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Global Sodium Consumption & Death from Cardiovascular Causes

Global Sodium Consumption & Death from Cardiovascular Causes | Heart and Vascular Health | Scoop.it

High sodium intake increases blood pressure, a risk factor for cardiovascular disease, but the effects of sodium intake on global cardiovascular mortality are uncertain.

In 2010, the estimated mean level of global sodium consumption was 3.95 g/ day, and regional mean levels ranged from 2.18 to 5.51 g/day. Globally, 1.65 million annual deaths from cardiovascular causes were attributed to sodium intake above the reference level; 61.9% of these deaths occurred in men and 38.1% occurred in women. These deaths accounted for nearly 1 of every 10 deaths from cardiovascular causes (9.5%). Four of every 5 deaths (84.3%) occurred in low- and middle-income countries, and 2 of every 5 deaths (40.4%) were premature (before 70 years of age). 

In this modeling study, 1.65 million deaths from cardiovascular causes that occurred in 2010 were attributed to sodium consumption above a reference level of 2.0 g per day.

Seth Bilazarian, MD's insight:

Nice multimedia presentation of the current data on salt and cardiovascular disease from NEJM editors.

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Salt in the Diet

Salt in the Diet | Heart and Vascular Health | Scoop.it

Table salt is made up of a chemical compound called sodium chloride. The sodium portion of salt is responsible for its health concerns. High sodium intake is linked to high blood pressure, which is known to cause strokes and heart attacks. The Dietary Guidelines for Americans from the US government recommend that adults eat no more than 2300 milligrams (mg) of sodium a day—about 1 teaspoon of salt. Furthermore, for about half of all Americans—those aged 51 years or older, African Americans of any age, and people with high blood pressure, diabetes, or chronic kidney disease—the recommended maximum intake of sodium is 1500 mg a day. Currently, in spite of these recommendations, US adults consume an average of 3400 mg of sodium a day.

Seth Bilazarian, MD's insight:
WHAT SHOULD YOU DO? Eat salt in moderation. Most salt in the diet is “invisible” and is contained in processed and restaurant foods. Therefore, salt intake can be decreased by eating out less often (especially at fast-food restaurants) and eating less prepared or packaged foods. If you do eat out, you can ask to have your meal prepared with less salt. Reading labels on prepared foods to look for sodium content per serving also helps. It is generally healthier to cook using fresh foods rather than buying already prepared or packaged foods.
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Change your salty ways in only 21 days from AHA

Change your salty ways in only 21 days from AHA | Heart and Vascular Health | Scoop.it

the everyday meal offender that might make your face feel puffy and your jeans look, and feel, tighter.  Did you know that by reducing your sodium intake during a three week period you can change your sodium palate and start enjoying foods with less sodium?  On Jan. 7, step up to the plate, re-charge your taste buds and give your heart-health a boost with the new Sodium Swap Challenge from the American Heart Association/American Stroke Association. 

Seth Bilazarian, MD's insight:
Here’s an outline of how you can kick-off your own Sodium Swap Challenge: -          Week 1 – Start by tackling your consumption of breads and rolls as well as cold cuts and cured meats.  For example, one piece of bread can have as much as 230 milligrams of sodium while a serving of turkey cold cuts could contain as much as 1,050 milligrams of sodium.  When your recommended daily intake is kept to 1,500 milligrams or less, it’s amazing how fast it all adds up.  Check your labels on these items, look for lower sodium items and track your sodium consumption each day and log how much you’ve shaved out of your diet. Portion control does make a difference.  Foods eaten several times a day add up to a lot of sodium, even though each serving is not high. -          Week 2 – Keep that momentum going!  This week’s foods include pizza and poultry.  If you’re going to eat pizza, try to aim for one with less cheese and meats or lower sodium versions of these items or try something different and add veggies instead.  When cooking for your family this week use fresh, skinless poultry that is not enhanced with sodium solution rather than fried or processed.  Keep your eyes on the 1,500 milligrams of sodium each day and, again, log your results. -          Week 3 – As you round out your challenge and embark on the last week of your challenge, your focus includes soups and sandwiches.  The two together typically make a tasty lunch or dinner duo, but one cup of chicken noodle or tomato soup may have up to 940 milligrams – it varies by brand --and, after you add all of your meats, cheeses and condiments to your sandwich, you can easily surpass  1,500 milligrams in one day.  This week, when choosing a soup, check the label and try lower sodium varieties of your favorites and make your sandwiches with lower sodium meats and cheeses and try to eliminate piling on your condiments.  Be sure to track your sodium and try to keep your daily consumption to less than 1,500 milligrams.
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Open Season on Salt: What the Science on Hypertension Really Shows

Open Season on Salt: What the Science on Hypertension Really Shows | Heart and Vascular Health | Scoop.it

My comment:  This article does a good job explaing that the short term risk of high salt intake is being exaggerated in kids. BUT as an adult cardiologist I can attest to many patients who strugle with this in their mid life.  By acquiring a taste (and compulsion) for salty foods may patients suffer lasting and difficult consequences on the  cardiovascular system including congrestive heart failure and kidney disease.  Changing their taste buds is often a major challenge for disease management becasue of what has been learned early in life

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The latest news reports about salt are enough to make a parent ponder a household ban on pizza and cold cuts. A study published last week in Pediatrics found that children eat, on average, 3.4 grams of sodium daily—more than twice the amount recommended for adults by the Institute of Medicine.

 

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The Soup Can Quiz; 60 seconds of nutritional teaching

The Soup Can Quiz; 60 seconds of nutritional teaching | Heart and Vascular Health | Scoop.it
Seth Bilazarian, MD's insight:

For the last several months I have made it a practice to do the "Soup Can Quiz" with my congestive heart failure patients.  I use the can pictured. All the patients acknowledge that they have heard that they should avoid salt, but after that the knowledge deficits rise quickly.

Patients (almost universally) tell me they don't us ANY salt.

 

What I hear from my older patients who need salt restriction:

1.  "Can't read the label - too small"

2.  "Are you promoting it for sale?:

3.  "Salt isn't listed on the nutrition label"

4.  "The can has a heart on it and says "healthy" so it's ok"

5.  Once prompted about sodium on the label - I ask "knowing that you are supposed to limit yourself to 2000 mg of sodium per day, how much sodium is there if you have this can of soup", I hear....

    -  410 mg - I explain that it is not correct since the servings per container is 2.5 so having the can would be closer to 1000 mg for the whole can.

     - some patients say - "so that means I can have 2 cans"

 

Getting patients to understand that the consequences of exceeding salt recommendations has more immediate consequences such as hospitalization for congestive heart failure and is different than not adhering to a diabetic diet, or strategies for weight loss because consequences for those problems are not as immediate or short term.  The effort has been instructive for me and has helped move patients along the health literacy curve a little bit with the hope of reducing CHF admissions and readmissions.

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Cut Salt, Save 500,000 U.S. Lives Over a Decade, Study Finds

Cut Salt, Save 500,000 U.S. Lives Over a Decade, Study Finds | Heart and Vascular Health | Scoop.it

Reducing salt in Americans' diets would save hundreds of thousands of lives over 10 years, according to a new study.

Excess salt, the primary source of sodium, contributes to high blood pressure and cardiovascular disease, the leading killer in the United States.

Immediately reducing people's salt consumption from current levels to the upper limit of the U.S. government guideline -- 2,300 milligrams a day -- would save 500,000 to 850,000 lives over the next decade, largely by reducing heart attacks and strokes, the study found.

Gradually reducing sodium levels in processed or restaurant foods by 4 percent a year for 10 years would still save 280,000 to 500,000 lives over a decade, the researchers concluded.

The average American consumes about 3,500 mg per day, and men tend to ingest much more than that, according to the study, which was published Feb. 11 in the journalHypertension.

Seth Bilazarian, MD's insight:

Saving 50,000 lives per year is pretty significant since there would also be a reduction in people living with diseases like stroke and heart attack and the associated disabilities.

To put this in perspective in the current debate about guns.

Guns are responsible for roughly 30,000 deaths a year in America; more than half of those deaths are suicides. In 2010, 606 people, 62 of them children younger than 15, died in accidental shootings.

from Atlantic http://goo.gl/itytZ ;

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Where the Salt Lurks on Restaurant Menus

Where the Salt Lurks on Restaurant Menus | Heart and Vascular Health | Scoop.it

American adults eat in restaurants an average of five times a week—which means they probably eat way too much salt. Even fine-dining menus offer little escape from sodium overload.

Starting with the bread and salad and ending with the final plate of tiny cookies, many of restaurants' least salty-seeming options are significant sources of dietary salt.

Seth Bilazarian, MD's insight:

From WSJ: More Taste, Less Sodium

Chef Jeremy Bearman's Fresh Herb Tagliatelle with Maine Lobster has 690 milligrams of sodium—far less than the 1,600 milligrams or more found in a typical serving of traditional pasta and shrimp in tomato sauce.

About 60% of the sodium comes from the lobster itself. Colorful vegetables—leek, fennel, broccoli—provide sensory appeal and potassium to balance the lobster's saltiness.Housemade pasta is flavored with saffron but not salt, rolled with fresh herbs and cooked in unsalted water.Minimally salted pasta sauce begins with unsalted fennel stock. It contains leek purée made with saffron, lobster oil, lemon juice, Espellete pepper powder and a pinch of salt.Lobster oil is made by roasting lobster shells with tomato, white wine, chili flake, peppercorns, tarragon, carrot, celery and onion and then steeping them in olive oil.A squeeze of fresh lemon adds bright flavor.
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