholesterol levels, the concept of a normal blood pressure has fallen strikingly as doctors learn what it takes to preserve good health. Decades ago, for example, my brother, Jeff, who had high blood pressure that hovered between 160/80 and 170/90, would have been considered normal.

Lacking good treatments for hypertension, no doctor was concerned when, at age 57, President Franklin D. Roosevelt’s blood pressure was 170/90. And so the president’s blood pressure rose inexorably over the next six years, and on April 12, 1945, at age 63 and with a pressure of 200/110, he died of a brain hemorrhage caused by severe hypertension.

But in 2000, when Jeff was 54, his cardiologist knew better. Now with excellent treatments, most often used in combination, an elevated pressure can be lowered to normal in most people. His doctor said that, with our family’s medical history of three coronaries on our father’s side occurring at ages 56 and 58, something should be done to protect Jeff’s health.

Jeff’s treatment “evolved” until he was taking a daily three-pill cocktail — Diovan HCT, a combination of a diuretic and angiotensin II receptor blocker; Norvasc, a calcium channel blocker; and Toprol XL, a beta blocker. He also works out on a treadmill several times a week, runs up and down stairs at home and at work all day, and eats a mostly heart-healthy diet, including five to 10 servings of fruits and vegetables a day, whole grain breads, nonfat milk and no added salt.

With his blood pressure now at 106/66, the low end of normal, my brother has thus far escaped a premature coronary death.

Hypertension, once known as the “silent killer,” is now not so silent. Through campaigns urging doctors to check patients’ pressure at every visit, most cases have been detected. Although treatment has been prescribed for nearly all people known to have blood pressures consistently above 140/90, now called the high end of normal, up to half of patients still have elevated pressures.

Still a Common Problem

Why? Because doctors are not aggressive and creative in treating the problem; because unlike my brother, many patients do not follow doctor’s orders and fail to fill prescriptions or neglect to take medicine daily; and because the rising weight of Americans and the passion for high-salt processed and restaurant-prepared foods have raised the once-normal pressures of many people to levels that experts say should be treated.

A new report from the American Heart Association describes untreated hypertension as now particularly serious among women. Midsection obesity, an important risk factor for hypertension, is found in 79 percent of hypertensive women as against 64 percent of hypertensive men. About a third of hypertensive women have blood pressure controlled at optimal levels, 120/80 or below.

The problem is particularly common among women taking oral contraceptives, whose risk of hypertension is two to three times as high as that of women their age who use some other form of contraception or none at all.

Hypertension is one of the nation’s most common life-threatening diseases, with an overall incidence among adults of nearly 30 percent, a survey of 14,600 people in 2003 and 2004 found. And as many as 66 percent of people 60 and older have elevated pressures that warrant treatment, the survey showed. An increase in blood pressure with age is common only in developed countries, largely a result of a rich and salty diet, overweight and inadequate exercise.

In the United States, the high incidence of hypertension and its inadequate treatment has helped level off a decades-long decline in coronary mortality. In addition to heart attacks, untreated or inadequately treated hypertension can cause strokes, congestive heart failure, kidney failure and diabetes.

According to a report last May in The Journal of Clinical Hypertension, myths persist. Last year, a national online survey of 1,245 adults with high blood pressure found that many people still thought that hypertension meant being tense or anxious and that about 30 percent of people thought that it could be cured by losing weight, Dr. Marvin Moser of the Hypertension Education Foundation in Scarsdale, N.Y., and Dr. Stanley S. Franklin of the University of California, Irvine, reported.

While weight loss and improvements in diet and exercise habits can indeed help people lower an elevated pressure, “most people can’t adjust their lifestyles enough to normalize their blood pressure,” Dr. Moser said in an interview. “Most people need help from medication, notably a diuretic in combination with one or two other drugs. The majority of patients don’t get their pressures to normal without such a combination.”

Doctors have more than 100 drugs to choose from. If one or two do not lower pressure to normal or cause unpleasant side effects, patients should insist on trying others, Dr. Moser said. Side effects of blood pressure medications are no longer the problem they once were, the doctor said. “In doses now used, more than 90 percent of people experience very few side effects.”

Difficulties of Following a Diet

One problem with a drug-free approach is the difficulty many patients have in adopting and sticking with a diet and exercise program that can significantly lower their pressure. Data from the latest national nutrition survey, described in the Feb. 11 issue of The Archives of Internal Medicine, said that a diet called DASH that effectively lowered blood pressure was poorly followed by people with hypertension. This diet is rich in fruits, vegetables and low-fat dairy products, a mix that provides excellent sources of fiber, potassium, magnesium and calcium. The diet is most effective if it is low in salt, with a sodium intake of about 1,500 milligrams a day.

The widely publicized value of the DASH diet was demonstrated in a major government-sponsored study published in 1997. But the new report found that in the years since, instead of improving, the dietary quality of people with hypertension has diminished.

Still, as my brother’s case showed, even with a good diet, regular exercise and a healthy weight, most hypertensive patients need medication to achieve an optimal blood pressure. And that includes the elderly, who generally do not respond as well as younger people to blood pressure drugs.

“Studies have shown that even a modest reduction in blood pressure is beneficial to the elderly, reducing their risk of strokes, heart attacks, heart failure and death,” Dr. Moser said. “And a new study in the very elderly, people 80 and older, showed that treating hypertension also reduces the overall risk of death.”

In all age groups, “physician inertia is a major problem,” he said, adding, “In 30 percent of patients whose blood pressure remains high despite treatment, nothing is done about changing the medication.”

He urged people whose blood pressure is higher than 140/90 to ask their doctors, “Shouldn’t we be doing something else?”



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Saturday, April 19, 2008

College Costs Plummet !

The (Yes) Low Cost of Higher Ed

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Published: April 20, 2008

ON Oct. 2, 2003, board members at the University of Virginia filed into the Upper East Oval Room of the Rotunda, the centerpiece of Thomas Jefferson’s campus design, for one of their regular meetings. As usual, they were joined by the university’s top administrators. Just before the meeting began, a member of U.Va.’s public affairs staff walked over to John T. Casteen III, the university president, to hand him a clipping from that morning’s newspaper.

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The clipping described a sweeping new financial-aid program that the University of North Carolina had just announced. North Carolina was going to cover nearly the full cost of any student whose family made less than 150 percent of the poverty level or, for a family of four, about $30,000 in today’s dollars. Students would still have to work 10 to 12 hours a week in a campus job, but they would not have to take out any loans.

At the time, it was one of the most aggressive aid programs at any major university.

The program touched a nerve with Mr. Casteen. The son of a shipyard worker from Portsmouth, in the southeastern corner of the state, he was the first member of his family to attend college. But during his 13 years as president, tuition had risen significantly, as it had at many colleges, and the Virginia campus had become even more dominated by upper-middle-class students. North Carolina’s new policy, which had the potential to lure students away from Virginia, could aggravate the situation.

Before the meeting had ended, Mr. Casteen announced to the room that he wanted the financial-aid staff to come up with a response. He wanted it quickly, he said, and he wanted something bigger than what North Carolina was doing. Four months later, at the board’s next meeting, it approved a plan that was similar but somewhat more generous than North Carolina’s. Making sure everyone had a chance to attend college, Mr. Casteen would say, was “a fundamental obligation of a free culture.”

That same spring, officials at Harvard had been working on their own plan. Three weeks after Virginia’s announcement, Lawrence H. Summers, then Harvard’s president, traveled to Miami to give a speech titled “Higher Education and the American Dream.” In it, he alluded to Jefferson’s views on the importance of educating poor and rich alike, and he decried the paucity of low-income students on college campuses. The punch line came toward the end of the speech, when Mr. Summers raised the bar on North Carolina and Virginia. Harvard would cover nearly the full college cost for any student whose family made less than $40,000.

The financial-aid bidding war at the nation’s top universities was under way.

North Carolina soon expanded its program, to cover 200 percent of the poverty level, or $41,300 today. In 2005, Yale undergraduates occupied the admissions office to demand that their university increase aid, and administrators soon did. The University of Maryland came forward with a plan. So did the Massachusetts Institute of Technology, the University of Pennsylvania and Stanford. In 2006, Harvard raised the bar again, saying parents making less than $60,000 would not have to pay anything toward the cost of their child’s education.

All of these moves focused on low- and middle-income students — an ever-rarer breed at elite universities over the last generation. But in 2007, the bidding war took on a new character: it began to address the concerns of the upper middle class as well. In July, Amherst College announced it would eliminate loans for all students, no matter their income. In December, Harvard — under Congressional pressure, like other wealthy colleges, to spend more of its endowment — introduced a policy under which most families making less than $180,000 a year would receive significant aid. For all but the most affluent 3 or 4 percent of the population, Harvard would be roughly as expensive as many state universities.

Harvard being Harvard, the policy received a huge amount of attention, and set in motion a frenzy that made the previous few years of dueling announcements look leisurely by comparison. Within weeks, Yale went as far as Harvard had, while Bowdoin, Colby, Dartmouth, Haverford, Pomona and others came up with their own — usually less generous — policies.

In less than five years, the entire tuition and financial aid system at the nation’s top colleges has been overhauled. Today, it looks a lot like a highly progressive tax code, in which the affluent are bearing an enormous share of the overall tuition burden. No matter how high the published cost — almost $50,000, typically — these top universities have become significantly more affordable for the majority of students.

It may be the first time that has ever happened.

The changes have not been greeted with a chorus of joy, however. At colleges without large endowments, administrators are worried about the pressure they will face. Some have suggested that they may end up reducing aid to low-income students to compete for more affluent students, who typically have higher test scores and thus help an institution’s ranking in U.S. News & World Report. In the past, these colleges were able to woo some students away from the Ivy League with merit scholarships.

Others say the latest round of changes will not solve the larger issue of economic opportunity raised by Mr. Casteen, Mr. Summers and others. “There is a perception that this has gone farther than it really has,” says Sandy Baum, an economist at Skidmore College who oversees the College Board’s annual report on college costs. “The number of students going to these schools is tiny. It’s not going to make a dent in educational opportunity.” Increases in the federal Pell grant, which typically go to students whose families make less than $40,000, would probably accomplish far more on that front.

Over the last decade, the average net cost of attending a four-year public college — including room and board as well as financial aid, and controlling for inflation — has risen to $9,980 a year, from $7,650, according to the College Board. The average net cost at private colleges has risen to $23,000, from $18,050.

Still, other education experts have pointed out that the new aid policies aren’t always as generous as administrators make them out to be. Some colleges, for instance, have committed to covering only tuition, not room and board, which can be substantial.

All of these concerns may well be valid. Yet it’s still worth taking a minute to consider how quickly — and how much — the recent announcements have actually changed the landscape of higher education.

THIS past November, the admissions deans from Harvard, Princeton and Virginia went on a recruiting tour together. They no longer had to spend the month reading applications, because they had abolished their early-admissions programs. So they hit the road instead, speaking at high schools across Virginia and West Virginia.

One night, they held an information session at a Holiday Inn in the Appalachian town of Bluefield, W.Va. They had sent invitations to about two dozen students and had told guidance counselors to spread the word. William Fitzsimmons, Harvard’s admissions dean, had expected about 45 students and parents to show up, based on previous recruiting trips.

Just three years earlier, John Blackburn, Virginia’s dean, had gone on a similar tour in nearby western Virginia and discovered that few students had heard about the university’s new financial-aid plan. “You can’t just raise the U.Va. flag and expect a lot of low-income kids to come out,” Mr. Blackburn had said after one lackluster night in 2004 at a college fair in Big Stone Gap, Va. Many had assumed U.Va. was simply too expensive, even if financial aid would have made it affordable for them. This assumption, officials say, is one reason the student body at elite colleges has become less economically diverse in recent decades.

But something may be changing. At the Bluefield Holiday Inn, 110 people showed up to listen to Mr. Blackburn, Mr. Fitzsimmons and Janet Lavin Rapelye, Princeton’s dean. “We were blown away,” Mr. Fitzsimmons recalls.

The best explanation seems to be that the flurry of high-profile announcements about financial aid has helped overcome years of headlines about rising tuition. As Ms. Baum of the College Board says, “Low- and moderate-income kids now know that it’s fine to apply to Harvard and Dartmouth and money won’t be an issue. And that’s good.”

The number of low-income students at top institutions is still fairly low but is growing. The share of Harvard undergraduates receiving Pell grants rose to 13 percent this year, from 10 percent in 2003-4. At Amherst, over the same span, the number has risen to 18 percent from 15 percent.

The purest case study may be Princeton. It took perhaps the first step down this road in 1998, when it replaced loans with grants for low-income students. It expanded the program to all financial-aid students in 2001. But other colleges didn’t follow suit. And the policy had only a modest effect on the makeup of Princeton’s student body. Between 1998 and 2005, the share of undergraduates with Pell grants rose to 7.7 percent, from 6.9 percent, says Robin Moscato, the director of undergraduate financial aid. But over just the last two years, with other colleges trumpeting their new programs, the share of Princeton undergraduates receiving the Pell has increased to almost 10 percent.

The elimination of loans is a crucial part of the changes. From a straight economic perspective, this doesn’t entirely make sense: because people with a bachelor’s degree make so much more on average than people without one, college loans are usually well worth their cost. But these benefits come years later, while the costs come immediately — and intimidate many families.

“A lot of students from smaller towns look at the university and they’re like, ‘No,’ ” says Carla Rojas, a senior at North Carolina whose father is a construction worker near Lincolnton, N.C., and whose mother does alterations there. Many students know there are scholarships, Ms. Rojas says, but they figure, “Oh, I won’t get one.”

Replacing loans with grants changes the calculation. Rather than having to persuade would-be applicants that loans are a good investment, recruiters can say the students will graduate debt-free. If anything, Ms. Rojas adds, she wishes North Carolina were doing more to publicize its policy.

Mr. Summers says the ultimate goal should be to repeat the success of affirmative-action policies. Affirmative action has become so ingrained that black students with a given SAT score are more likely to apply to Harvard than white students with the same score, according to a university analysis. High-achieving poor students, however, are much less likely to apply to elite colleges than their affluent counterparts.

Closing that gap will require more than just money. “Increasing financial aid is terrific,” as Mr. Summers says. “But as important or more important is recruitment and the way students are admitted.”

If admissions officers were to give poor students more credit for what they had overcome, colleges would become considerably more diverse. But they would risk angering alumni, whose children would face tougher competition to be admitted. Recruiting more low-income students would also bring a big price tag, because the newly expansive aid policies would then apply to many more students.

It’s easier for college administrators to be generous with financial aid when their campuses don’t have very many poor students to begin with.

THERE are several arguments for increasing economic diversity at elite colleges. For one thing, it makes the universities more consistent with their self-image as meritocracies. In recent decades, as colleges have become more diverse geographically, racially and religiously — changes they regularly celebrate — they have also become less so economically, according to the Higher Education Research Institute at the University of California, Los Angeles.

At the same time that their campuses were becoming more affluent, the colleges have come to play arguably a larger role in American society.

George H.W. Bush, George W. Bush and Bill Clinton all graduated from elite colleges (Yale, Yale and Georgetown). So did Barack Obama (Columbia) and Hillary Rodham Clinton (Wellesley). The number of United States senators and Supreme Court justices with Ivy League degrees has risen in recent years.

Recent research also suggests that lower-income students benefit more from an elite education than other students do. Two economists, Alan B. Krueger and Stacy Berg Dale, studied the earnings of college graduates and found that for most, the selectivity of their alma maters had little effect on their incomes once other factors, like SAT scores, were taken into account. To use a hypothetical example, a graduate of North Carolina State who scored a 1200 on the SAT makes as much, on average, as a Duke graduate with a 1200. But there was an exception: poor students. Even controlling for test scores, they made more money if they went to elite colleges. They evidently gained something like closer contact with professors, exposure to new kinds of jobs or connections that they couldn’t get elsewhere.

“Low-income children,” says Mr. Krueger, a Princeton professor, “gain the most from going to an elite school.”

Given all this, some have argued that Harvard, Yale and other universities are mistaken in giving financial aid to upper-middle-class students rather than using the money to recruit more low-income students. Awarding a $30,000 scholarship to someone whose parents make $180,000 a year doesn’t exactly reduce economic inequality. But it does have two other benefits.

For one, it gives the new financial aid a more solid base of support among alumni. Anthony W. Marx, the president of Amherst, has been talking about the importance of making the college more economically diverse since his inauguration address in 2003. But he says he received more congratulatory e-mail messages after announcing last summer that Amherst would eliminate loans for all students than after any of his announcements about recruiting poorer students.

Expanding the pool of aid recipients may also make the policies more popular among students. It would be rather counterproductive if the children of midlevel corporate executives, who were paying $50,000 in tuition and fees, ended up resenting the children of police officers, who were paying nothing.

The most important issues facing higher education still have relatively little to do with this small group of colleges. Those issues involve preparing more low- and middle-income children to attend college, lifting the graduation rates at community colleges and at four-year colleges that educate large numbers of these students, and simplifying and expanding federal financial aid.

That said, what happens at the country’s best-known universities still matters, both because of their role in society and because of how they shape the discussion about higher education. Yes, the new policies have flaws, and they are likely to make life more difficult for administrators at other colleges. But just imagine if, five years ago, somebody had said that Harvard, Amherst and their peers would soon be using their endowments to reduce costs to almost nothing for most families making less than $60,000 — and to give large scholarships to families making as much as $180,000. Would anyone have argued that this sounded like a bad idea?

David Leonhardt writes the Economic Scene column for The Times.



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Wednesday, April 09, 2008

Your Heart Rate

Personal Best

The Flutter Over Heart Rate

Filip Kwiatkowski for The New York Times

Published: April 10, 2008

I have a confession to make. I get so competitive about heart rates when I am at the gym that my husband will not tell me his.

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Do you monitor your heart rate when you work out? Why or why not? Share your thoughts.

“How was your workout?” I’ll ask when we get off of Spinning bikes or elliptical cross-trainers. He’ll reply that it was good, he worked at “80 percent.” But 80 percent of what? I want to know what he thinks his maximum is. But he won’t say.

Of course, I know it’s ridiculous to think that a higher maximum heart rate means that I’m a better athlete than my husband. He may have a slower heart rate, but he can beat me in cycling any day. And, after all, the goal in exercise is to get more blood to your muscles. The heart does that by beating faster and by pumping more blood with each beat. If your heart is more powerful, it does not have to beat as fast. “There is no association between maximum heart rate and exercise performance,” said Hirofumi Tanaka, the director of the Cardiovascular Aging Research Laboratory and an exercise physiologist at the University of Texas in Austin.

In fact, Dr. Tanaka said, when people start exercising regularly their maximum heart rate often goes down.

And I know that the whole heart-rate monitoring issue is contentious. Many athletes strap on those slender black bands around the chests. Then they try to keep their rate at some percentage of their maximum, 70 percent, say, or 80 percent, depending on their goals for the workout.

For some activities, like using an elliptical cross-trainer or riding most Spinning bikes at the gym, it can be difficult to gauge your effort without a heart-rate monitor. You can’t figure out speed or distance the way you can if you are swimming in a pool or running or cycling outside. Maybe it’s all that sweating, but it always feels as if you’re working hard even when your heart rate tells you that you could do a lot more.

But experts disagree on whether heart-rate monitoring makes sense.

Exercise physiologists tend to favor it. “You need to keep track of exercise intensity” in order to meet performance goals or to improve, Dr. Tanaka said. He does not rely on standard formulas for finding maximum heart rate, though, because they vary so much from person to person. Instead, he advises that people find their maximum “in a field setting.” He suggests going to a track and gradually increasing your speed until your heart rate stops climbing.

Some coaches, like the one who trains Dr. Richard Friedman, 51, a masters swimmer in New York, set their own heart-rate goals for athletes. And, that, said Dr. Friedman, a psychiatrist at Cornell, is a problem. Even though he is one of the fastest on his team, his coach insists that he should hit a heart rate of 150 when he does, say, repeats of 50 meters freestyle in 60 seconds.

“I can never get my heart rate up to his target no matter how hard or fast I swim,” Dr. Friedman said.

Others, like Kevin Hanson, coach to Brian Sell, who just made the United States Olympic men’s marathon team, advise against monitoring your heart rate.

The classic formula for determining your maximum rate, 220 minus your age, is notoriously inaccurate, he said. And glancing at your heart-rate monitor all the time can hinder your training, he cautioned.

“It ends up playing mind games with you,” Mr. Hanson said. “Let’s say you are out for a 10-mile run and you don’t feel tired. Then you look at your heart rate,” and it is so high you decide you must have overdone it. Suddenly, he said, you feel tired and slow down.

Everyone’s maximum heart rate declines, slowly and steadily, with the passing years. So if your heart rate is higher than expected, doesn’t that mean you are exercising like a younger person?

It depends. On the one hand are athletes like Lance Armstrong, known for having an unusually high maximum heart rate. And that, said Edward F. Coyle, an exercise physiologist who has studied Mr. Armstrong, was to his advantage because his heart also was extremely efficient. A high maximum heart rate, helps, “all other things being equal,” Dr. Coyle said. The problem, he noted, is that there are so many other factors in performance that rarely are all other things equal.

So if Dr. Friedman could get his heart rate to 150, wouldn’t he be faster?

Not necessarily. And the story of Rebecca Soni, a swimmer at the University of Southern California, helps explain why. Ms. Soni, who has the second fastest time for an American woman in the 200-meter breast stroke, had an irregular heart beat. At times when she exercised her heart would beat up to an astonishing 400 times a minute.

Instead of making her swim faster, though, her fast-beating heart made her go limp. In 2006, in order to continue competing, she underwent a procedure to destroy heart tissue that was causing her heart to beat so fast.

This suggests two things. First, a faster heart isn’t necessarily better. And, second, hearts can beat much faster than they ever actually beat when most of us exercise. Something slows our hearts down, probably for the good of our performance or survival.

A heart beating at its maximum possible rate may be inefficient, Dr. Tanaka explained. As the heart beats more quickly, there comes a point when there is too little time between beats for it to fill with blood. “For exercise capacity, heart rate is not the issue,” said William Haskell, an exercise physiologist at Stanford University. “The heart has got to be an efficient pump.”

It turns out that the heart rate is controlled by three factors. First is the heart’s own intrinsic rate, how fast it would beat if you cut all its nerves and removed it from the body. The heart’s own internal pacemaker would make it beat roughly 40 to 60 beats per second more slowly than its maximum rate. And, Dr. Tanaka said, the heart’s intrinsic rate declines with age parallel to the maximum heart rate’s decline with age. No one knows why.

The other factors controlling heart rate are the sympathetic nerves, which speed it up, and those that slow it down, the parasympathetic nerves.

When you start to exercise, said Patrick O’Connor, an exercise physiologist at the University of Georgia, the first thing that happens is that the parasympathetic nerves become less active. That makes your heart beat faster. As the intensity of your effort increases, the sympathetic nerves come into play, speeding the heart still more.

But there are complications. Anxiety, for example.

“We had people on treadmills who were getting ready to start,” Dr. O’Connor said. “Their heart rates were 160 or 170.” They weren’t exercising, just nervous, he explained. And when they started to run on the treadmill, their heart rates went down.

There’s a lesson here, of course, for runners who use heart-rate monitors during a race. Be careful about interpreting those numbers.

Then there are the differences among sports. Swimmers, for example, have lower heart rates when they swim than runners when they run. The reason, Dr. O’Connor explained, is that during running, your heart has to push blood against gravity to bring it to your head. During swimming, your heart does not have to exert that extra force.

Maybe Dr. Friedman should tell his coach.

As for my husband, he knows that my fixation on whose heart rate is higher is ridiculous. Still, I wish I knew what he thinks his maximum is and how he knows it.



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Monday, April 07, 2008

Get Uncluttered !


Slate Magazine
reading list

The Great Uncluttering

The best books, articles, and Web sites for helping you organize your life.

By Michael Agger

Ah, springtime: new beginnings and all that. Lately, I've been trying to streamline my life under the tutelage of Unclutterer, a blog devoted to "getting and staying organized." The site's writers have given a lot of thought to "pocket clutter," "inherited clutter," landing zones (the places where you drop your stuff when you come in the door), and more abstract notions such as uncluttering your social life. Where does all this uncluttering lead? Erin Doland, the site's editor-in-chief, wrote about the satori-like state she achieved through her efforts. So far, I've achieved a rather intense relationship with the Container Store.

Unclutterer is part of the blossoming "lifehacker" movement, which takes the ethos of computer hacking (elegant solutions to knotty problems) and applies it to life skills. What's the best way to drink coffee to maintain optimal brain performance? "Consume in small, frequent amounts." How do you stop wasting time by clicking around? Install a program that analyzes your Web use and calculates the hours you've spent watching NBA highlights on YouTube. The epicenter of the movement is Gina Trapani's Lifehacker blog*, and the site's best hacks are collected in a new book, Upgrade Your Life.

One hack that I'm fond of—but have failed at—is the efficient idea that every e-mail you send should be five sentences or fewer. Outside my inbox, brief writing is thriving with the publication of Not Quite What I Was Planning, an anthology of six-word memoirs. Amusing examples abound ("Most successful accomplishments based on spite"), and more than a few have a melancholy kick ("He left me for good eventually"). Wired editor Kevin Kelly points out the boomlet in brief-review sites, such as The Four Word Film Review and Paul Ford's six-word music reviews. But none of these match the wit of their more long-winded ancestor, the Guardian's The Digested Read. When you need to skewer a pretentious book in six paragraphs, only an Englishman will do.

The appeal of brevity is that it will help us cope with the avalanche of music, movies, books, magazines, television shows, and blogs. On the site lifehack.org, writer Dustin Wax suggests that our moaning about information overload is misplaced: "What you need less of is input—all the crap that flows at you masquerading as information." He outlines a plan for a "high-information diet" in which you forgo the "comfort food" of reality TV and Perez Hilton for sturdier stuff that imparts useful knowledge.

Fair enough, but reading Proust can be hard work. Why not outsource it? That's the advice of the newly minted lifestyle guru, Timothy Ferriss, author of The 4-Hour Workweek. Ferriss went so far as to outsource his online dating, but in his milder moments, he makes the case that hiring a virtual assistant to summarize your e-mails and keep a schedule isn't so far-fetched. Yet if having some guy in Bangalore read your mother's e-mails doesn't jibe with your idea of economic justice, there's an easier lifehacking tenet to embrace: Do one thing at a time. Start your newly focused life by reading Walter Kirn's haunting, hilarious essay in the Atlantic "The Autumn of the Multitaskers," the story of "one man's odyssey through the nightmare of infinite connectivity."

Correction, April 7, 2008: This article originally misspelled Gina Trapani's name. (Return to the corrected sentence.)

Michael Agger is a Slate senior editor. You can reach him at slate.browser@gmail.com

Article URL: http://www.slate.com/id/2188229/



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Wednesday, April 02, 2008

Improving Willpower


Op-Ed Contributors

Tighten Your Belt, Strengthen Your Mind

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Published: April 2, 2008

DECLINING house prices, rising job layoffs, skyrocketing oil costs and a major credit crunch have brought consumer confidence to its lowest point in five years. With a relatively long recession looking increasingly likely, many American families may be planning to tighten their belts.

Readers' Comments

"Does this mean I can't lose weight and save money at the same time? Darn."
Tarra Kohli, Washington, DC

Interestingly, restraining our consumer spending, in the short term, may cause us to actually loosen the belts around our waists. What’s the connection? The brain has a limited capacity for self-regulation, so exerting willpower in one area often leads to backsliding in others. The good news, however, is that practice increases willpower capacity, so that in the long run, buying less now may improve our ability to achieve future goals — like losing those 10 pounds we gained when we weren’t out shopping.

The brain’s store of willpower is depleted when people control their thoughts, feelings or impulses, or when they modify their behavior in pursuit of goals. Psychologist Roy Baumeister and others have found that people who successfully accomplish one task requiring self-control are less persistent on a second, seemingly unrelated task.

In one pioneering study, some people were asked to eat radishes while others received freshly baked chocolate chip cookies before trying to solve an impossible puzzle. The radish-eaters abandoned the puzzle in eight minutes on average, working less than half as long as people who got cookies or those who were excused from eating radishes. Similarly, people who were asked to circle every “e” on a page of text then showed less persistence in watching a video of an unchanging table and wall.

Other activities that deplete willpower include resisting food or drink, suppressing emotional responses, restraining aggressive or sexual impulses, taking exams and trying to impress someone. Task persistence is also reduced when people are stressed or tired from exertion or lack of sleep.

What limits willpower? Some have suggested that it is blood sugar, which brain cells use as their main energy source and cannot do without for even a few minutes. Most cognitive functions are unaffected by minor blood sugar fluctuations over the course of a day, but planning and self-control are sensitive to such small changes. Exerting self-control lowers blood sugar, which reduces the capacity for further self-control. People who drink a glass of lemonade between completing one task requiring self-control and beginning a second one perform equally well on both tasks, while people who drink sugarless diet lemonade make more errors on the second task than on the first. Foods that persistently elevate blood sugar, like those containing protein or complex carbohydrates, might enhance willpower for longer periods.

In the short term, you should spend your limited willpower budget wisely. For example, if you do not want to drink too much at a party, then on the way to the festivities, you should not deplete your willpower by window shopping for items you cannot afford. Taking an alternative route to avoid passing the store would be a better strategy.

On the other hand, if you need to study for a big exam, it might be smart to let the housecleaning slide to conserve your willpower for the more important job. Similarly, it can be counterproductive to work toward multiple goals at the same time if your willpower cannot cover all the efforts that are required. Concentrating your effort on one or at most a few goals at a time increases the odds of success.

Focusing on success is important because willpower can grow in the long term. Like a muscle, willpower seems to become stronger with use. The idea of exercising willpower is seen in military boot camp, where recruits are trained to overcome one challenge after another.

In psychological studies, even something as simple as using your nondominant hand to brush your teeth for two weeks can increase willpower capacity. People who stick to an exercise program for two months report reducing their impulsive spending, junk food intake, alcohol use and smoking. They also study more, watch less television and do more housework. Other forms of willpower training, like money-management classes, work as well.

No one knows why willpower can grow with practice but it must reflect some biological change in the brain. Perhaps neurons in the frontal cortex, which is responsible for planning behavior, or in the anterior cingulate cortex, which is associated with cognitive control, use blood sugar more efficiently after repeated challenges. Or maybe one of the chemical messengers that neurons use to communicate with one another is produced in larger quantities after it has been used up repeatedly, thereby improving the brain’s willpower capacity.

Whatever the explanation, consistently doing any activity that requires self-control seems to increase willpower — and the ability to resist impulses and delay gratification is highly associated with success in life.

Sandra Aamodt, the editor in chief of Nature Neuroscience, and Sam Wang, an associate professor of molecular biology and neuroscience at Princeton, are the authors of “Welcome to Your Brain: Why You Lose Your Car Keys but Never Forget How to Drive and Other Puzzles of Everyday Life.”



What's On My Other Blogs today: (click blog name to go there) = / 1.3rd Eye Blog / 2. Favorites Blog/ 3. Vita Excolatur (Living Well ...) Blog/ 4. Humor Me Blog/ 5. News and Current Events Blog/ 6. Consider This ... Blog/ 7. Consumer Warnings Blog/ 8. New Orleans Pentimento Blog/ 9. We Constant Gardeners Blog/ 10. Chaillot Family Blog/

Tuesday, April 01, 2008

Get Discipline or die

Op-Ed Columnist

Pitching With Purpose

Published: April 1, 2008

A few years ago, a former professional baseball player mentioned a book that had made a great impression on him. It was called “The Mental ABC’s of Pitching,” by a sports psychologist named H.A. Dorfman. I read the book one spare evening, though, as you may have noticed, I’m not a pitcher — and no major league organization has expressed interest in making me one.

The book left an impression on me too, mostly for its moral tone. Dorfman offers to liberate people from what you might call the tyranny of the scattered mind. He offers to take pitchers, who may be thinking about a thousand and one things up on the mound, and give them mental discipline.

Others are eloquent about courage and creativity, but Dorfman is fervent about discipline. In the book’s only lyrical passage, he writes: “Self-discipline is a form of freedom. Freedom from laziness and lethargy, freedom from expectations and demands of others, freedom from weakness and fear — and doubt.”

His assumption seems to be that you can’t just urge someone to be disciplined; you have to build a structure of behavior and attitude. Behavior shapes thought. If a player disciplines his behavior, then he will also discipline his mind.

Dorfman builds that structure on the repetitiousness of baseball. It’s commonly said that it takes 10,000 hours of practice to master any craft — three hours of practice every day for 10 years. Dorfman assumes that players would have already put in those hours doing drills and repetitions. He urges them to adopt their own pregame rituals. He notes that Trevor Hoffman, the San Diego Padres closer, walks from the clubhouse to the dugout every game in the fourth inning and moves to the bullpen in the seventh.

As a pitcher enters a game, Dorfman continues, he should bring a relentlessly assertive mind-set. He should plan on attacking the strike zone early in the count, and never letting up. He will not nibble at the strike zone or try to throw the ball around hitters. He will invite contact. Even when the count is zero balls and two strikes, he will not alter his emotional tone by wasting a pitch out of the strike zone.

Just as a bike is better balanced when it is going forward, a pitcher’s mind is better balanced when it is unceasingly aggressive. If a pitcher doesn’t actually feel this way when he enters a game, Dorfman asks him to pretend. If your body impersonates an attitude long enough, then the mind begins to adopt it.

Dorfman then structures the geography of the workplace. There are two locales in a pitcher’s universe — on the mound and off the mound. Off the mound is for thinking about the past and future, on the mound is for thinking about the present. When a pitcher is on the pitching rubber, Dorfman writes, he should only think about three things: pitch selection, pitch location and the catcher’s glove, his target. If he finds himself thinking about something else, he should step off the rubber.

Dorfman has various breathing rituals he endorses, but his main focus during competition is to get his pitchers thinking simple and small. A pitcher is defined, he writes, “by the way the ball leaves his hand.” Everything else is extraneous.

In Dorfman’s description of pitching, batters barely exist. They are vague, generic abstractions that hover out there in the land beyond the pitcher’s control. A pitcher shouldn’t judge himself by how the batters hit his pitches, but instead by whether he threw the pitch he wanted to throw.

Dorfman once approached Greg Maddux after a game and asked him how it went. Maddux said simply: “Fifty out of 73.” He’d thrown 73 pitches and executed 50. Nothing else was relevant.

A baseball game is a spectacle, with a thousand points of interest. But Dorfman reduces it all to a series of simple tasks. The pitcher’s personality isn’t at the center. His talent isn’t at the center. The task is at the center.

By putting the task at the center, Dorfman illuminates the way the body and the mind communicate with each other. Once there were intellectuals who thought the mind existed above the body, but that’s been blown away by evidence. In fact, it’s easiest to change the mind by changing behavior, and that’s probably as true in the office as on the mound.

And by putting the task at the center, Dorfman helps the pitcher quiet the self. He pushes the pitcher’s thoughts away from his own qualities — his expectations, his nerve, his ego — and helps the pitcher lose himself in the job.

Not long ago, Americans saw the rise of a therapeutic culture that placed great emphasis on self-discovery, self-awareness and self-expression. But somehow the tide seems to have turned from the worship of self, and today’s message is: transcend yourself in your job — or get shelled.

A fitting reminder from opening day.



What's On My Other Blogs today: (click blog name to go there) = / 1.3rd Eye Blog / 2. Favorites Blog/ 3. Vita Excolatur (Living Well ...) Blog/ 4. Humor Me Blog/ 5. News and Current Events Blog/ 6. Consider This ... Blog/ 7. Consumer Warnings Blog/ 8. New Orleans Pentimento Blog/ 9. We Constant Gardeners Blog/ 10. Chaillot Family Blog/