Why You Should Take Less Salt?

It has been known and probably shown by dozens of studies that consuming too much salt (sodium) can cause hypertension (high blood pressure), which in turn will increase the risk of heart disease and stroke.

CDC (Centers for Disease Control and Prevention) estimated that more than 800,000 Americans die from heart disease, stroke and other vascular diseases every year. According to AHA (American Heart Association), nearly half of all deaths caused by cardiovascular disease in the United States are related to hypertension. 

Statistics shows that Americans consumes an average of 3,600 mg of salt a day (about a teaspoon and a half), which is obviously much higher than that stipulated in recommended guidelines.

Current dietary guidelines recommend that people should take less than 2,300 mg of salt a day (about a teaspoon). For people who are 51 or older, are African-American or have hypertension, diabetes or chronic kidney disease, their daily intake should not be more than 1,500 mg.

A paper published February 11, 2013 in the journal ‘Hypertension’ suggested that hundreds of thousands of lives could be saved in the next decade, if Americans could cut the amount of salt they consume.

Scientists from the University of California San Francisco, Harvard Medical School and Simon Fraser University in Canada each used completely different computer simulation models to estimate how lowering sodium would save lives, largely by reducing the number of heart attacks and strokes.

One model examined the effects of gradually reducing sodium intake by 40 percent over 10 years to 2,200 milligrams a day (about a teaspoon), the second model calculated the impact of instantly reducing sodium intake by 40 percent, and the third model assessed the benefits of instantly cutting sodium intake to 1,500 mg a day, about a half teaspoon. 

All the 3 models found consistent and substantial benefits of lowering sodium consumption from the current level of intake. While gradually reducing sodium intake by 40 percent over 10 years could save an estimated 280,000 to 500,000 lives, immediately lowering sodium intake would save 500,000 to 850,000 more lives, about 60 percent more.

The researchers admitted that people might not be able to instantly reduce their salt intake, taking into account of the prevailing high salt intake. It might be more realistic for people to gradually reduce their salt intake over time.

According to AHA, an estimated 80 percent of salt intake comes from commercially prepared and processed foods. Hence, it is important that the public health approach should target lower levels of added sodium in these products through a combined effort of regulation, consumer education and food labeling and voluntary partnership with food manufacturers.

Why Less Sugary Drinks Should Be Consumed?

There are plenty of evidence showing sugar-sweetened beverages are loaded with calories that carry little nutritional value. These beverages are considered as a public health hazard as they are linked to obesity. A large number of deaths are actually caused by obesity-related diseases including cancer, heart disease, high blood pressure, stroke, and Type-2 diabetes.

A paper presented at EPI/NPAM by researchers from the Harvard School of Public Health in Boston linked sugar-sweetened beverage consumption to 180,000 deaths a year worldwide, including 25,000 deaths a year in the United States, mainly due to Type-2 diabetes. EPI/NPAM, stands for Epidemiology & Prevention and Nutrition, Physical Activity & Metabolism, was a conference hosted by American Heart Association (AHA) and held between March 19 and 22, 2013 in New Orleans.

Information from 114 countries was included in the new study that looked at dietary surveys to assess sugar-sweetened beverage consumption, and the number of deaths from certain diseases. Information from earlier studies was also used to estimate the effect of sugary drink consumption on weight gain, and the effect of weight gain on the risk of death from cardiovascular disease, diabetes and cancer.

As indicated by their analysis, sugar-sweetened beverage consumption was linked to 133,000 deaths from diabetes, 44,000 deaths from cardiovascular diseases and 6,000 deaths from cancer.

In 2010, Latin America/Caribbean had the most diabetes deaths at 38,000, and East/Central Eurasia had the most cardiovascular deaths at 11,000. Among the 15 most populated countries, Mexico had the highest rate of death linked to the beverages at 318 yearly deaths per million adults, and Japan had the lowest at 10 yearly deaths per million adults.

It is hoped that the new findings could push policy makers worldwide to implement effective policies like taxation and mass media campaigns to lower consumption of sugary beverages.

Nevertheless, other health professionals in the fields cautioned the study found only association and did not prove that sugar-sweetened beverage consumption actually caused those deaths.

Sugar-sweetened beverages are often just part of a bad diet that contribute to bad health. That is why people should still focus on overall diet. If people could improve the quality of diets by cutting down the sugar intake, salt intake and everything else, they should have better health. Reducing sugar-sweetened beverages but eating more of other junk foods could actually worsen the health.

The AHA recommends adults consume no more than 450 calories per week from sugar-sweetened beverages, based on a 2,000 calorie per day diet.

Beware Of Harms By Hypertension!

High blood pressure, also known as hypertension, is the most common cardiovascular disease. If it is left untreated, it could lead to not only vision problems and kidney failure but also life threatening events such as stroke and heart attack. In the United States, 1 in 3 adults have high blood pressure.

According to the announcement made by The World Health Organizations (WHO) on the eve of World Health Day on April 7, 2013, nearly 1.5 million people died of high blood pressure each year in South-East Asia making it the single-most important risk factor for non-communicable diseases like heart attack and stroke.

What makes high blood pressure dangerous is that it rarely causes any symptoms! Hence it is also called “the silent killer”. In fact, nearly one-third of people who have high blood pressure do not realize it. Certain symptoms still, however, persist if one’s blood pressure is extremely high. These include severe headache, chest pain, vision problems, fatigue, confusion and irregular heartbeat.

Regular checkup is probably the only way that one can tell whether his or her blood pressure is high. Most of the mortality caused by high blood pressure can simply be prevented through healthy lifestyles, early detection and treatment by medications.

Every individual does have the obligation to prevent hypertension by adopting a healthy lifestyle: eat a balanced diet, reduce salt, has regular exercise, avoid excessive consumption of alcohol, quit smoking and check the blood pressure regularly.

Meanwhile, health-promoting environments created by governments are essential as it can help people adopt healthy lifestyle and impose regulations for lowering the amount of salt in packaged food and making healthier foods affordable and accessible.

Remember this, it is cheaper to prevent, detect and treat hypertension than interventions like cardiac bypass surgery or kidney dialysis that may be required if hypertension is not diagnosed and treated in time.

Almost 95 percent of hypertensive patients have so-called essential hypertension in which the underlying causes cannot be determined. While essential hypertension is somehow mysterious, it has been linked to certain risk factors including family history, age, consumption of salt, obesity, diabetes, stress, lack of physical activity, insufficient intake of potassium, calcium and magnesium and chronic alcohol consumption.

The remaining 5 percent of hypertensive cases belong to so-called secondary hypertension in which the cause can be identified. Such causes include kidney disease, tumors, birth control pills and pregnancy.

Hypertension is a serious global issue. That is why in September 2011, the United Nations General Assembly adopted the Political Declaration of the High-Level Meeting on the Prevention and Control of Non-communicable Diseases, and committed governments to a series of actions.  Member States have agreed to 9 global targets for prevention and control of non-communicable diseases including lowering the prevalence of hypertension by 25 percent by 2025.

Can Eating Fish Prolong Life?

American Heart Association (AHA) recommends that people who have no coronary heart disease (CHD) should eat a variety of fish, preferably oily fish such as salmon and tuna, at least twice a week.  

Eating fish is good for the health because of omega-3 fatty acids, particularly EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid), These fatty acids have been shown to benefit the heart of healthy people and those at high risk for or who already have cardiovascular disease.

In a study released on April 2, 2013 in the journal ‘Annals of Internal Medicine’, researchers from the Brigham and Women's Hospital, Harvard Medical School, Harvard School of Public Health, University of New Mexico, Fred Hutchinson Cancer Research Center and University of Washington reported that people, who were 65 and older and ate fish, may live an average of 2 years longer than people who did not consume the omega-3 fatty acids.

While other studies have found link between omega-3 fatty acids and lower risk of heart disease, this study aimed to determine the link between fish eating and mortality risk.

Researchers analyzed records of older people by scanning 16 years of data on about 2,692 American adults aged 74 years (plus or minus 5 years) without prevalent CHD, stroke, or heart failure. These participants were not taking fish oil supplements.

Their findings indicated that those with the highest blood levels of omega-3 fatty acids had the lowest risk of dying from any cause, and lived an average of 2.2 years longer than those with low levels. Omega-3 fatty acids were found mainly in fish like salmon, tuna, halibut, sardines, herring and mackerel.

DHA was found to be the most strongly linked to lower risk of CHD death. EPA, on the other hand, was strongly related to lower risk of nonfatal heart attack and DPA (docosapentaenoic acid) was most strongly associated with lower risk of dying from a stroke. Even after adjusting for demographic, lifestyle and diet factors, the results persisted.

Importance of adequate blood omega-3 levels for cardiovascular health was indeed supported by the findings, which also suggested that in life these benefits could extend the years of remaining life.

According to AHA, people who had CHD are advised to consume about 1 gram of EPA and DHA per day, preferably from oily fish, though EPA & DHA supplements could be taken as well but should be in consultation with their doctors. People who have elevated triglycerides require 2 to 4 grams of EPA and DHA provided as capsules on a daily basis under doctor’s care.

Would Weight-Loss Surgery Benefit Diabetics?

When a person becomes obese, the only option he or she can opt for is to lose weight. This is because obesity could lead to many serious medical conditions including Type-2 diabetes, heart disease, high blood pressure and stroke.

Of course, there are several avenues that can help achieve the weight loss.  First of all, he or she should start off with combining a reduction of processed foods high in saturated fats, sugar, salt and caloric content of the diet with an increase in physical activity.

If this fails, which always does, he or she might have to approach the doctors for other means that include use of drugs to decrease appetite, block fat absorption or reduce stomach volume.

Bariatric surgery might be recommended in cases of severe obesity. 2 effective types of bariatric surgical procedures are gastric bypass and gastric banding that can limit intake of food energy by reducing stomach size. 

The FDA (Food and Drug Administration) has approved gastric banding for people with a BMI (Body Mass Index) between 30 and 35 who have an illness linked to obesity. Each year, more than 113,000 bariatric surgeries are performed in the United States. They have saved countless lives but these procedures do carry risks as with any other surgery. As they are complex surgeries, they sometimes result in serious complications. The complication rate for all types of bariatric surgery is about 7.5 percent, according to the National Institutes of Health.

However, a gastric bypass or other type of weight-loss surgery could actually help diabetics who are moderately obese. This was what researchers from the University of California, Los Angeles, Rand Health, VA Greater Los Angeles Healthcare System, Olive View-University of California, and the Akasha Center for Integrative Medicine wrote in their paper that was published on June 5, 2013 in ‘Journal of the American Medical Association’ (JAMA).

Their analysis was based on a review of evidence supporting the use of bariatric surgery to treat people who are diabetic and who have a BMI of between 30 and 35, considered to be on the low end of the obesity spectrum.

Diabetics with moderate obesity were found to lose more weight and had better glucose control over 2 years if they got such surgery rather than opting for non-surgical treatment like dieting and drugs. The researchers also noted that patients who had a gastric bypass achieved better results (more short term weight loss and better control of blood sugar levels) than those who underwent gastric banding.

But since the findings were arrived from a relatively small number of trials, it is necessary to carry out more studies to include on how patients do after 2 or more years, complication rates and side effects. Until then, it is inappropriate to recommend bariatric surgery over nonsurgical weight-loss treatment to people who are obese.

How To Better Predict Stroke In Patients With Atrial Fibrillation?

Atrial fibrillation (or simply AF) is the most common type of arrhythmia, which is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.

Though people with AF might not have any symptoms, they are actually at a higher risk of getting a stroke. As AF could lead to the formation of blood clots that can travel to the brain and block an artery, AF independently raises the risk of ischemic stroke 4-to-5-fold. AF could also lead to heart failure and other kinds of heart disease.

Being highly age-dependent, AF affects 10 percent of those aged above 80. About 2.7 million Americans are living with AF.

There is no doubt that predicting ischemic stroke and major bleeding are both relevant to the anticoagulation decision, but previous decision analyses have indicated that risk of ischemic stroke is the more important one for most patients with AF.

In order to help physicians decide whether to begin blood-thinning treatment for patients with AF, a more accurate and reliable stroke prediction model has been jointly developed by researchers from Kaiser Permanente, Massachusetts General Hospital, University of California San Francisco and Stanford University School of Medicine. The findings were published online June 19, 2013 in the ‘Journal of the American Heart Association (JAHA)’. 

To predict AF stroke risk factors, the new model incorporates common clinical features and uses a broader range of age categories to calculate a risk score. The risk score helps doctors and their patients weigh the benefits and risks of starting a blood-thinning treatment.

Clinical features used in the new model include coronary artery disease, diabetes, excess urinary protein excretion, female gender, heart failure, hypertension, kidney dysfunction, peripheral arterial disease, prior ischemic stroke, and older age,

Strong increased stroke risk across the entire age range was found. Individuals aged above 85 were at nearly double the risk of those aged between 75 and 84. But individuals who had experienced a prior stroke were at higher risk regardless of age. Age, prior stroke and their interaction proved to be the dominant risk factors. 

While warfarin (a blood-thinner and anticoagulant) has been known to be highly effective in preventing ischemic stroke, treatment could be difficult to control and often leads to hemorrhage. Based on the prevailing risk assessment formulas recommended by leading clinical practice guidelines, doctors could only have moderate ability to predict which patients will have a stroke.

The new model was effective in calculating risk in primary prevention patients whose stroke risk is most uncertain. These patients pressingly require personalization in the anticoagulation decisions and better prediction in severe stroke.

Laugh More To Be Healthy!

“Laughter can be the best medicine.”

Believe it or not, this is what people always talk about. Is this statement true? If yes, what are the reasons behind such claim?

After years of research, scientists have found some justifications on why laughing is good for the health.  

First of all, laughing boosts the immune system. Laughter has been shown to raise levels of salivary immunoglobulin A (IgA), an important antibody that fights bacteria and infections, especially those in the respiratory system.

Pain could be relieved by laughter, which is effective, free and available everywhere. Endorphins are human body’s natural painkiller that can help ease chronic pain. It is released when people laugh.

Laughing might also increase the tolerance for pain. By watching just 15 minutes of comedy with other people pushed up the pain threshold by about 10 percent, according to a paper published in 2011 in ‘Proceedings Of The Royal Society B: Biological Sciences’ by researchers from the University of Oxford in Britain. Watching drama, factual shows or feel-good nature program, in contrast, did not affect the pain threshold.

Blood sugar levels might be positively affected by laughter, too. In a study, people with Type-2 diabetes and those without diabetes attended a boring lecture after eating a meal. On the next day, the participants joined a comedy show after eating the same meal. The blood glucose levels did not increase after the meal for the diabetic patients at the comedy show. While the researchers have not figured out the exact cause, they suspected that laughter might impact the neuroendocrine system and restrain blood sugar levels from spiking, or cause the acceleration of glucose use by muscle motion.

As shown by studies, laughter could lower or balance blood pressure and increase vascular blood flow. People who lower their blood pressure will reduce their risk of heart attack and stroke. 

By improving blood circulation and increasing oxygenation of the blood, laughter might help fight against heart disease. In a study conducted by the University of Maryland in 2005, laughter was linked to cardiovascular health. The findings found that laughter seemed to cause the endothelium (tissue that composes the lining of blood vessels) to expand and allow for better blood flow.

For those who are unable to do other physical activity due to injury or illness, laughter could be a great cardio workout. Laughing can help the heart pump and burn a similar amount of calories per hour as walking at a slow to moderate pace.

Nevertheless, laughter cannot simply replace medications. Patients should still take the drugs, if any, that are prescribed by their doctors.

Beware Of Heart Disease Even For Youngsters!

Being the number one killer in the United States, heart disease can be prevented with healthy habits for 80 percent of cases, according to the American Heart Association (AHA).

A paper that was published online April 1, 2013 in AHA’s journal ‘Circulation’ revealed that more than 80 percent of the American teens will eventually develop heart disease because of their poor diets: too much fat, salt and sugar, insufficient fruits and vegetables. In addition, they do not exercise enough. Such unhealthy lifestyle is translating into obesity and overweight that will ultimately lead to high blood pressure, high cholesterol and blood glucose at these young ages.

The researchers examined the components of cardiovascular health in 4673 participants aged between 12 and 19 years from the 2005–2010 National Health and Nutrition Examination Surveys. The sample is demographically representative of the 33.2 million adolescents in the United States.

Participants answered questions regarding eating and exercise habits, and they underwent medical examinations too. Their blood pressure, cholesterol and blood sugar levels, as well as weight and diet and exercise habits were recorded. 

Heart disease risk behaviors of participants were ranked according to how well they compiled with the 7 factors that the AHA recently defined as critical for optimal heart health. These factors are maintaining a healthy body weight; eating a healthy diet; being physically active; keeping blood pressure, cholesterol and blood glucose within normal ranges; and not smoking.

Only 45 percent of boys and 50 percent of girls in the study met 5 or more of these criteria, and less than 1 percent of the teens were eating an ideal healthy diet: 4.5 or more cups a day of fruits and vegetables, 2 servings of fish a week, 3 ounces a day of whole grains, less than 1,500 mg of salt a day and no more than 450 calories worth of sugar-sweetened drinks a week.

Regarding physical activity, 44 percent of the girls and 67 percent of boys exercised an hour or more per day, with 13 percent of boys and 23 percent of girls not physically active at all. Meanwhile, 20 percent of boys and 17 percent of girls were found to have a poor body mass index (BMI).

Fortunately, it is possible to reverse the unhealthy trends by using treatments that are neither expensive nor complicated. A lifestyle change, like eating a healthy diet and becoming more active every day, can simply lead to improvements in many of the heart disease risk factors.