Treating high blood pressure, cutting down on salt and getting rid of trans fats could prevent nearly 100 million premature deaths (Repost from The London Economic)
*Originally posted on The London Economic. All the information, phrases, content and research posted here belongs to The London Economic. Click here for the original article.
Targeting these three interventions could have a massive effect on mortality around the world, the authors claim.Treating high blood pressure, cutting down on salt and getting rid of trans fats could prevent nearly 100 million premature deaths globally, a new study reveals.
Targeting these three interventions could have a massive effect on mortality around the world, the authors claim.
Researchers estimated that treating 70 per cent of the population for blood pressure would save 39.4 million people and reducing salt intake by 30 per cent would account for another 40 million.
Eliminating trans fats, found in margarine and food fried in vegetable fats, could save another 14.8 million by 2040 – a total of 94.2 million lives.
And experts from the Harvard TH Chan School of Public Health thinks these three steps are achievable over the next quarter century.
Lead author Goodarz Danaei, associate professor of global health at Harvard Chan School said: “Although scaling up the three interventions globally presents a major challenge, they are both achievable and affordable.
“A worldwide effort to lower people’s blood pressure, cut their sodium intake, and eliminate trans fat from their diet could dramatically reduce the incidence of premature death from cardiovascular disease (CVD) over a quarter century.
“Focusing our resources on the combination of these three interventions can have a huge potential impact on cardiovascular health through to 2040.
“Scaling up the three interventions would be a huge challenge and require countries to commit additional resources to boost health care capacity and quality.
“However previous analyses have shown that the interventions are achievable and affordable.”
The study published in the journal Circulation used global data from multiple studies and estimates from the World Health Organisation.
More than half of all delayed deaths, and two-thirds of deaths delayed before age 70, will be among men, who have the highest numbers of noncommunicable disease deaths globally.
Regions expected to benefit most from the interventions include East Asia, the Pacific, and South Asia, as well as countries in sub-Saharan Africa.
At the forefront of the plan would be to increase the use of blood pressure medications, many of which are safe and affordable.
Prof Danaei added: “These are realistic goals that have been shown to be attainable on smaller scales. We need the commitment to scale up the programs to achieve them globally.”
By: Jim Leffman
Article report from Circulation 2019, June 10 - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.038160
Patients with high blood pressure unlikely to reduce salt (Repost from European Society of Cardiology)
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Lack of adherence to recommended lifestyle changes is leading to higher salt intake for hypertensive patients, more medications needed to treat their condition and more side effects from those medications, according to lead author Dr Kazuto Ohno, Enshu Hospital, Hamamatsu, Japan.
Patients may be able to improve this vicious cycle by restricting salt intake," Dr Ohno said. "In consequence, they may avoid diseases caused by hypertension, such as heart attacks, stroke and heart failure. Moreover, they may be able to avoid side effects from antihypertensive drugs, such as dizziness and fainting."
Excess salt intake is one of the most important causes of hypertension and salt restriction is a key strategy to manage it, but few studies have been done on the relationship between salt intake and blood pressure in hypertensive patients undergoing antihypertensive drug treatment.
Study authors enrolled 12,422 patients taking medication for hypertension who visited the hospital for a physical checkup from 2010-2016. Individual salt intake was estimated in grams per day using a spot urine calculation formula shown to be effective in previous studies.
Blood pressure levels and patients maintaining the target blood pressure of less than 140/90mmHg improved during the seven-year study among all groups, but individual salt intake increased across all groups as well.
Guidelines for the Management of Hypertension 2014 published by the Japanese society of hypertension, recommend less than six grams of salt intake per day, Dr Ohno said, but less than four percent of study participants were following those recommendations.
Patients in the study were divided into three groups according to whether they were currently prescribed one, two, three or more antihypertensive drugs.
"The observational study in hypertensive patients with antihypertensive drugs found two comparative facts: an improvement of blood pressure levels and an increase in salt intake," Dr Ohno explained. "In particular, in hypertensive patients with multiple antihypertensive drugs, salt intake was higher than those taking only one antihypertensive drug."
Salt intake for healthy people was targeted less than 8 g/day for men and less than 7 g/day for women in Dietary Reference Intakes for Japanese (2015) published by Ministry of Health, Labor and Welfare.
"However, the National Health and Nutrition Examination Survey 2016 reported 10.8 g/day in men, 9.2 g/day in women," Dr Ohno said. "More awareness about the harms of higher salt intake is needed in both hypertensive patients and healthy people. We can check the amount of salt in a lot of food and seasoning, such as soy sauce, miso paste, mayonnaise and so on, which are printed on the food labels. It is impossible to measure salt intake in every meal, so all of us should try to take food with reduced salt by referring to food labels."
Dr Ohno said future research should consider whether nutritional guidance can improve the accomplishment rate of the target blood pressure and decrease the number of antihypertensive drug prescriptions.
"As a new attempt, we have explained their estimated salt intake value and gave nutritional guidance including salt, calories and so on to participants since 2017. We think salt restriction is an important modifiable factor of lifestyle to treat and prevent high blood pressure," he concluded.
Salads served in high-street restaurants contain more salt than a pizza, survey finds (Repost from Telegraph)
*This is just a short summary of an article originally posted on Telegraph UK. All the information, phrases, content and research posted here belongs to Telegraph and was written by Henry Bodkin. Click here for the original article.
Salads being served in high-street restaurants contain more salt than pizzas, a survey has found.
An investigation by the health campaigners Action on Salt (AoS) also revealed some ready-to-eat salads sold in supermarkets contain nearly the maximum recommended daily allowance for salt.
The group said the findings highlighted "a distinct lack of commitment" from the food industry to reduce salt.
Current health guidelines say adults should eat no more than 6g of salt a day, or around one teaspoon.
Even salads branded as a particularly healthy option contained high amounts of salt, such as Benugo's Supercharged Omega Salmon with 3.5g of salt.
AoS said the findings clearly demonstrated the need for clear, consistent nutrition labelling in restaurants and fast food outlets to help customers compare products and make healthier choices.
Of the 312 supermarket salads surveyed this year, Marks & Spencer's Teriyaki Chicken Sticky Rice Salad with a soy and wasabi dressing was the saltiest with 3.50g per pack.
Only 17 per cent of retail salads surveyed were low in salt and would receive a green label on front of pack information.
*This is just a short summary of an article originally posted on UPI. All the information, phrases, content and research posted here belongs to UPI and was written by Steven Reinberg. Click here for the original article.
Leading scientists propose to track salt’s effects on health by controlling how much is given to inmate volunteers.
1Suppose you wanted to do a study of diet and nutrition, with thousands of participants randomly assigned to follow one meal plan or another for years as their health was monitored?
In the real world, studies like these are nearly impossible. That’s why there remain so many unanswered questions about what’s best for people to eat. And one of the biggest of those mysteries concerns salt and its relationship to health.
But now a group of eminent researchers, including the former head of the Food and Drug Administration, has suggested a way to resolve science’s so-called salt wars. They want to conduct an immense trial of salt intake with incarcerated inmates, whose diets could be tightly controlled.
The researchers, who recently proposed the idea in the journal Hypertension, say they are not only completely serious — they are optimistic it will happen.
Using inmates as study subjects is controversial, to say the least. History is laden with horror stories. In the 1940s, prisoners were deliberately infected with malaria. In the 1950s, inmates were infected with hepatitis. A decade later, scientists irradiated prisoners’ testicles.
“Prisons are an inherently coercive environment,” said Ruth Macklin, an ethicist and professor of epidemiology and population health at Albert Einstein College of Medicine.
But “that doesn’t mean informed consent is impossible.”
The point of the proposed study is to put an end to decades of scientific disagreement over salt and its benefits and hazards.
On one side are researchers who say Americans eat too much sodium and that it is harming their health.
For healthy people, the American Heart Association recommends 2,300 milligrams a day. But for those with high blood pressure, the ideal amount is 1,500 milligrams, or less than half a teaspoon.
The higher one’s blood pressure, the greater the risk of heart attacks and strokes. Low-salt diets lower blood pressure, so a very low-salt diet ought to result in less cardiovascular disease and fewer deaths.
On the other side are scientific dissenters who say, “Prove it.”
They worry that very low sodium levels can actually make health worse, citing studies that found higher death rates and rates of heart attacks and strokes in people following low-sodium diets.
And the stubborn resistance of people told to consume less salt indicates to some experts that humans crave salt for a reason — they need it for their health.
Average sodium consumption in the United States and in many other countries has not budged for decades. It is about 3,200 milligrams a day.
For years, medical experts, including a group that produced a report for the Institute of Medicine on dietary sodium, have called for a randomized clinical trial of sodium in the diet that looked at outcomes like deaths and strokes, not at risk factors like blood pressure.
But there has never been such a trial, and that has made this subject a minefield for scientists and consumers alike.
Dr. Daniel W. Jones, a professor of medicine and physiology at the University of Mississippi School of Medicine and former president of the American Heart Association, was alarmed by the bitter arguments and increasingly personal disputes between researchers who disagree about salt.
So he invited senior medical scientists on both sides of the debate to meet in Jackson, Miss., to figure out how to settle their differences.
“I wanted a balance between different points of view,” said Dr. Jones, who believes low-salt diets are healthier. “And I wanted people who had avoided the temptation of disparaging the motives of those who disagreed with them.”
Tellingly, those criteria “got me down to a small list of people to invite,” Dr. Jones said.
Those he invited, six in all, agreed to sit down to hash out their differences at the university in Jackson, Miss. (He later invited two other researchers — Dr. Eric Peterson, a clinical trials expert at Duke University, and Dr. Robert Califf, also at Duke and a former head of the Food and Drug Administration — to weigh in on the final paper.)
Dr. Jones and Dr. David McCarron, a nutrition researcher at the University of California, Davis, who worries that low-sodium diets are dangerous to health, led the discussion.
They began by putting the Institute of Medicine report before the group and highlighting the recommendation that there be a randomized clinical trial in a population whose diet can be controlled. Then they asked, “What are we going to do about it?”
“Is it not time for somebody to try to do this? And if the answer is yes, what is the ideal population?” Dr. Jones said, recalling the conversation.
For two days, the group debated and mulled over various options. Conduct the study among military personnel? Too young.
Nursing homes? Too many residents are already prescribed low-sodium diets.
The best option, by far, seemed to be people who were incarcerated.
So suppose you do the study in prisons, said Dr. Jones. Is the research supposed to benefit the prisoners or just the population in general? If the prisoners would not benefit, the study would be unethical.
People who are not incarcerated can choose how much sodium they consume, but prisoners cannot — they eat whatever the facility provides. If there is uncertainty about the ideal amount of sodium, the experts concluded, prisoners would benefit from a study that settled the matter.
The group consulted with Marc Morjé Howard, a professor of government and law at Georgetown University. He also teaches at a nearby maximum security prison.
“It’s a little bit of an ethical minefield,” Dr. Howard said in a telephone interview. “My concern would be that it not in any way be detrimental to prisoners’ health and it would be voluntary.”
But, Dr. Howard said, “I do think it is possible if it is done very, very carefully with the full cooperation of prison authorities.”
He added that many incarcerated people have outgrown their criminal pasts and have a desire to help society. “They want to repent,” he said.
“I wouldn’t be surprised at all if many people would say, ‘I would love to be part of this study,’” he added.
Dr. Macklin, in a telephone interview, also said many prisoners would be happy to jump in. She has taught in a maximum security facility and has studied the ethics of doing research in prisons.
“They would say they want to give back to society,” Dr. Macklin said. “Even if there are more self-centered reasons, any deviation from the routine of being a prisoner is welcome.”
Prison administrators have told Dr. Jones they would be willing to consider a proposal for a randomized trial of salt. He also will be speaking to the American Civil Liberties Union, which runs a project on inmate rights, to explain the study and why it addresses important questions for prisoners.
The plan is to start with a pilot project involving prisoners aged 55 and over. That would be followed by a large trial lasting about five years and involving 10,000 to 20,000 prisoners in that age group.
The researchers plan to request funding from the National Institutes of Health. Of course, Dr. Jones said, the trial at this point is just a proposal.
“There are a bunch of steps between here and there,” he said. “But we are a group of serious people, senior people who disagree strongly. We came together to find a solution.”
“It is sad that that is amazing. But it is amazing.”
*This is just a short summary of an article originally posted on UPI. All the information, phrases, content and research posted here belongs to UPI and was written by Steven Reinberg. Click here for the original article.
An otherwise healthy diet isn't going to offset damage to your heart from too much salt, a new study suggests.
Our latest findings show that the adverse relation of salt intake to blood pressure is not counteracted or reduced by other nutrients consumed, including about 80 that we assessed," said researcher Queenie Chan.
High-salt diets lead to high blood pressure, a major cause of heart disease and stroke, the researchers pointed out.
The association recommends adults consume no more than one teaspoon of salt -- about 2,300 milligrams (mg) of sodium -- a day in total. And most adults would do better with 1,500 mg daily, the group advises.
But one can of soup alone can have as much as 1,800 mg of sodium, experts have warned. Commercially made breads and rolls, cold cuts, cheese, and savory snacks like chips, crackers, and pretzels are other high-sodium foods.
This new study finds that salt's adverse effects on blood pressure cannot be blunted by augmenting the diet with fruits, vegetables and other nutrients, Chan said.
If a frozen pizza, chicken pot pie, or a ham and cheese sandwich contains 1,340 mg of salt, then that is the amount your body has to manage, whether you try to dilute it or not, Heller explained.
One solution to reducing salt intake, she said, is to read nutrition labels on foods and make more foods fresh at home.
"This can be done with a bit of forethought and planning and, ultimately, will help save money, too," Heller said.
To help lower high blood pressure, she recommends potassium-rich meal plans like the DASH diet, or Dietary Approaches to Stop Hypertension.
Potassium works with sodium to help maintain the body's fluid and electrolyte balance, she said. This new study found that at lower levels of 24-hour sodium excretion, potassium intake mitigated the sodium-blood pressure relation, but not at higher levels.
"A diet high in salt indicates that the diet is high in ultra-processed foods like hot dogs, frozen pizza, fast and junk foods like chips, commercially baked products, such as breads and prepared foods, and low in potassium-rich vegetables, fruits, legumes and grains," Heller said.
For the study, Chan and colleagues looked at data on salt consumption and the consumption of 80 nutrients, including proteins, fats, vitamins, minerals and amino acids. All might affect blood pressure, the researchers said.
Also included in the review were data on urine levels of salt and potassium.
The study population was made up of more than 4,600 women and men aged 40 to 59 in the United States, the United Kingdom, Japan and China.
*This is just a short summary of an article originally posted on UPI. All the information, phrases, content and research posted here belongs to UPI and was written by Allen Cone. Click here for the original article.
"Like our efforts to reduce tobacco use, our work in nutrition can do much to reduce the burden of chronic disease and the early death we see as a result of avoidable illness," Gottlieb, who took over as FDA commissioner last May, told the attendees. "It can also help to break cycles of poor health, poor educational attainment, and complications from chronic disease that exacerbate burdens of illness and risk fracturing society along socioeconomic lines."
There remains no single more effective public health action related to nutrition than the reduction of sodium in the diet," Gottlieb said. "Excess sodium in the diet results in hypertension, which increases the risk of strokes and heart attacks."
He noted that reducing sodium intake by one-half teaspoon a day could prevent nearly 100,000 premature deaths a year, as well as 120,000 new cases of coronary heart disease, 66,000 strokes and 99,000 heart attacks.
The FDA, he said, has proposed short-term, voluntary targets for sodium reduction in foods of 3,000 milligrams per day from the current average intake of more than 3,400 milligrams. Gottlieb said the FDA would update its voluntary short-term sodium targets in 2019.
Americans' addiction to salt may be waning, according to a survey of more than 172,000 households found between 2000 and 2014. In that timespan, the salt content of packaged foods consumers purchased decreased 12 percent and the amount of salt in the packaged food and drinks people bought was reduced by nearly 400 mg a day -- dropping from more than 2,300 mg to less than 2,000 mg a day.
The FDA is also considering changing labeling so consumers know that they are consuming salt.
"We've been petitioned to allow the use of alternative names for 'potassium chloride' -- to make it clear that this product is a salt -- and we're actively considering this request," Gottlieb said.
Gottlieb said the concept may extend to other ingredients, such as using "vitamin B6" instead of "pyridoxine" and "vitamin B12" in place of "cyanocobalamin" so that people can "better understand what's in their food."
"Consumers want 'clean labels' that are readable and understandable," he said. "Manufacturers are taking this consumer preference seriously, and FDA has a role here as well. We're considering what changes could make ingredient information more consumer friendly."
The FDA also has decided to keep the Nutrition Facts update promoted by former first lady Michelle Obama after a compliance deadline was delayed 18 months. In January 2020, large food companies will start having to use the new labels that include the disclosure of added sugars and use a bigger font for caloric content.
The FDA also plans to streamline its process for reviewing qualified health claims from the industry to prioritize the ones that are based on the strongest science and could have great effect on public health.
"These claims can show that a food component may reduce the risk of a health-related condition, such as the relationship between folate and the reduction in risk of a child being born with certain birth defects," he said. "One example of how such claims can make a difference is manufacturers' ability to use a qualified health claim linking early peanut introduction in certain infants to a reduced risk of developing a peanut allergy."
"I'm committed to advancing our work in nutrition as one tool to help reduce health disparities, and improve the lives of all Americans, and to help every family live more free from the burden of preventable illness," Gottlieb said.
Nearly half the U.S. population has high blood pressure. Here’s what to do about it. (Repost from Miami Herald)
*This is just a short summary of an article originally posted on Miami Herald. All the information, phrases, content and research posted here belongs to Miami Herald and was written by Allison Horton. Click here for the original article.
Because of its lack of symptoms, high blood pressure (HBP or hypertension) is commonly known as the "silent killer". With the release of updated blood pressure guidelines by the American Heart Association and the American College of Cardiology, about 46% of the U.S. adult population are now considered to have high blood pressure.
Previously, blood pressure numbers of 140/90 indicate high blood pressure; these numbers are now lowered to 130/80.
High blood pressure is a risk factor for stroke and heart disease. According to the guidelines, for a person who reaches age 45 without having hypertension, the risk for developing hypertension within the next 40 years is 93 percent for African Americans, 92 percent for Hispanics, 86 percent for whites, and 84 percent for Asian Americans.
If you know that you have high blood pressure, here's what to do:
"Changing one’s diet and exercise is often the first step in treating patients with hypertension", said Dr. Gervasio Lamas, chief of cardiology at Mount Sinai Medical Center in Miami Beach. In South Florida, Latin food is often high in salt and calories. Two of the highest obese populations are Hispanics and African Americans because of diet, portion size and genetics.
Studies show that following the DASH (Dietary Approaches to Stop Hypertension) diet, which encourages a low-salt, high-potassium diet with fruits and vegetables along with an active lifestyle, can help to control elevated blood pressure. This can be supplemented by exercising at least 30 minutes daily, three-to-fives times weekly, said Dr. Ian Del Conde, cardiologist and head of vascular medicine at the Miami Cardiac & Vascular Institute at Baptist Health South Florida.
Reducing alcohol consumption also plays a role. Alcohol intake affects blood pressure, said Dr. Carl Orringer, cardiologist at the University of Miami Hospital and associate professor of medicine at the University of Miami Miller School of Medicine. Men should limit alcoholic drinks to two a day, women once a day.
If lifestyle modifications don’t work or the patient’s risk is high, then the patient should be treated with medication. Hypertensive patients with a high risk are advised on lifestyle modification but are started on medication to reduce chances of complications, Orringer said. Patients who are diabetic, smoke or have high cholesterol are more prone to be treated with medication.
Patients can be proactive and check their blood pressure as well. To have a proper blood pressure measurement, the patient needs to rest for at least five minutes prior. Also, have the appropriate size blood pressure cuff for their body type. If a patient has a heavy arm and a small cuff is used, that can result in an inaccurate reading. Avoid drinking coffee or alcohol 30 minutes before measuring blood pressure.
With that being said, people should not neglect having their blood pressure checked by their doctor. “Keep a log with the date and time of blood pressure reading,” Del Conde said. “Patients will then have a very good feel for their blood pressure and be able to tell doctors their blood pressure history.”
*This is just a short summary of an article originally posted on Quartz. All the information, phrases, content and research posted here belongs to Quartz Media LLC and was written by Nadine Rubin Nathan. Click here for the original article.
In more recent years, parents are becoming increasingly aware of the consequences of a high fat and high sugar diet and are making more effort to reduce their children's consumption of sugar and fat. However, in an attempt to stop giving them sugary cakes, ice cream and cookies, we tend to pass them the savoury snacks instead- a switch that can similarly damage children's health.
Salt is a topic that is not as often brought up among children and teens, yet it can pose health problems in the long term that are as serious as eating a high sugar and fat diet. Salt, much like sugar, is hiding in the everyday "healthy" foods we offer our children.
Few of us realize that other commonly thought of as nutritious foods such as breads, breakfast cereals, pre-prepared vegetable soups, pasta sauces, and canned foods like beans, chickpeas, or tuna are culprits too. Even cheese can contain a whopping amount of sodium. “Don’t be fooled—one cheese sandwich can contain 1,000mg of sodium or more. That’s already the entire daily allowance for a three-year-old in a single sandwich. Add a slice of ham to that sandwich and you’re way over the limit,” Sydney-based pediatric nutritionist Mandy Sacher says.
According to the American Association of Pediatrics (AAP), an estimated 3.5% of all children and teens in the United States have high blood pressure, however, the condition often goes undetected and untreated.
For ages one to three, the recommended amount of sodium is just 1,000-1,500 mg per day; ages four to eight, no more than 1,900 mg sodium per day, and even at ages nine to thirteen, the recommendation is slightly less than one teaspoon of salt—2,200mg sodium per day. (According to the World Health Organization, no one should eat more than one teaspoon of salt per day).
Tips for reducing sodium intake: