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.

Learning to love my gums

I did this for a health behaviour challenge (class work). I'm presenting it today and am paranoid I won't be able to load this video... so I'm putting it here just in case!

This doesn't have anything to do with food or nutrition but...
Did you know that flossing could help prevent heart disease? I learned something new!

Preventing a second, or a first, heart attack: Part 3

Eating the right type of fat.

Our dietary fat intake has actually decreased over the years... but heart attack and strokes have increased.

Obviously, fat isn't the enemy and, in fact, including the right type of fat in your diet can help decrease your risk of having a first, or a second, heart attack or stroke.

Unsaturated fats include:

Monounsaturated fat- Olives, olive oil, canola oil, peanut oil, nuts, seeds, natural peanut and seed butters and avocadoes.

Polyunsaturated- Fish and corn, soybean, safflower, sunflower, soybean and cottonseed oils.

Replace the Bad with the Good:

Replacing saturated fats or carbs in your diet with unsaturated fats has been shown to decrease the 'lousy' LDL cholesterol (the one that clogs up your arteries), prevent the increase in triglycerides (the fat that's in your blood) that has been linked to heart disease and that increases with high refined carb intake (sweets, desserts, white bread, white pasta, white rice etc.), reduces the risk of blood clot formation, and decreases erratic heartbeats- the main cause of sudden cardiac death.

Dr. Willett and his team at the Harvard School of Public Health calculated that replacing 5% of calories as saturated fat with unsaturated fat reduces the risk of heart attack by 40%!

Assuming you eat 2000 calories, that would means replacing 11g saturated fat with 11g unsaturated fat.

For example, eat 1 oz nuts (about 1/4 cup) instead of 1/2 cup ice cream or eat 2 Tbsp peanut butter instead of 2Tbsp cream cheese or 1 oz hard cheese.

Speaking of nuts, the Nurses' Health Study, published in the British Medical Journal in 1998, looked at the health of more than 86,000 women. It found that those who ate 142 grams (five ounces) of nuts per week were 35% less likely to develop heart disease than women who ate less than one ounce per week.
The 2002 U.S Physicians Health Study found that men who ate nuts two or more times per week were 47% less likely to die of a heart attack and 30% less likely to die of heart disease than men who rarely ate nuts.

Bottom Line

Make sure that every day you replace some of the saturated fat in your diet- found in animal products like meat, milk products, eggs, lard, shortening and butter- and excess refined carbs with various sources of unsaturated fat, including fish, vegetable oils, nuts, seeds, avocadoes, peanut butter, olives and non-hydrogenated margarine.

Want to read more?

Click here for Part 1
Click here for Part 2

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.

Coconut oil: Good fat or bad fat?

Saturated fat is a bad fat- it increases your "lousy" LDL cholesterol that transports cholesterol to the arteries, causing plaque to form on your artery walls, increasing your risk of a heart attack or stroke.

In general, foods from animals sources contain mostly saturated fat (ie. meat, milk, cheese, butter, lard) whereas foods from plant sources contain mostly unsaturated fats (olive oil, canola oil, nuts, avocadoes).

There is one main exception though: tropical oils. These so-called tropical oils, like palm oil and coconut oil, are mostly saturated. In fact, coconut oil is 92% saturated! As such, it has generally been recommended to limit intake of coconut oil, along with animal fats, to reduce your risk of heart disease.

That said, recent studies have indicated that coconut oil may not be as bad as we had thought.

In a 1995 study, 28 people with high cholesterol followed a diet providing 36% of total calories from fat, 50% of which came from either butter, coconut oil or safflower oil (only about 10% saturated). After 6 weeks, total cholesterol and the "lousy" LDL cholesterol were significantly higher in those on the butter diet compared to the coconut oil diet. The safflower oil diet was associated with significantly lower total cholesterol and LDL cholesterol levels compared to the butter and coconut oil groups. The same researchers confirmed the above results on healthy subjects as well.

Although coconut oil is more saturated, the saturated fat in butter comes from palmitic acid whereas the one in coconut oil comes from lauric acid. Palmitic acid (also the main fat in palm oil) has been found to have a greater negative effect on cholesterol and is therefore more conducive to heart disease than lauric acid.

So... what does this mean?

It means that non-hydrogenated coconut oil can be an alternative to butter or hydrogenated or partially-hydrogenated vegetable oils that are high in trans fats, but it shouldn't replace other more healthful, mainly unsaturted, oils such as olive, canola, soybean, corn, safflower or sunflower oils.

Tomatoes: Lycopene, Cancer & Heart Attacks

Tomatoes are rich in the antioxidant lycopene that's been linked to reduced rates of cancers, especially lung, stomach and prostate cancers.

A study by the Harvard School of Public Health showed that men that ate 10 or more servings of tomato-based foods a week had a 45% reduced prostate cancer rate.

Lycopene is bound inside cell walls, making it difficult for the body to extract it from raw tomatoes. This explains why cooked tomatoes (ie tomato sauce) seem to be more protective than raw tomatoes or tomato juice- the heat seems to release the lycopene.

Lycopene is also fat-soluble so cooking tomatoes in oil (ie. tomato sauce!) enhances the absorption of the antioxidant.

What's causing some confusion is a study conducted at the Ohio State University on about 200 rats (a good model for human prostate cancer, supposedly). Some rats were fed diets containing whole tomato powder and others were fed rat food fortified with pure lycopene (and, consequently, received more lycopene than the tomato powder group). Reserachers caused prostate cancer in these rats.The rats fed the pure lycopene actually had more tumors and a significantly greater risk of death!

What this study suggests is that there seems to be other components in tomatoes that have a protective effect- the whole food is beneficial whereas isolated lycopene may not be.

It seems that tomatoes may also protect the heart. An Itailan study looked at the diets of 507 heart attack victims and of 478 controls- one of the items on the food frequency questionnaire was pizza. Surprisingly, regular pizza eaters (eating about 500g or just over 1/2lbs pizza a week) were 40% less likely to suffer a heart attack than those who never ate pizza!

Maybe the pizza eaters were eating less high saturated fat hamburgers. Remember that real Italian pizzas are not like the North American meat-lovers-pepperoni-3 cheese- stuffed crust ones- they have a thin crust and are dressed with olive oil, a lot of tomato sauce and some cheese. Another possibility that Dr. Schwarcz proposes is that the tomatoes may be responsible: That yellow stuff around the seeds of tomatoes contain flavonoids that have anti-clotting properties... possibly reducing the risk of heart attacks!


Bottom line: Aim to treat yourself to tomatoes, processed tomatoes or tomato products cooked in oil every day. Stay away from lycopene supplements until more research is done.

Red meat linked with death

A study published in March’s Archives of Internal Medicine looked at the meat intake of half a million Americans aged 50-71 for 10 years.

After controlling for age, race, BMI, education, smoking history, alcohol intake, caloric intake, fruit and vegetable intake, vitamin intake, hormone therapy and physical activity, researchers found that the more red meat and processed meat people ate, the higher the mortality risk- in fact, they had a 20-40% increased risk of death. They also had a higher risk of heart disease and cancer.

The participants that ate the most meat were more likely to be of white (non-Hispanic) ethnicity, married, smokers, have a higher BMI, higher caloric, fat and saturated fat intake, have lower education and physical activity levels and lower intakes of fibre, fruits and veggies. Remember, that all these factors were controlled for though.

So, how much meat were they eating? The subjects that are the most meat were eating about 160g red meat or processed meat per day- the equivalent of about a 5 oz steak a day. The ones getting the least meat were eating just under 1 oz a day.

This study adds to what we’ve already known: red meat and processed meat are major sources of saturated fat which have been associated with high blood cholesterol, heart disease and cancer. Meat has also been shown to be a source of cancer-causing agents which are formed during high-temperature cooking. Processed meats also contain carcinogenic nitrosamines.

Since it's pretty clear that eating a diet rich in red meat and processed meat puts your health at risk, try to limit your intake- there are so many delicious vegetarians options available now... try them! Also replace your red meat with beans and lentil-based meals, fish and/or white meat as often as possible.

Vitamin supplements undo benefits of exercise

First, some facts:

Exercise has loads of health benefits including decreasing your risk of insulin resistance and type 2 diabetes by making your body’s cells more sensitive to insulin.

The more sensitive your cells are to insulin, the easier it is for the glucose (sugar) that’s in the foods you eat to get used up by your body. When your cells become insensitive or resistant to insulin, the glucose doesn’t get used up by your body but instead stays floating in your blood, causing high blood sugar. You body cries out for the glucose it needs to function causing your pancreas to over-compensate and produce even more insulin. This combination of insulin-resistance and insulin over-production by the pancreas leads to diabetes and/or obesity, increased risk of heart disease.

Inhaling oxygen produces free radicals. These free radicals attack the body causing you to age and also causes illnesses like heart disease and cancer and, eventually, death. 2-3% of the oxygen consumed by our cells is converted into free radicals.

When we exercise, we use lots of oxygen, increasing free radical production and all the stuff that goes with that.

Antioxidants are those highly publicized substances found in plant foods like fruits and vegetables that neutralize free radicals.That's why eating a diet rich in fruits and vegetables is good for you!

The Study:

It seems logical that taking supplemental antioxidants, like Vitamins C and E, would reduce the harmful effects of the free radicals produced during exercise and promote longer life and better health, right?

That’s what German researchers thought when they decided to observe 40 young healthy men (half were pretty sedentary and half exercised about 6 hours a week)- randomly assigned, half took a combination of 1000mg of vitamin C (btw, the recommended intake is 75mg and 90mg/day for women and men respectively) and 400 IU of vitamin E (recommended intake is 33 IU/d)- these amounts are commonly found in over-the-counter supplements- for 4 weeks while the other half didn’t. Both groups exercised, supervised, 85 minutes a day, five days a week for the 4 weeks of the study (workouts included biking, running and circuit training).

What they Found:

The exercisers NOT taking the antioxidants did have more free radicals floating around in their bodies but had a significant increase in insulin sensitivity (a good thing), as predicted. However, there was no increase in insulin sensitivity in those taking the antioxidants... but there were less free radicals.

It seems that the supplemental antioxidants prevent the health benefits of exercise when it comes to diabetes prevention. According to the authors, the free radicals produced during exercise are actually a good thing as they activate the body’s defense systems against exercise-induced stress, allowing it to use carbohydrates (glucose) more efficiently, thus helping to prevent diabetes and possibly other diseases. Taking supplemental antioxidants blocks this process and therefore health promoting effects of exercise.

Bottom Line:

Antioxidants like Vitamins C and E found in food protect our body from damage and help prevent diseases like cancer- this doesn’t change. However, taking high doses in supplemental form can be harmful.

As I’ve said before, if you're healthy and eat a balanced diet that includes a variety of fruits and vegetables, you don’t need supplements!

Previous blog entries that drive this point home: Vitamin Supplements Can Kill You & Get Rid of your Multivitamin and Eat Real Food!

Diet Myth #1: Fat makes you fat

It's almost summer, time to get bikini-ready, and the perfect time to debunk some of those diet myths!

Nope. Dietary fat does not make you fat.

- Randomized weight loss studies show little net weight change after a year of following a low fat diet- although people on the low fat diets generally lost 2-4 lbs after a few weeks, they also tended to regain that weight while continuing with the diet.

- In European country-to-country surveys , women eating the least amount of fat were the most likely to be obese while those with the higher fat intake were least likely to be so. (For European men, there was no relation between fat intake and obesity).

- In the United States, the gradual reduction of the fat content of the average diet from 40% of total calories to about 33% has been accompanied by a gradual increase in the average weight and a dramatic increase in obesity rates.

Bottom line:

The fat in your diet doesn't make you fat. You gain weight when you eat more calories (whether coming from carbs, protein or fat) than you burn off.
The goal is to cut back on bad fats (saturated and trans fats) and increase good fats (monounsaturated and polyunsaturated fats).

If you're already on a low fat diet, think about replacing some of those carbs with unsaturated fats.

An added benefit of replacing saturated fats and carbs in your diet with unsaturated fats is that your risk of coronary heart disease and stroke will decrease by :

- Lowering your "lousy" LDL cholesterol, - Preventing the increase of your triglycerides (fat in your blood),
- Reducing development of erratic heartbeats, the main cause of sudden cardiac death,
- Reducing the tendency for arterial blood clots to form.