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

 

 

Study Shows that the Whooping Cough Vaccine May Become Less Effective Over Time

Vaccination is a hot topic in today’s world.  It is often a debated and changing subject.  Vaccination is proven to safeguard children against diseases such as whooping cough, but new research has shown that the vaccine may become less effective over time. 

A recent outbreak of whooping cough, also known as pertussis, was in California in 2010.  The outbreak sickened more than 9,000 people and left 10 infants dead.  This outbreak is what compelled an examination into the effectiveness of the vaccine.  The study found that the vaccine is effective, but it does become less effective over time, especially leaving children 7 to 10 years old vulnerable.

Lara Misegades, an epidemiologist at the US Centers for Disease Control and Prevention in Atlanta said, “The pertussis vaccine is our best protection against disease.”  Misegades also said, “We found that unvaccinated children were eight times more likely to be a pertussis case than vaccinated children.  Parents should ensure children complete the childhood series and make sure your children get the adolescent booster too.”

Just this year alone, the US has had more than 36,000 whooping cough cases have been reported.  There were 16 deaths, mainly in infants younger than 3 months old, according to the CDC.

"We're continuing to evaluate the changing epidemiology [of pertussis], but it's too early to speculate if there's a need for an additional booster," Misegades said.

The results of the study are available in the November 28^th issue of the Journal of American Medical Association.

The vaccine is commonly referred to as the DTaP vaccine.  It also includes immunizations for diphtheria and tetanus.  The vaccine is a 5 dose series that are administered at age 2 months, 2 months, 6 months, 15 months and between 4 and 6 years old. The CDC recommends a booster at the age of 11 or 12.

The research study was intended to evaluate how much time had elapsed since the last DTaP vaccination and the development of whooping cough in the patients in the California outbreak, which was the largest state outbreak in 60 years.

Included in the data for the study were 15 counties in California with a high incidence of pertussis cases.  A total of 682 children with ages ranging from 4 to 10 years old who developed pertussis were included and for each child in the this group, three children of the same age that did not have pertussis were also included for comparison.

The study found that in comparison to the controls, the children who had contracted pertussis were 89% less likely to have received all the recommended doses of the vaccine. Those children that developed the disease were more likely to be unvaccinated than those that did not have the disease 7.8% versus 0.9%.  The researchers also found that the vaccine became less effective with the more time that had passed.  

"Within the first few years, the vaccine's efficacy was around 98 percent," Misegades said. "Five or more years out, the vaccine effectiveness had dropped to about 71 percent."

The study also showed that the highest incidence of disease occurred in 7 to 10 year old children and that the incidence increased with age.  For example, about 3% of the cases occurred in 4 year olds and 31% of the cases were found in 10 year olds.  The current vaccine available is an acellular vaccine; it does not contain whole cells of the bacterium that is responsible for whooping cough infections.  The previous version of the vaccine did contain whole cells of the bacterium; however it was more likely to cause side effects, according to researchers.

The switch to the newer vaccine may explain the reemergence of pertussis, according to the editorial by Dr. Eugene Shapiro, accompanying the journal article.  Dr. Kenneth Bromberg, director of the Vaccine Study Center at the Brooklyn Hospital in New York City, agreed that the previous whole-cell vaccine might have been more effective than the current vaccine, but he pointed out that the whole-call vaccine did have production issues, including batch effectiveness variance. He also said that the components of the whole-cellular vaccine may have been the reason for the risk of side-effects.

The take-home message for parents, according to Bromberg is, “"the vaccine works. It's effective, so make sure everyone is appropriately vaccinated according to the current schedule." "We'll have to wait for further study to [determine if the current dosing schedule needs change]," he said. "Parents should stay tuned as to whether we recommend additional vaccinations for pertussis."

To learn more about pertussis, visit http://www.cdc.gov/pertussis/vaccines.html.

 

Adapted from: http://health.usnews.com/health-news/news/articles/2012/11/27/whooping-cough-vaccine-less-effective-over-time-study.