heart disease

Salt: New Research Says Too Little May Be Unhealthy
Morton Salt

Morton Salt

Salt in the diet is necessary for good health and proper functioning of body processes. Diets consisting largely of unprocessed foods with some added salt for seasoning don’t appear to cause problems; the excess salt problems appear when diets are primarily processed or restaurant food. Since moving away from salty snacks and processed foods like breads, soups, pizza, and fast food both reduces excess salt consumption and has other health benefits, people should still work toward avoiding excess processed and restaurant food.

But the Conventional Wisdom on salt, like on animal fats, was that intake should be reduced as much as possible to lower blood pressure and reduce heart disease. Like many conclusions of past public health medicine, it was based on reduction of a marker for harm caused, not the harm itself — that reducing salt in the diet does reduce blood pressure, and high blood pressure is correlated with heart disease. But there was no real evidence that lowering blood pressure through salt restriction beyond standard dietary levels lowered heart disease or extended lives.

The Wall Street Journal reports on a study which seems to say that too little salt may be as bad as too much, and cause excess deaths due to heart disease and stroke. This is only an association from one urine sampling, and it could easily be true that those who have adopted very low salt diets have done so because their knowledge of pre-existing heart disease issues:

A long-running debate over the merits of eating less salt escalated Wednesday when one of the most comprehensive studies yet suggested cutting back on sodium too much actually poses health hazards.

Current guidelines from U.S. government agencies, the World Health Organization, the American Heart Association and other groups set daily dietary sodium targets between 1,500 and 2,300 milligrams or lower, well below the average U.S. daily consumption of about 3,400 milligrams.

The new study, which tracked more than 100,000 people from 17 countries over an average of more than three years, found that those who consumed fewer than 3,000 milligrams of sodium a day had a 27% higher risk of death or a serious event such as a heart attack or stroke in that period than those whose intake was estimated at 3,000 to 6,000 milligrams. Risk of death or other major events increased with intake above 6,000 milligrams.

The findings, published in the New England Journal of Medicine, are the latest to challenge the benefit of aggressively low sodium targets—especially for generally healthy people. Last year, a report from the Institute of Medicine, which advises Congress on health issues, didn’t find evidence that cutting sodium intake below 2,300 milligrams reduced risk of cardiovascular disease.

The rest of the article reports on the overwhelming evidence that very high salt consumption does lead to heart disease and early death, and the complete lack of a controlled scientific study showing that reducing salt intake as is commonly recommended to below 2300 mg sodium per day has any positive benefits for healthy people.

For more on diet and science-based weight loss:

Getting to Less Than 10% Body Fat Like the Models – Ask Me How!
Starbucks, Jamba Juice Make You Fat
Fat Doesn’t Make You Fat. Government Guidelines Did!
‘Fed Up’ Asks, Are All Calories Equal?
Fructose: The True Villain?
More on “Fed Up”, Sugar Subsidies, and Obesity
Another Study on Diet Drinks
LeBron James Cut Carbs for Lean Look
Why We’re Fat: In-Depth Studies Under Way
Almonds: Superfood, Eat Them Daily for Heart Health
Fish Oil Supplements Ward Off Dementia
More on Diet Drinks: Best Studies Show They Aid Weight Loss
Vani Hari: “Food Babe” and Quack
Cleanses and Detox Diets: Quackery
Sugared Soft Drinks: Health Risk? (and What About Diet Soda?)
Gluten-Free Diets: The Nocebo Effect
Acidic Soft Drinks and Sodas: Demineralization Damages Teeth
Fish and Fish Oil for Better Brain Health
Bulletproof Coffee: Coffee, Oil, and Butter for Breakfast?

Low-Dose Aspirin Reduces Pancreatic Cancer

kirkland-signature-low-dose-tp_3383401300339165283f

Low-dose aspirin therapy — the daily 75 mg aspirin which was commonly recommended to reduce heart disease some years ago, but since found less useful for that purpose unless disease is already present — has been found to greatly reduce the rare but almost always fatal pancreatic cancer, which killed at least two of my friends (so far.)

A study out of Yale (Samantha A. Streicher, Herbert Yu, Lingeng Lu, Mark S. Kidd, and Harvey A. Risch. Case–Control Study of Aspirin Use and Risk of Pancreatic Cancer. Cancer Epidemiology, Biomarkers & Prevention, June 2014 DOI: 10.1158/1055-9965.EPI-13-1284) reports convincing evidence of the protective effect:

Men and women who took low-dose aspirin regularly had 48 percent reduction in their risk for developing pancreatic cancer. Protection against pancreatic cancer ranged from 39 percent reduction in risk for those who took low-dose aspirin for six years or less, to 60 percent reduction in risk for those who took low-dose aspirin for more than 10 years.

“Older studies of aspirin use have been clouded by the use of [regular- or high-dose] aspirin for pain relief from conditions that themselves might be related to the risk for pancreatic cancer. Only recently have people been using low-dose aspirin for long enough times [to prevent cardiovascular disease] that the use might bear on risk of pancreatic cancer development,” explained Risch.

“There seems to be enough evidence that people who are considering aspirin use to reduce the risk for cardiovascular disease can feel positive that their use might also lower their risk for pancreatic cancer, and quite certainly wouldn’t raise it,” Risch added.

Study subjects were recruited from the 30 general hospitals in Connecticut between 2005 and 2009. There were 362 pancreatic cancer cases and 690 controls. Study subjects were interviewed in person to determine when they started using aspirin, the number of years they used aspirin, the type of aspirin they used (low versus regular dose), and when they stopped using aspirin, among other things. Confounding factors, including body mass index, smoking history, and history of diabetes, were taken into account.

Of the study participants, 57 percent were men, about 92 percent were non-Hispanic white, about 49 percent were former or current smokers, and 19 percent had been diagnosed with diabetes within the three years prior to this study.

A dose of 75 to 325 mg of aspirin per day was considered as low-dose aspirin (usually taken for heart-disease prevention), and a dose higher than that, generally taken every four to six hours, was considered as regular-dose aspirin taken for pain or anti-inflammation purposes.

Of the participants, 96 percent of low-dose aspirin users and 92 percent of regular-dose aspirin users reported daily aspirin use.

The earlier a person started regularly taking low-dose aspirin, the greater the pancreatic cancer risk reduction, ranging from 48 percent reduction in those who started three years before the study, to 60 percent in those who started taking it 20 years before the study. On the other hand, discontinuation of aspirin use within two years prior to the study was associated with a threefold increased risk for pancreatic cancer compared with continuing use.

As usual, this study proves an association but not causality: it may be that those people who followed a low-dose aspirin regimen had other health habits that were protective. But absent a true controlled study of long-term use, this will have to do.

Low-dose aspirin (75 mg/day) also is associated with reductions in bowel cancers and probably other cancers, while side-effects may include increased bleeding. But it appears on the whole beneficial for older people generally, especially if they have early-stage heart disease.

Getting to Less Than 10% Body Fat Like the Models – Ask Me How!
Daily Aspirin Regimen Reduces Cancer Rates
Almonds: Superfood, Eat Them Daily for Heart Health
Fish Oil Supplements Ward Off Dementia
Lower Back Pain: Acetaminophen (Tylenol, Paracetamol) Useless
Cleanses and Detox Diets: Quackery
Gluten-Free Diets: The Nocebo Effect
Scams: Multi-Level Marketing, Herbalife
Fish and Fish Oil for Better Brain Health
Vitamin D: Anti-Dementia?
Salt: New Research Says Too Little May Be Unhealthy

Fat Doesn’t Make You Fat. Government Guidelines Did!

FalselyBlamedCow

Not entirely, but the FDA’s “food pyramid” played a role in changing diets away from meat and animal fats and toward carbs — sugars and grains — that did result in the fat and unhealthy average citizen of today.

The Wall Street Journal’s Saturday Essay, “The Questionable Link Between Saturated Fat and Heart Disease: Are butter, cheese and steak really bad for you? The dubious science behind the anti-fat crusade,” just recaps what alert people already know: animal fat is not especially harmful in moderation, while we know substitutes (cheap carbs and starches) are:

“Saturated fat does not cause heart disease”—or so concluded a big study published in March in the journal Annals of Internal Medicine. How could this be? The very cornerstone of dietary advice for generations has been that the saturated fats in butter, cheese and red meat should be avoided because they clog our arteries. For many diet-conscious Americans, it is simply second nature to opt for chicken over sirloin, canola oil over butter.

The new study’s conclusion shouldn’t surprise anyone familiar with modern nutritional science, however. The fact is, there has never been solid evidence for the idea that these fats cause disease. We only believe this to be the case because nutrition policy has been derailed over the past half-century by a mixture of personal ambition, bad science, politics and bias.

Our distrust of saturated fat can be traced back to the 1950s, to a man named Ancel Benjamin Keys, a scientist at the University of Minnesota. Dr. Keys was formidably persuasive and, through sheer force of will, rose to the top of the nutrition world—even gracing the cover of Time magazine—for relentlessly championing the idea that saturated fats raise cholesterol and, as a result, cause heart attacks.

Critics have pointed out that Dr. Keys violated several basic scientific norms in his study…. But there was no turning back: Too much institutional energy and research money had already been spent trying to prove Dr. Keys’s hypothesis. A bias in its favor had grown so strong that the idea just started to seem like common sense. As Harvard nutrition professor Mark Hegsted said in 1977, after successfully persuading the U.S. Senate to recommend Dr. Keys’s diet for the entire nation, the question wasn’t whether Americans should change their diets, but why not? Important benefits could be expected, he argued. And the risks? “None can be identified,” he said.

In fact, even back then, other scientists were warning about the diet’s potential unintended consequences. Today, we are dealing with the reality that these have come to pass.

One consequence is that in cutting back on fats, we are now eating a lot more carbohydrates—at least 25% more since the early 1970s. Consumption of saturated fat, meanwhile, has dropped by 11%, according to the best available government data. Translation: Instead of meat, eggs and cheese, we’re eating more pasta, grains, fruit and starchy vegetables such as potatoes. Even seemingly healthy low-fat foods, such as yogurt, are stealth carb-delivery systems, since removing the fat often requires the addition of fillers to make up for lost texture—and these are usually carbohydrate-based.

The problem is that carbohydrates break down into glucose, which causes the body to release insulin—a hormone that is fantastically efficient at storing fat. Meanwhile, fructose, the main sugar in fruit, causes the liver to generate triglycerides and other lipids in the blood that are altogether bad news. Excessive carbohydrates lead not only to obesity but also, over time, to Type 2 diabetes and, very likely, heart disease.

The real surprise is that, according to the best science to date, people put themselves at higher risk for these conditions no matter what kind of carbohydrates they eat. Yes, even unrefined carbs. Too much whole-grain oatmeal for breakfast and whole-grain pasta for dinner, with fruit snacks in between, add up to a less healthy diet than one of eggs and bacon, followed by fish. The reality is that fat doesn’t make you fat or diabetic. Scientific investigations going back to the 1950s suggest that actually, carbs do….

Seeing the U.S. population grow sicker and fatter while adhering to official dietary guidelines has put nutrition authorities in an awkward position. Recently, the response of many researchers has been to blame “Big Food” for bombarding Americans with sugar-laden products. No doubt these are bad for us, but it is also fair to say that the food industry has simply been responding to the dietary guidelines issued by the AHA and USDA, which have encouraged high-carbohydrate diets and until quite recently said next to nothing about the need to limit sugar.

Indeed, up until 1999, the AHA was still advising Americans to reach for “soft drinks,” and in 2001, the group was still recommending snacks of “gum-drops” and “hard candies made primarily with sugar” to avoid fatty foods.

Read the whole thing — some very interesting material on the health hazards of vegetable oils in high heat and the flaws of many “scientific” studies of diet, plus a special blindness toward women’s heart disease issues.

Further discussion in the comments at Althouse.

And let me plug again Gary Taubes’ Why We Gat Fat: And What to Do About It, a thorough and detailed look at the science of minimizing fat: Recommended.

For more on diet and weight loss:

Getting to Less Than 10% Body Fat Like the Models – Ask Me How!
Starbucks, Jamba Juice Make You Fat
‘Fed Up’ Asks, Are All Calories Equal?
Fructose: The True Villain?
More on “Fed Up”, Sugar Subsidies, and Obesity
Another Study on Diet Drinks
LeBron James Cut Carbs for Lean Look
Why We’re Fat: In-Depth Studies Under Way
Almonds: Superfood, Eat Them Daily for Heart Health
Fish Oil Supplements Ward Off Dementia
More on Diet Drinks: Best Studies Show They Aid Weight Loss
Vani Hari: “Food Babe” and Quack
Cleanses and Detox Diets: Quackery
Sugared Soft Drinks: Health Risk? (and What About Diet Soda?)
Gluten-Free Diets: The Nocebo Effect
Acidic Soft Drinks and Sodas: Demineralization Damages Teeth
Fish and Fish Oil for Better Brain Health
Salt: New Research Says Too Little May Be Unhealthy
Bulletproof Coffee: Coffee, Oil, and Butter for Breakfast?