THE SODIUM DILEMMA-HOW LOW IS LOW ENOUGH?

Salt is considered a dirty word till recently and it constituted along with sugar and fat the infamous triumvirate of unhealthy food constituents to be shunned to maintain good health and good quality life. All three are implicated in heart diseases when consumed in excess. Of these, salt, if consumed at uncontrolled levels is supposed to raise blood pressure consequences of which include heart failure, stroke and kidney failure. The moot question is, at what level of consumption it becomes excess? The recommended level of salt consumption was progressively reduced during the last few years and to day many health pundits say that man should not consume more than half teaspoon of salt daily, working out to about 1500 mg of sodium equivalent!. Billions of dollars are being pumped to take up campaigns to persuade people to bring down salt intake and many awareness programs to educate them. Now comes the news that mindless reduction of salt can be injurious to health and a healthy person must take salt that will supply 3000 to 7000 mg of sodium per day through the diet and outside this range man is vulnerable to heart disease! Here is a take on this latest finding that throws the current perception out of the window! 

The United States dietary guidelines, based on the 2005 Institute of Medicine report, recommend that the general population aim for sodium levels of 1,500 to 2,300 milligrams a day because those levels will not raise blood pressure. The average sodium consumption in the United States, and around the world, is about 3,400 milligrams a day, according to the Institute of Medicine — an amount that has not changed in decades. But more recently, researchers began looking at the actual consequences of various levels of salt consumption, as found in rates of heart attacks, strokes and death, not just blood pressure readings. Some of what they found was troubling. One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths — 15 as compared with 6 in the higher-salt group. Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day. There are physiological consequences of consuming little sodium, said Dr. Michael H. Alderman, a dietary sodium expert at Albert Einstein College of Medicine who was not a member of the committee. As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. Each of these factors can increase the risk of heart disease.

It is terrible to imagine that during the last one decade how many lives might have been lost due to sodium insufficiency across the world because of the current misconception and ceaseless salt "bashing". Besides causing heart disease low sodium is also reported to be contributing to increased fat build up and diabetes with other serious consequences. A look back on the salt consumption levels of human beings reveal the predominance of salt in products like pickles, saurkrauts, cured meat, dried fish etc and there were no reports of adverse consequences of high salt intake among them. It is after the explosive development of processed food industry during the last 2-3 decades that there were spurts of incidences of heart disease and other life style health disorders and as the proportion of processed foods in daily diet increased, the on-slaught of the the above diseases also gained momentum assuming epidemic proportion.   

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com

HDL CHOLESTEROL BENEFITS UNDER THE SCANNER-A PERPLEXING SCENARIO

Cholesterol is a dreaded word for many people because of its perceived association with atherosclerosis and heart attack.  Some people are aware of the differentiation between High Density Lipoproteins (HDL) and Low Density Lipoproteins (LDL). Lay man recognizes HDL as good cholesterol and LDL as its bad cousin, with the latter causing heart disease. Even many physicians advise their clients to work for increasing the HDL level as high as possible imagining that it can protect the heart. There are millions of dollars of investment riding on the above hypothesis to develop drugs that can boost HDL levels in the blood though no appreciable success has yet been achieved. Against such a background comes an earth shaking finding that a high HDL level need not be a guarantee against heart disease and those with high HDL inherited genetically cannot be considered as less prone to heart attack. Here is a take on this new revelation which seems to have turned the clock back regarding the current knowledge about the role of lipo proteins on human health.   

"Now, a new study that makes use of powerful databases of genetic information has found that raising HDL levels may not make any difference to heart disease risk. People who inherit genes that give them naturally higher HDL levels throughout life have no less heart disease than those who inherit genes that give them slightly lower levels. If HDL were protective, those with genes causing higher levels should have had less heart disease. Researchers not associated with the study, published online Wednesday in The Lancet, found the results compelling and disturbing. Companies are actively developing and testing drugs that raise HDL, although three recent studies of such treatments have failed. And patients with low HDL levels are often told to try to raise them by exercising or dieting or even by taking niacin, which raised HDL but failed to lower heart disease risk in a recent clinical trial. "I'd say the HDL hypothesis is on the ropes right now," said Dr. James A. de Lemos, a professor at the University of Texas Southwestern Medical Center, who was not involved in the study. Dr. Michael Lauer, director of the division of cardiovascular sciences at the National Heart, Lung and Blood Institute, agreed. "The current study tells us that when it comes to HDL we should seriously consider going back to the drawing board, in this case meaning back to the laboratory," said Dr. Lauer, who also was not connected to the research. "We need to encourage basic laboratory scientists to figure out where HDL fits in the puzzle — just what exactly is it a marker for." But Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, who is helping conduct studies of HDL-raising drugs, said he remained hopeful. HDL is complex, he said, and it is possible that some types of HDL molecules might in fact protect against heart disease".

The million dollar question is whether high HDL level in blood is maintained due to good health or lower level of HDL heralds changes that lead to heart associated problems. It looks like HDL may not be a sure marker any more for insurance against heart disease while LDL certainly is a marker for bad health. Probably the present approach to cholesterol management will undergo dramatic changes if the above findings are confirmed by future studies. One question that naturally arises out of this development is whether the multi billion dollar Statin drug industry is going to be adversely affected. According to the authors of the above study, it is always healthy if LDL levels are controlled and those who cannot reduce the same will have to resort to drug intervention using Statins.

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com