Sunday, December 11, 2011

Sodium can be a Killer

The sodium component of salt (salt (sodium chloride) is 40% sodium, 60% chloride) is vital for controlling the amount of water in the body, maintaining the normal pH of blood, transmitting nerve signals and helping muscular contraction. Salt is present in all foods in varying degrees, and almost all processed foods contain added salt.
  • Sodium is a mineral found in many foods. It helps keep normal fluids balanced in the body. But most people in developed countries consume much too much sodium.  The recommended daily limits differ by country: 
  • U.S. 1500 mg of sodium (Adequate Intake level) & 2300 mg (Tolerable Upper Limit)  . The U.S. average daily usage is 3,436 mg of sodium [1].
  • UK 2300 mg, 
  • Canada 1000-1500 mg recommended (the average usage in Canada is 3,100mg/day)).[3]
In Canada, the recommended daily limit is further divided by age.
            1000mg            less than 3 yrs
            1200                4-8 yrs
            1500                9-50
            1300                51-70
            1200                over 70 yrs

And, all these recommendations are even lower if you are in a high-risk group[2].

Now look at the amount of sodium in your diet.
  • Salt - 1 oz(28 gms) contains 6,852 mg of sodium.

Some people think that sea salt and kosher sale are healthier but their numbers are even worse, by weight, than regular table salt.
  • Sea Salt - 1 oz(28 gms) contains 13,104 mg of sodium.
  • Kosher Salt - 1 oz(28 gms) contains 10,453 mg of sodium.
But sea salt and kosher salt do have larger crystals, which means they take up more space and, in theory, are lower in sodium by volume standards.
Look at some other quantities of table salt:
  • Salt - 1 Tsp(6 gms)            contains            2,325 mg of sodium.
  • Salt - 1 Tbsp(18 gms)       contains            6,976 mg of sodium.
  • Salt - 1 Cup(292 gms)       contains        113,174 mg of sodium.
When salt intake is reduced, blood pressure begins decreasing for most people within a few days to weeks.

People who have experienced heart problems or have high blood pressure should follow a low-salt diet and be serious about taking advice from their health care professional. Reducing sodium has been proven to be one of the best ways of lowering high blood pressure, especially in combination with broader dietary changes.

Why worry about high blood pressure?
High blood pressure often leads to heart disease and/or heart failure and as a result, is considered a major risk factor.

What is high blood pressure?
High blood pressure is also called hypertension.
  • One in three American adults has hypertension, this represents about 50 million people. Up to half of them don't know it until they suffer a stroke or myocardial infarction (heart attacks). This is why hypertension is known as the "silent killer."
  • 34 million adults have high normal blood pressure. At least 1/3 of all heart attacks and strokes occur in people with high normal blood pressures.
  • Fewer than half of all Americans have ideal blood pressures.
High blood pressure is more common in:
  • People with family members who have a history of high blood pressure, cardiovascular disease or diabetes
  • African Americans
  • People 60 years and older
  • Women who take oral contraceptives
  • People who are overweight

Heart Failure & a Low-Sodium Diet
To educate yourself about sodium and diet, there are several areas to be aware of:
  • More than 4 million people in the United States suffer from congestive heart failure (CHF), according to the Cleveland Clinic[2]
  • Heart failure, the leading cause of hospitalization in people over the age of 65, means your heart is not strong enough to pump blood and deliver oxygen efficiently to all parts of the body.
  • A person with chronic heart failure often has to change his eating habits to make it easier for the heart to do its job.
  • A low-sodium diet is the same thing as a low-salt diet, according to the Heart Failure Society of America.
It is important to avoid salt when you have CHF or any form of heart disease because the condition causes the body to retain sodium. Water accumulates in the legs, ankles and abdomen and can cause shortness of breath or weight gain. Excess sodium makes the body retain water, and this extra fluid makes your heart work harder. And, if your heart can't work harder, it fails.

In future posts, we will discuss:
  • sodium in packaged foods
  • applied salt
  • cooking at home
  • fruits and vegetables
The U.S. Food and Drug Administration (FDA) has defined what nutrient content claims in food must mean[4]:
  • Sodium-free in U.S. food must mean that there is less than 5 mg per normal serving and that the food contains no ingredient that is sodium chloride or generally understood to contain sodium
  • Low in sodium in U.S. food must mean that there 140 mg or less per normal serving (and only 50 mg if normal serving is small)
  • Very Low Sodium must mean that there is 35 mg or less per normal serving.
  • Reduced Sodium must mean that there is a minimum of 25% less sodium per normal serving than an appropriate reference food.
With these restrictions, even when the sodium is reduced, the salt content may still be too high for you.

The message here is that sodium-free
doesn't mean free of sodium.


References:
[1] http://www.cdc.gov/features/dsSodium/
[2] http://my.clevelandclinic.org/heart/prevention/htn/yourbp.aspx
[3] http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/qa-sodium-qr-eng.php#a4
[4] http://is.gd/s1Kl1m

Saturday, December 10, 2011

Yale University Study on Heart Attacks wants Your Help

This is some information on a survey study that Yale is currently conducting.  It is about patients who delay getting medical help during acute myocardial infarctions (AMI) and acute coronary syndrome (ACS) events.  The study team knows that there isn't an effective intervention for getting people to the hospital much earlier than the typical median time of around 4 hours, even though it is known that one gets the most therapeutic benefit if they are in the hospital emergency department within the first hour of acute symptoms onset.

The difference between this study and others is that this one emphasizes:
1.    the behavior of the individual; and,
2.    the behavior of those around her or him in getting care. 

This study focuses on:
1.    a broad range of behavioral variables of :
    a.    decision making;
    b.    perception and interpretation of symptoms;
    c.    situational setting;
    d.    the advice and perceptions of lay others helping the individual;
    e.    the day and time of day;
    f.    prior experience with EMS systems and the health care system; and,
    g.    how the individual’s evaluation and level of concern changed over the care-seeking period.
2.    trying to compile a national sample of individuals rather than one taken from one hospital or community. 

The study team knows, from generally accepted data, that people delay on the second and subsequent events.  This is known as ‘cumulative adversity’.  People seem to delay a bit longer before seeking help because:
1.    they do not want to repeat the same experiences;
2.    they want to make certain that the event is real; and,
3.    they don’t want to burden family or friends if unwarranted.

The problem being studied in this effort is how do you get someone to drop all of their social activities to get medical care.  If you ask anyone what they would do if they had an AMI and they all say that they would seek care immediately. But few people drop everything and go.
 
People:
1.    have to be certain it is a real problem;
2.    have to finish the task at hand;
3.    need to make arrangements if they are to be hospitalized;
4.    have to cancel appointments
5.    make sure they are clean enough for a doctor visit;
6.    don’t want to bother others, especially the hard working doctor in the middle of the night; and,
7.    don’t want to be taken out of their office or home by EMS personnel. 

They only agree to go when the signs and symptoms become so overwhelming that they have few choices or when someone takes charge of the situation and calls 911.

The text for this blog is from a previous interview with Angelo A. Alonzo, PhD, Research Scientist, at Yale University in New Haven, Connecticut and it is copied here as an encouragement for you to join the study.  It will take, at most, 30 minutes of your time. For me, it was only 16 minutes. So, please go to:
                                              https://heartstudy.yale.edu/hacs/