Sodium Lowering Tips- Part 1

Here's a video I created (Part 1 of 2) for a class- meant to be for a fictitious website.
The topic is sodium and it stars my classmate and I...
Enjoy! :)

Salt's for Dinner?

We had to create 3 pages for a fictitious website for an assignment- including 3 original pictures and a video.... thought I'd share them here over the next few days!
The topic: Sodium.
This is page 1.
Hope you like it!

Salt’s for Dinner?

The average Canadian is eating too much sodium. Are you?

What’s the difference between salt and sodium?

Salt, or table salt, is made up of the minerals sodium and chloride.

1 teaspoon of salt has 2300 milligrams (mg) of sodium.

Do I need sodium?

Yes. Sodium keeps your blood pressure and water levels in balance in your body. Your muscles and nerves also need sodium to work properly.

How much sodium do I need?

Healthy adults need 1500 mg of sodium per day. Eating more than 2300 mg a day can be harmful to your health.

The average Canadian eats 3100 mg of sodium each day!

Is too much sodium bad for me?

Yes! Even if you’re healthy now, regularly eating too much sodium can lead to high blood pressure, and increase your risk for heart and kidney diseases, and stroke.

Which foods are high in sodium?

80% of your sodium intake comes from processed and packaged foods, not your salt shaker.

Foods like fast food and restaurant meals, canned soups, frozen meals, packaged rice and pasta mixes, and sauces and dressings have sodium.

Even some foods that don’t taste salty, like breads, cereals, and baked goods, may have a lot of sodium.

If I don’t use the salt shaker, could I still be eating too much sodium?

Yes. Only 15% of our daily sodium intake comes from using the salt shaker and adding salt when cooking.

Even if you don’t use your salt shaker, you may be eating too much sodium since many commonly eaten foods are high in sodium.

(sorry- it's not referenced... if you need references, let me know!)

Sodium Hype- Is it justified?

As predicted, sodium has become a major public health issue. In fact, the New York City Health Department just announced their initiative for restaurants and food manufacturers to voluntary reduce sodium in their food by 25% in the next 5 years.

But is the hype justified?

A recap of what we know

The research is clear. Salt increases blood pressure.

BUT

Only about 10-25% of North Americans are salt-sensitive (Another source states that its closer to 50%), meaning that salt will only increase the blood pressure of 10-25% of the population.

The research is also clear: High blood pressure is an important risk factor for heart attacks and strokes.

But wait. Does that mean that salt causes heart attacks and strokes?

That’s the message that’s being thrown out there:

In Ottawa, the Canadian Stroke Network and Blood Pressure Canada teamed up to put ads on buses with the message: Sodium kills 30 Canadians a day.

The Center for Science in the Public Interest (CSPI), a prominent nutrition advocacy group, have been very vocal in associating sodium intake with heart attacks and strokes, stating that a reduction in sodium can save 150,000 lives a year.

Just this week, a study was published in the New England Journal of Medicine stating that reducing salt intake by 1200 mg a day (that’s quite a bit) could prevent up to 66,000 strokes, 120,000 new cases of heart disease, and 92,000 deaths a year.

Sounds good but the thing is, all of these numbers are actually just predictions based on the role of sodium on blood pressure.

Why didn’t they look at the direct role of sodium on heart attacks, stroke or death? Because that data isn't really available.

Review of the research on sodium and heart disease or death

Some fellow students and I decided to do a thorough review of the scientific literature to see if sound research had looked at the role of sodium on death, heart disease or strokes.

What we found was pretty surprising: there are very few studies looking at this direct association; only 4 in the last 10 years, in fact!

And what these 4 studies found wasn’t as clear cut as has been reported:

One study found that the higher the sodium intake, the higher the incidence of heart disease, however, the study had many limitations.

Another study also found that the higher the sodium intake, the higher the incidence of heart disease... but only in overweight people.

Interestingly, two (1,2) studies found that the higher the sodium intake, the lower the incidence of heart disease and death! (so, the lower the sodium intake, the higher the incidence of heart disease and death!)

Clearly, more research needs to be done before directly associating sodium with heart disease.

Update: Turns out that, according to the CSPI, Michael H. Alderman, an author of the aforementioned articles (1,2), is a consultant for the Salt Institute. Click here to read a great piece on the controversy over sodium-and-health papers.

What else do we know?

We know that we’re eating too much salt.

If you’re healthy, you need only 1200-1500mg sodium/day.

The upper tolerable level (the maximum you should eat) is 2300mg/day.

The average North American consumes a whopping 3000-4000mg/day.

80% of this sodium is not coming from the salt-shaker, but is in processed foods.

What does this all mean?

We are, as a population, eating too much salt.

Will a population-wide sodium reduction initiative result in lowering blood pressure? Yes, in some people.

Will a population-wide sodium reduction initiative result in less heart attacks, strokes and death? We really can’t say.

Obviously, it won't harm our health...

But would spending the energy and resources to, instead, focus on initiatives to reduce obesity rates or to make healthy foods more affordable than fast/junk food have a greater, more important, impact on our health?

What do you think?

Sodium-lowering tips

Click Here for some ways you can take matters in your own hands and reduce the sodium in your diet.

The Fun Theory

This is great!



A pilot study in Sweden found that when sedentary people took the stairs for 12 weeks,
their:

• VO2 max (used to measure aerobic capacity) increased by 8.6%,
• Mortality risk decreased by 15%,
• Body fat decreased by 1.7%,
• Waist circumference decreased by 1.8%,
• Diastolic blood pressure decreased by 2.3%, and
• LDL (lousy) cholesterol decreased by 3.9%!
  

Wow.

Visit thefuntheory.com for some more fun.

The Sodium Crisis: A Major Health Concern

A few years ago, there was a huge effort to enlighten the public on the health effects of trans fats.

The result: Mandatory labeling, the removal of trans fats from many products, and entire cities banning trans fats from restaurants.

Looks like sodium's next!

The CSPI has called sodium the “deadliest ingredient in the food supply” and the “forgotten killer”.


Why is Salt Bad?

High sodium intake has been linked with high blood pressure- 1 in 6 people worldwide have high blood pressure, as do 65 million Americans. 45 million more are considered “pre-hypertensive” (between normal and high blood pressure).

Don’t have high blood pressure? Chances are you will. 90% of Americans will. And, even if you don’t have high blood pressure, cutting back on sodium can reduce your chances of getting cardiovascular diseases by 25% and your risk of dying from it by 20%. Same goes for kids!

Eating less salt is also one of the most important ways in preventing heart disease. High sodium intake has also been linked to obesity, stomach cancer, kidney stones, kidney disease, osteoporosis and an increase in asthma symptom severity.


How Much is Too Much?

The WHO recommends we eat less than 2000mg sodium/day whereas US and Canadian guidelines, based on Institute of Medicine recommendations, recommend less than 2300 mg/day, less than 1500mg/day if you have high blood pressure.

In fact, we only need about 1200-1500mg/d. As a reference, 2.5 little pickles contain 1550 mg/day.

We’re eating about double the limit, 3500-4000mg sodium/day... and that’s too much!

Where’s All This Salt?

Believe it or not, the majority of salt isn’t coming from the salt shaker. About 80% of our sodium is coming from processed foods!

Between 1994-2004, sodium in food has increased by 6%.

Packaged foods and restaurant meals are huge sources of salt in the diet. For example, a slice of pizza has about 1770mg sodium. A Denny’s Meat Lover’s breakfast (2 eggs, bacon, 2 sausages, toast and hash browns) has 3460mg sodium!

Hamburgers, pizza, hot dogs and subs are the main source of sodium in the Canadian diet.

Click here to find out what the saltiest restaurant meals in America are!

What’s Happening?

Although the food industry is slowly starting to develop lower sodium in some products- watch the commercial below for Knorr Sidekicks that have reduced sodium by 25% in 22 of their products- it’s not enough.







It’s estimated that 8.5 million worldwide deaths could be avoided over 10 years by adopting public strategies to reduce sodium intake.

The Center for Science in the Public Interest (CSPI) is asking for sodium to be recognized as a food additive rather than GRAS (Genereally Recognized As Safe) in the States, so it could be regulated. They’re also suing the restaurant chain Denny’s for not disclosing the large amount of salt in their food which, according to them, is putting unknowing consumers at a huge health risk. They also want the restaurant chain to post warnings on their menus about the high sodium levels.

Canada’s Sodium Working Group was started in 2007 and is made up science/health professionals (including 2 dietitians!), food industry and NGO representatives as well as government officials. The group plans to come up with a plan to reduce Canadian’s sodium intake in 4 years, a bit too slow for some.

New York City, always a leader in health initiatives (first to ban trans fats in restaurants and implement mandatory menu calorie labelling) has started its own initiative and plan to cut sodium in restaurant foods by 25% in the next 5 years.

Strategies That Work!

Finland, and more recently the UK, should serve as models for Canadians and Americans. Both countries have partnered with the food industry to reduce sodium in products and educate the public through mass media campaigns.

Click here for another great British ad:


Finland started this in the 70s and they’ve seen a drop in sodium intake from 5600mg/d to 3200mg/d! They’ve also seen a huge 70% reduction in stroke and heart attack deaths!

Both countries have also adopted an easy labeling system: green label for low salt, amber for medium salt and red for high salt. The result in the UK: a reduction of 400mg sodium in just 4 years!






More to come on this topic for sure!

Preventing a second, or a first, heart attack: Part 2

The obvious:

If you smoke, quit. Smoking is the single leading cause of heart disease: smokers are 2-3 times more likely to die from a coronary heart disease than non-smokers. Smoking disrupts your heart rhythm, decreases your "Healthy" HDL cholesterol (that gets rid of artery-clogging plaque) and damages your arteries. Smoking also doubles your risk of a second heart attack. Stay away from second-hand smoke too!

Lose weight, if you need to. Lots of studies have shown that BMIs over 25 increase the risk of dying young, mainly from heart disease. Click here to calculate your BMI. An alternative to the BMI is to measure your waist measurement. The more fat you have around your middle, the greater your risk of high blood pressure, high cholesterol, high blood sugar and heart disease. Men should keep their waists circumferences (measured at the belly button) to less than 37 inches or 94 cm, women to less than 31 inches or 80cm. What's your waist circumference?

Exercise regularly. Regular exercise will go a long way in preventing a second heart attack, even if you don't lose weight. Exercise strengthens your heart, increases your "Healthy" HDL cholesterol, decreases your "Lousy" LDL cholesterol (that clogs up your arteries) and also can help prevent depression often associated with a heart attack. A study found that people that have had a heart attack and that increased their physical activity levels were nearly twice as likely to be alive after 7 years compared to those that stayed inactive.

The American Heart Association recommends a minimum of 30 minutes of walking or other moderately vigorous exercise at least five times each week, or 20 minutes of vigorous exercise at least three times each week, along with activities to increase or maintain muscular strength twice a week as well as daily activities like gardening and housework.

Not everybody can tolerate exerise the same way after a heart attack. Talk to your doctor who will probably ask you to do a stress test- your heart is monitored while walking on a treadmill or riding a stationnary bike. Many people participate in a cardiac rehabilitation program after their first heart attack where the heart is monitred during exercise to ensure the intensity is safe.

Take the stairs!

I'm sure that, at some point, you resolved to take the stairs instead of the elevator.

Researchers from the University Hospital of Geneva in Switzerland decided to see what happens when people actually follow through on this resolution.

69 sedentary (less than 2 hrs exercise a week) employees were asked to exclusively take the stairs instead of the elevator for 12 weeks.

The result:

VO2 max (used to measure aerobic capacity) increased by 8.6%.
The mean increase of aerobic capacity corresponds to a 15% decrease in all-cause mortality risk.

Body fat decreased by 1.7%.

Waist circumference decreased by 1.8%.

Diastolic blood pressure decreased by 2.3%.

LDL (lousy) cholesterol decreased by 3.9%.

Although the results of this pilot study need to be confirmed in a larger randomised controlled trial,
maybe these results will motivate you to ditch the elevator...?!

Do you have diabetes and not know it?

Did you know that being over the age of 40 alone puts you at risk for developing Type 2 Diabetes? Everybody over that age should get their blood sugar checked at least every three years.

More than 2 million Canadians and 23.6 million Americans have diabetes but at least a quarter of them don't know it!

Most people diagnosed with diabetes have Type 2 diabetes.

If you're over the age of 40 and have any of the following risk factors, you're at a higher risk of developing diabetes and should have your blood sugar checked earlier and more often:

Overweight or obese,
Have a family history of diabetes,
Are a member of any of the following high-risk ethnic groups: African, Hispanic, Native American/Aboriginal, Asian American and South Asian, Pacific Islander,
Have high blood pressure or high cholesterol,
Had gestational diabetes when you were pregnant,
Gave birth to a baby that weighed more than 9lbs (4kg),
Been diagnosed with polycystic ovary syndrome, acanthosins nigricans or scizophrenia.

Click here to determine your risk for having diabetes.

Symptoms of diabetes include:

Being very thristy,
Having to urinate frequently,
Weight change,
Low energy and fatigue,
Blurred vision,
Recurring infections,
Cuts that take time healing,
Tingling or numb hands and feet,
Trouble getting or maintaining an erection.

If you have any of these symptoms, talk to your doctor.
If diabetes goes undiagnosed and untreated, you have a high risk of having a stroke or heart attack, of organ and nerve damage, of having eye problems than can lead to blindness, gum and mouth disease and skin disorders.

The good news is that all these complications can be avoided with early detection and treatment.

Visit the CDA and the ADA websites for more information and talk to your doctor to schedule your next blood test!

Should you be watching your sodium intake?

Yes!

According to the World Health Organization, hypertension is the leading risk factor for death in the world and according to Blood Pressure Canada, it's the leading risk factor for death in Canada, causing most of the strokes and heart disease. High sodium intake has also been linked to increased severity and frequency of asthma, osteoporosis, stomach cancer, kidney stones and worsening of symptoms and signs of congestive heart failure.

Excess dietary sodium is said to be the cause of hypertension in at least one million Canadians. In Canada today, 46% of women and 38% of men over 60 years of age are taking anti-hypertensive medications.

The average Canadian consumed 3100-3500 mg sodium a day. On average, men consume more sodium than women: 4000 mg/day compared to 2700mg/day (19-30 year olds).

Health Canada and the US National Academy of Sciences (Institute of Medicine) have determined that an adequate intake (an intake you should aim for) is 1200-1500 mg/day of sodium. The research shows that lowering sodium intake to this level could reduce the incidence of stroke and heart disease by as much as 30%.

As the Director of the Canadian Stroke Network points out: “if we discovered that a food additive was causing 30% of all cancers, something would be done right away”.

An intake of 1500mg/day allows for sodium loss in sweat for those that are moderately physically active. Very active people may require a sodium intake that’s a bit higher.

Sodium recommendation by age are:

Age	Sodium Intake per Day (mg)
0-6 months	120
7-12 months	370
1-3 years	1000
4-8 years	1200
9-50 years	1500
50-70 years	1300
>70 years	1200

Tips to help you reduce your sodium intake:

• Read labels. Nutrition Facts table lists the amount of sodium (in milligrams) per one serving of the food. You can also refer to the % Daily Value which compares the amount of sodium in one serving of your product to 2400 milligrams. Generally, foods low in sodium have a % Daily Value of 5% or less.
• Pay attention to serving size. Sodium numbers on a nutrition label are for the serving indicated!
• Use herbs and spices instead of salt when cooking - try garlic, lemon juice, onion, vinegar and herbs. Remove the salt shaker from the table to break the habit of salting food at the table.
• Limit your intake of processed meats such as bologna, ham, sausage, hot dogs, bacon, deli meats, and smoked salmon.
• Limit your use of salty condiments such as bouillon cubes, soy sauce, Worcestershire sauce, soy sauce or bbq sauce.
• Rely less on convenience foods such as canned soups, frozen dinners and packaged rice and pasta mixes.
• Choose lower sodium products.
• Be assertive when dining out. Request that salt not be added and order sauces and dressings on the side so you can control the amount you use.
• Rinse canned food when possible (like canned vegetable, beans, tuna). Research done at Duke University has shown that rinsing vegetables for 1 minute reduced sodium content by 41% and rinsing tuna 1 minute reduced sodium by 76%.

Sources:

Press Releases - Reductions needed in the sodium added to foods http://ww2.heartandstroke.ca/Page.asp?PageID=1613&ContentID=27085&ContentTypeID=1 Oct 25 2007

Sodium Policy – Blood Pressure Canada & Collaborating Organizations ttp://www.dietitians.ca/news/highlights_positions.asp Oct 25 2007

http://www.lesliebeck.com/page.php?id=2437&type=art

Brody, Jane. The Good Food Book: Living the High-Carbohydrate Way. Bantam: 1987.