Excessive Salt Intake Linked to Millions of Deaths

 

New research has shown that excessive salt consumption has played a role in over two millions heart-related deaths worldwide in 2010 alone, with 40% of those deaths premature.  The study was detailed at the American Heart Association’s meeting in New Orleans on March 21, 2013.  Researchers looked at 247 surveys of adults that participated in the 2010 Global Burden of Disease Survey, an international collaboration between researchers from 50 countries worldwide.  Time summarized the investigation’s scope and methods:  

[Study participants] reported on their sodium intake from 1990 to 2010 in food questionnaires. Overall, adults around the world ate an average of 4,000 mg of sodium a day, either from prepared foods or from table salt, soy sauce or additional salt sprinkled into meals while cooking. That’s twice the amount recommended by the World Health Organization (2,000 mg per day) and nearly three times the amount the AHA says is healthy (1,500 mg per day).

Researcher’s reported that salt’s impact on global health has been substantial.  A second study that was a meta-analysis of 107 randomized controlled trials helped to show the effects of excess sodium consumption and its impact of people’s risk of cardiovascular disease around the globe.  Highlights include:

·         Among the 30 largest countries, the highest death rates due to excess salt consumption per million adults were Ukraine (2,109); Russian (1,803); and Egypt (836).

·         The United States ranked 19th out of the 30 largest countries, with 429 salt-related deaths per million adults (which translates to 1 in 10 heart-related deaths in the U.S., according to the study authors).

·         Among all countries surveyed (187 in total), those with the lowest salt-related death rates per million adults were Qatar (73); Kenya (78); and United Arab Emirates (134).

·         84% of deaths occurred in low and middle-income countries

·         Kenya was reportedly the only country surveyed to adhere to the AHA's recommended 1,500 mg/day limit.

·         The highest proportion of cardiovascular disease related deaths tied to salt-laden diets were in the Philippines, Myanmar and China.

Time  also included a details from the Salt Institute:

The Salt Institute criticized the study, noting that the added heart-disease risk was compared with an unrealistically low level of salt consumption that no country in the world met. “This latest AHA statistical study on the worldwide mortality from dietary salt is misleading and totally devoid of genuine evidence,” said Morton Satin, vice president of science and research for the Salt Institute, in a statement. “Using a highly flawed statistical model, researchers simply projected potential reductions in mortality without considering all known health risks resulting from low salt intake.”

Adults aren’t the only ones at risk.  Other research discussed at the AHA meeting included some that showed children are already consuming too much salt.  The high sodium content in many prepackaged meals and snacks that are aimed at kids can force them into eating unhealthy amounts.  According to the data presented, about 75% of pre-packaged meals are high in sodium, defined as containing more than 210 mg per serving.  The study found that toddler meals could contain up to 630 mg of sodium per serving.

“Our concern is the possible long-term health risks of introducing high levels of sodium in a child’s diet, because high blood pressure, as well as a preference for salty foods, may develop early in life. The less sodium in an infant’s or toddler’s diet, the less he or she may want it when older,” said lead author Joyce Maalouf, a fellow at the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta, in a statement.

The AHA advised people to remember that salt doesn’t only come from the shaker but can be found in many of the packaged foods consumed each day.  Because this is often hidden, they advise closely reviewing the nutrition facts on foods that you don’t make yourself.  They also advise that when cooking at home, keep a close eye on the amount of salt added to foods and try to substitute with other flavors such as herbs and spices or lemon juice to trick taste buds into thinking they are getting the “salt” they are looking for.

 

 Adapted from: http://healthland.time.com/2013/03/22/salty-truth-adults-worldwide-eating-too-much-sodium/?iid=tsmodule

 

 

Smoking Bans Decrease the Incidence of Heart Attacks

 

 

 

Stepping out of your office for a quick smoke break?  You might now be praised as a public health icon.  Workplaces and restaurants that have put in place smoking bans limiting smoking to outside areas only have managed to improve Americans’ health, in spite of rising levels of obesity and Type 2 diabetes, says a new study.   The study was published Monday in the Annals of Internal Medicine.  It was focused on Olmsted County in Minnesota.  The study tracked the rate of heart attacks and sudden heart attack deaths in the aftermath of the smoking bans that cleared the Olmsted County restaurants, bars and workplaces of the potentially hazardous tobacco smoke.

Banning indoor use of tobacco smoke from restaurants and workplaces has driven down the rate of heart attacks by one-third in Olmsted County.  It has reduced the sudden cardiac death rates in Olmsted by 17%.  One interesting finding in the study was that banning smoking only in restaurants did not have an impact on the rate of heart attacks.  But once phase 2 was implemented, which banned smoking in the workplace and bars, it became clear that the rates of heart attacks were decreasing.

A hike in tobacco taxes and smoking-cessation campaigns encouraged many Minnesotans to quit smoking during the study period (2002-2007). 

“But those trends did not fully explain the drop in heart attacks and sudden cardiac deaths they wrote: Removing the exacerbating effect of second-hand-smoke appears to have accelerated a trend already in the making.”

Those who are taking their smoking outside may be “reluctant public heroes,” but the accompanying editorial in the Annals of Internal medicine makes it clear that those who choose to continue smoking do not smoke more at home to compensate for not being able to smoke indoors.  Instead, the trend has leaned toward implementing no smoking zones within homes as well.  The affect seems to be a decrease in the amount of smoking.

While this is good news, second-hand smoke is not disappearing.  Tobacco smoking is still allowed in multi-unit housing, where ventilation is shared and can travel between units.  Smoking still continues in cars, casinos and outdoors. 

UC San Francisco physicians Sara Kalkhoran and Pamela M. Lin have written, "We should prioritize the enforcement of smoke-free policies, eliminating loopholes in existing policies as well as encouraging the expansion of smoke-free policies" to include apartment buildings, cars, casinos and outdoor locations.  They also state that these places may house and employ lower-income people, whose health should not continue to be compromised by loopholes in the laws.

Women who quit smoking before 40 may avoid earlier death

 

 

 October 30, 2012

Darlene Karoly, a graphics production artist from Cleveland, had been smoking for over 20 years -- and trying to quit for the last 15.

"I tried the patch, I tried the gum, I tried hypnosis, I tried willpower, I tried cutting down cold turkey, I tried Wellbutrin, I've tried Chantix. The American lung Association has a program, I tried that. I've tried everything and I've tried most things multiple times," the 49-year-old admitted.

She stopped about 70 days ago thanks to a smoking cessation counselor from Cleveland Clinic, and although a smoker since 20, a new study reveals that quitting may have added years to Karoly's life.

In possibly the largest study ever on the hazards of smoking and benefits of stopping, researchers found that smokers lose at least 10 years of their lives due to their habit. The good news is the earlier they quit the better. Women who successfully quit before 40 avoided 90 percent of the added risk of early death caused by smoking, while stopping before 30 helped women avoid 97 percent of the added risk.

"If women smoke like men, they die like men - but, whether they are men or women, smokers who stop before reaching middle age will on average gain about an extra ten years of life," co-author Richard Peto, professor of Medical Statistics and Epidemiology at the University of Oxford in Oxford, England, said in the press release.

The research looked at the Million Women Study, which involved1.3 women in the U.K. between the ages of 50 to 65 years during 1996 through 2001. Women were surveyed about their lifestyle, medical and social factors and then surveyed again three years after their first questionnaire.

They were also monitored via the National Health Services central register, which told researchers when patients died and cause of death. Researchers also followed-up with patients an average of 12 years after joining the study to see if they were alive.

Twenty percent of the study pool were smokers, 28 percent were ex-smokers and 52 percent had never smoked. Those who were still smoking at the time of the three-year follow-up questionnaire where three times more likely to die over the next nine years than nonsmokers, even though some had reduced their risk by temporarily quitting between the first and second survey.

According to the results, two-thirds of all the deaths of smokers in their 50s, 60s and 70s were caused by smoking: Risk of dying from a smoking-related disease like lung cancer, chronic lung disease, heart disease, or stroke went up with the amount of cigarettes they consumed. But, even light smokers who smoked one to nine cigarettes a day were twice as likely to die than those who didn't smoke at all.

Dr. Sumita Khatri , head of Cleveland Clinic's Asthma Center and board member for the American Lung Association said to CBSNews.com that this study was unique not only because it looked at a large number of subjects, but because it focused on women whereas most smoking studies looked at men. The results however showed that smoking cuts years from your life, regardless if you are a man or a woman.

"Being an advocate for women, we deserve all the same rights as men, but this is one way we don't want to be the same as men," she said.

She said in addition to all the lung problems that smoking causes, it can also affect blood vessels, cause aneurisms in a person's chest and block blood flow, which most people don't realize,

The takeaway from the study is that it's never too late to quit, even if you reach middle years, she pointed out.

"The sooner you quit, the better," she said. "And, also, not smoking at all would be really good."

The study was published online on Oct. 27 in The Lancet.

Article from CBSNews.com - http://www.cbsnews.com/8301-204_162-57541559/women-who-quit-smoking-before-40-may-avoid-earlier-death/

Red wine, minus the alcohol, may lower blood pressure

 

 

 

Doctors have been telling us for years that a glass of red wine at night may be good for our hearts. But they still can't tell us why, exactly.

Does the answer lie in the antioxidants known as polyphenols, which may or may not boost blood-vessel function, improve cholesterol levels, and fight inflammation? Or does alcohol play the more important role?

A small new study may provide a clue. To compare the effect of polyphenols and alcohol on blood pressure, researchers instructed 67 older men at risk for heart disease to consume the same beverage every day for one month at a time: red wine (about two glasses), non-alcoholic red wine, or gin (about two shots).

The daily doses of alcoholic red wine and of gin—which doesn't contain polyphenols—had no discernible effect on blood pressure. By contrast, when the men drank the non-alcoholic red wine, theirsystolic anddiastolic blood pressure fell by an average of 6 and 2 points, respectively, over the course of the month. (Systolic pressure is the top number in a blood pressure reading.)

Health.com: Natural ways to lower blood pressure

Though modest, blood-pressure declines in the same range have been shown to reduce the risk of heart disease and stroke by up to 20%, according to the study, which was published today in the American Heart Association journal Circulation Research.

"Our opinion is that [these] blood pressure-lowering...effects should be attributed to the polyphenols contained in wine," says senior author Dr. Ramon Estruch, M.D., Ph.D., a researcher at the University of Barcelona, in Spain.

"Alcohol," he adds, "seems to counteract the effects of the non-alcoholic fraction in red wine."

Health.com: The worst habits for your heart

The researchers suspect that polyphenols lowered blood pressure by raising blood levels of nitric oxide, which relaxes the arteries and allows blood to circulate more freely. In the study, only non-alcoholic red wine was associated with an increase in nitric oxide levels.

Despite the growing evidence of red wine's heart benefits, doctors generally don't recommend it to their patients because of the hazards associated with alcohol. Non-alcoholic red wine might be an option for people who want to consume polyphenols without the alcohol, Estruch and his colleagues say.

The study, however, left several questions unanswered that will need to be addressed in future research.

It's not clear, for instance, whether the same experiment would produce similar results in healthy people or in women. And the researchers didn't measure the exact polyphenol content of the wines, raising the possibility that some other property of the non-alcoholic wine helped lower blood pressure.

Health.com: The 10 best foods for your heart

Another important drawback is that the researchers measured blood pressure on one day only, at the end of each month-long period, says Dr. Sharonne Hayes, M.D., founder of the Women's Heart Clinic at the Mayo Clinic in Rochester, Minnesota.

"Whether this [effect] would be sustained with longer-term use is unknown," Hayes says.

Copyright Health Magazine 2011

Post by: Amanda Gardner - Health.com Filed under: Health.com • Heart • Living Well

 

Stroke Risk Higher After Bypass Than Angioplasty: Analysis

About 1 in 80 surgery patients, 1 in 300 angioplasty patients have stroke complication, new review shows

By Kathleen Doheny
HealthDay Reporter

MONDAY, Aug. 20 (HealthDay News) -- The potential for a stroke is far more common after a bypass than after angioplasty, new research reports, even though the risk after either heart procedure is still relatively low.

A team of researchers analyzed the results of 19 clinical trials involving nearly 11,000 patients who were assigned randomly to get coronary artery bypass graft surgery (CABG) or angioplasty, also called PCA (percutaneous coronary intervention), a procedure in which a balloon is used to re-open the clogged artery.

"At 30 days, stroke was about four times more common with bypass surgery compared to PCA," said study author Dr. Gregg Stone, a professor of medicine at Columbia University Medical Center in New York City.

Stroke is an important complication to track, Stone noted, adding, "Next to death, it is probably the most feared complication."

The new analysis is published online Aug. 21 in JACC: Cardiovascular Interventions. It will also be published in the Aug. 28 issue of the Journal of the American College of Cardiology.

In bypass surgery, a healthy artery or vein taken from the patient is grafted, or connected, to other arteries in the heart to bypass the blocked vessel. In angioplasty, a catheter is inserted into the vessel to the point of blockage, and then a balloon is inflated to clear it. Sometimes a stent is used to keep open the vessel.

Stone's team looked at the patients' stroke rates 30 days and a year after the procedures.

At 30 days, 1.2 percent of the surgery patients had suffered a stroke, compared with .34 percent of the angioplasty patients. At the one-year mark, 1.83 percent of the surgery patients and .99 percent of the angioplasty patients had had a stroke.

Put another way: "The likelihood of stroke is about 1 in 80 for patients who have surgery and 1 in 300 for patients who have angioplasty," Stone said.

The finding held, he added, even after researchers took into account the extent of disease and other variables.

While some patients clearly need surgery, Stone said, some have disease that could be treated either way. For those patients, he said, the findings about stroke can be weighed into their decision about which treatment to choose.

The study findings echo what cardiologists have long believed, said Dr. Kirk Garratt, director of interventional cardiology at Lenox Hill Hospital in New York City.

In bypass surgery, he said, there is naturally more trauma to the body than there is during angioplasty.

The new analysis, he said, "confirms what has been accepted by cardiologists."

While some patients have the option of either procedure, such as patients with only one or two blockages, surgery is indicated if a patient has multiple blockages, Garratt added.

According to the U.S. Centers for Disease Control and Prevention, hospital discharge data from 2009 shows about 415,000 bypass graft surgeries and 605,000 angioplasties or atherectomy (a similar procedure) were done that year.

More information

To learn more about heart disease, go to the American Heart Association.

SOURCES: Kirk Garratt, M.D., director, interventional cardiology, Lenox Hill Hospital, New York City; Greg Stone, M.D., professor, medicine, Columbia University Medical Center, New York City; Aug. 21, 2012, JACC: Cardiovascular Interventions and Aug. 28, 2012, Journal of the American College of Cardiology

Last Updated: Aug. 20, 2012

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