Wednesday, November 23, 2011

Lower Your Salt Intake? No Way!

For years, I have been lecturing and writing about the nonsensical argument the conventional powers-that-be claim that lowering salt in the diet will reduce your risk of cardiovascular disease. The data has never been shown that lowering salt intake to ridiculously low levels of 1,500mg/day will reduce your risk of heart disease. In fact, many studies show that lowering your salt intake to these levels will cause more heart attacks and mortality. Furthermore, low salt diets will lead to elevated insulin levels. Finally, low salt diets do not significantly lower blood pressure. More information about this can be found in my book, Salt Your Way To Health.

A recent study in JAMA (November 23/30, 2011-Vol. 306, No. 20) looked at the association between sodium excretion and cardiovascular events in patients with established cardiovascular events or diabetes. The authors studied nearly 29,000 adults and found cardiovascular death was increased among those with the lowest and the highest sodium excretion.

Sodium excretion is tied to how much sodium (or salt) is ingested. The more salt that is ingested the more sodium that is excreted in the urine. The reverse is true also; the less sodium ingested, the less sodium excreted. A crude estimate can be made that the amount of sodium ingested is equal to the amount of sodium excreted (as long as someone is not sodium deficient).

We have been told we are ingesting too much salt. The Institute of Medicine (IOM) states, “Americans consume unhealthy amounts of sodium in their food, far exceeding public health recommendations. Consuming too much sodium is a concern for all individuals, as it increases the risk for high blood pressure, a serious health condition that is avoidable and can lead to a variety of diseases. Analysts estimate that population-wide reductions in sodium could prevent more than 100,000 deaths annually.”

The IOM claims that Americans ingest more than 3,400mg of sodium per day which is about 1.5 tsp of salt per day. They claim that we should ingest no more than 1 tsp/day or 2,300mg/day. For those with hypertension, experts recommend less—about 1,500mg/day of sodium.

The recent JAMA (November 23/30, 2011) study found the lowest rate of cardiovascular disease, cardiovascular death, heart attack, stroke, congestive heart failure and non- cardiovascular death occurred when the sodium intake was 4-6,000mg/day. Lower and higher intakes were found to increase a compositd of all the outcomes studied (in a near linear fashion). You read that right; lower and higher salt intakes were all associated with worse outcomes.

In my book, I wrote about the dangers of a low-salt diet. Salt is a vitally important nutrient for the human body. We cannot live without adequate amounts of salt. Don’t believe the low-salt nonsense. However, you should educate yourself about which type of salt is a healthy salt.
The healthiest salt is unrefined salt with its full complement of minerals. Celtic Brand Sea Salt, Redmond’s Real Salt and Himalayan salt are all good brands of unrefined salt.

There are medical conditions where the body does not tolerate large amounts of salt. This can occur with those suffering from kidney failure or congestive heart failure. If you have these illnesses, please discuss your salt intake with your doctor.

Friday, November 18, 2011

Avoid Sucralose

Sucralose is an artificial sweetener found in many low-calorie, sugar-free products. Unfortunately, it has become a staple in our food supply. It is 600x as sweet as table sugar and over three times sweeter than aspartame (i.e., NutraSweet). I would venture a guess that a product that is 600x sweeter than table sugar is not be a healthy item for the human body.

Sucralose contains three chlorine atoms in its structure. Heating sucralose can create a chemical reaction with the chlorine atoms where they are transformed into a toxic product.

A recent study (Env. Sci. Techn. 2011; Aug 31.PMID:21879743) reported that water treatment plants were unable to fully remove sucralose from the finished drinking water. The researchers studied 19 U.S. water treatment plants serving more than 28 million people. The scientists reported that sucralose was found in the finished drinking water in 13 of 19 sites. What this means is that the water treatment plants were unable to remove sucralose from the end product coming out of your tap.

Sucralose is not a healthy product. We eat more artificial sweeteners than any other people on the face of the planet. We also have more obesity than any other people on the face of the planet. I have found it nearly impossible for my obese patients to lose weight if they ingest artificial sweeteners. Besides the weight issues there is a whole host of adverse effects associated with artificial sweeteners including neurological and hormonal problems.

The research behind sucralose has been largely funded by the industry that manufactures sucralose. Industry-funded research has been shown to be biased. I do not believe sucralose is a healthy product. It is best to avoid any food item containing sucralose.

Sunday, November 6, 2011

Vitamin Study Flawed

A study released a few weeks ago stated, “…dietary vitamin and mineral supplements may be associated with increased total mortality risk.” (Archives in Int. Med. Vol. 171. No. 18. Oct. 10, 2011). This article made the rounds in the media with headlines proclaiming, “Dietary Supplements Linked to Higher Mortality.” (

Are supplements dangerous? If you believe the media, the answer is “yes.” Let me sift through the study for you so that you can make an educated decision.

The authors of the study looked at 38,772 older women in the Iowa Women’s Health Study. Their mean age at baseline, in 1986, was 62 years. The study participants self-reported their use of supplements three times over an 18 year period. The authors split the women into two groups; those that took dietary supplements and those that did not.

Let’s go through the results. However, this is where things get tricky. In Table 2, the scientists reported that women who took dietary supplements such as vitamin B complex, Vitamins C, D, and E and calcium had a slightly decreased death rate as compared to nonusers of supplements. When the researchers adjusted the data for various factors such as educational level, place of residence, body mass index and others, the benefits of the supplements disappeared (except for calcium which still showed a benefit).

In Table 3, comparing supplement users to non-users, the study found the risk of cancer mortality decreased in the vast majority of supplement users who used such items as a multivitamin, vitamins A, C, D, E an calcium. However, copper supplementation showed a higher cancer mortality rate. Most other nutrients studied showed a neutral effect. When the authors ‘adjusted’ the data for place of residence, diabetes, high blood pressure and other items, most of the beneficial effects disappeared.

Table 4 looked at the risk of mortality from the use of supplements across the three time periods where the subjects turned in their questionnaires. The only supplements that showed an increased mortality rate were folic acid and iron.

This was a very difficult study to read. The authors seem to have ‘adjusted’ the data to make supplement use appear to be problematic. However, even with their ‘adjustments’ I did not feel the study indicated that supplement use was detrimental. In fact, this paper found many different supplements (Vitamins C, D, E and calcium) actually decreased mortality rate. When the researchers began ‘adjusting’ the data, the positive numbers all began to look worse. However, the authors emphasized the negative results in the abstract and did not mention the positive results (except for calcium). This negative interpretation is what was picked up by the media.

It is interesting to look at Table 4 where multivitamin users had a decreased mortality rate as compared to nonusers. I wonder why the media did not comment on this finding.

This study can be faulted for many reasons. It looked at three surveys from 38,000 women over an 18-year time period. Think about that; these women were only surveyed three times in 18 years. No laboratory tests were ordered. Which supplements did the women take? Did they take them continually over the 18 years? Were the supplements doctor recommended? Did anyone check blood levels of these nutrients? No one knows. Data from surveys are notoriously problematic.

The negative findings of this study occurred when the authors ‘adjusted’ the data. Even most of the negative findings were not significant. There was only a small increase in mortality—about 1% from those taking a multivitamin. This is a very small effect and could be due to chance.

I say, “Forgetaboutit.” This study is a bunch of nonsense. If the authors had emphasized the positive aspects of nutritional supplementation found in this study it would never have been published in this journal.

There are hundreds of articles on nutritional supplements every month. Some are positive, some are negative. My experience has shown the judicious use of supplements has many positive benefits.