Saltiest Foods in American Diets

by Dr Alex Jimenez | Diets, Fitness

You probably know that Americans consume way too much salt, but a new U.S. government report points the finger at some surprising sources of salt in the diet.

The report said the top 5 culprits were:

Bread.

Pizza.

Sandwiches.

Cold cuts and cured meats.

Soup.

Surprisingly, potato chips, pretzels and other obviously salty snacks didn’t make it into the top five, though they did ring in at number 7.

“Most Americans are consuming too much salt and it’s coming from a lot of commonly consumed foods — about 25 foods contribute the majority of salt,” said lead researcher Zerleen Quader. She’s an analyst from the U.S. Centers for Disease Control and Prevention.

Knowing which foods contribute the most salt is important for reducing your salt intake, she said.

Sodium is an essential mineral that helps the body maintain fluid balance, according to the American Heart Association. But, too much in the diet increases the risk for high blood pressure, which in turn boosts the risk for heart attack and stroke. Table salt contains about 40 percent sodium. One teaspoon of table salt has 2,300 milligrams (mg) of sodium, which is the maximum amount recommended by health experts.

The new CDC report found that in 2013-2014, Americans consumed about 3,400 mg of salt daily. That far exceeds the recommended amount, and is more than double the American Heart Association’s “ideal” intake of 1,500 mg daily.

And, clearly, all that salt doesn’t come from the salt shaker. Most comes from packaged, processed and restaurant foods, the report said.

Many of these foods contain moderate amounts of salt, but are eaten all day long, Quader said. It’s not necessarily that foods such as bread are high in salt, but eating several slices a day quickly adds to the total amount of salt you consume.

One way to reduce salt is to pay attention to food labels when shopping and choose the lowest salt option, Quader suggested.

“When cooking at home, use fresh herbs and other substitutes for salt. When eating out, you can ask for meals with lower salt,” she added.

Quader said the food industry can help by lowering the amount of salt it adds to its products. Gradually reducing salt in foods can help prevent high blood pressure (“hypertension”) and reduce the risk of cardiovascular disease and won’t even be noticed by consumers, she said.

The CDC researchers found that 44 percent of the salt people eat comes from just 10 foods. These include bread made with yeast, pizza, sandwiches, cold cuts and cured meats, soups, burritos and tacos, salted snacks, chicken, cheese, eggs and omelets.

Seventy percent of salt in the diet is from 25 foods, the report said. Some of the foods included in the top 25 are bacon, salad dressing, French fries and cereal, the researchers found.

In addition, 61 percent of the salt consumed daily comes from store-prepared foods and restaurant meals. Restaurants have the saltiest foods, Quader said.

Processed foods not only raise blood pressure, but may also increase the risk for cancer, one nutritionist said.

Samantha Heller is a senior clinical nutritionist at New York University Medical Center in New York City.

“Processed meats such as bologna, ham, bacon and sausage, and hot dogs have been classified as carcinogens by the World Health Organization,” Heller said.

In addition, these and other highly processed foods are huge contributors to the excess salt in the Western diet.

“Parents need to understand that feeding hot dogs, fries, and ham and cheese sandwiches to their kids (and themselves) is significantly increasing their risk for certain cancers, hypertension and heart disease,” Heller said.

Lowering salt in your diet is “as simple and as difficult as cooking at home and using fresh ingredients, as often as possible,” she suggested.

“This can save money and time in the long run, and certainly is better for our health,” Heller said. “It may take some time to re-pattern your shopping and eating habits, but your health is worth it.”

The report was published March 31 in the CDC’s Morbidity and Mortality Weekly Report.

Regular Exercise May Slow Parkinson's Progression

by Dr Alex Jimenez | Diets, Fitness

Parkinson’s disease can cause tremors, stiffness and trouble with walking. But a new study suggests that regular exercise can slow the progression of the disease.

Even those with advanced Parkinson’s can benefit from activity, the study authors said.

The research included more than 3,400 patients in North America, the Netherlands and Israel who were followed for more than two years. During that time, Parkinson’s-related changes in mobility were assessed by timing how long it took patients to rise from a chair, walk about 10 feet, turn and return to a sitting position.

The results were published online recently in the Journal of Parkinson’s Disease.

“We found that people with Parkinson’s disease who maintained exercise 150 minutes per week had a smaller decline in quality of life and mobility over two years compared to people who did not exercise or exercised less,” said lead investigator Miriam Rafferty, of Northwestern University and Rehabilitation Institute of Chicago.

“The smaller decline was significant for people who started the study as regular exercisers, as well as for people who started to exercise 150 minutes per week after their first study-related visit,” she said in a journal news release.

The study didn’t look at what specific types of exercise might be best for people with Parkinson’s disease. But the findings suggest that at least 150 minutes a week of any type of exercise offers benefits.

“People with Parkinson’s disease should feel empowered to find the type of exercise they enjoy, even those with more advanced symptoms,” Rafferty added.

The study also found that people with more advanced Parkinson’s disease saw the greatest benefit from 30-minute-per-week increases in exercise. This finding could prove important in making exercise more accessible to these people. Currently, their increased disability may limit their independent participation in community and group exercise programs, according to the researchers.

“The most important part of the study is that it suggests that people who are not currently achieving recommended levels of exercise could start to exercise today to lessen the declines in quality of life and mobility that can occur with this progressive disease,” Rafferty said.

Are Any Fad Diets Good for Heart Health?

by Dr Alex Jimenez | Diets, Fitness

It may be tempting to latch on to the latest diet fad like juicing or going gluten-free to lose weight or achieve other health goals. But when it comes to heart health, doctors say sticking with old standbys like fruits, veggies and olive oil is still the best approach.

To see what kind of diet patterns might be the most heart healthy, a team of doctors and researchers examined results from more than a dozen previously published nutrition studies. Taken together, all of this evidence shows the best regimen for heart health includes plenty of fruits, vegetables, whole grains and legumes, the study concludes.

“There is a great amount of misinformation about nutrition fads, including antioxidant pills, juicing and gluten-free diets,” said lead study author Dr. Andrew Freeman, director of cardiovascular prevention and wellness in the division of cardiology at National Jewish Health in Denver.

“However, there are number of dietary patterns that have clearly been demonstrated to reduce the risk of many chronic diseases, including coronary heart disease,” Freeman said in a statement. “There is growing consensus that a predominantly plant-based diet that emphasizes green, leafy vegetables, whole grains, legumes and fruit is where the best improvements are seen in heart health.”

Based on the scientific data available, nuts in moderation, extra-virgin olive oil and lean meats can also be part of a heart healthy diet, Freeman and colleagues report in the Journal of the American College of Cardiology.

To help avoid high cholesterol, one risk factor for heart disease, the study authors also recommend skipping or limiting eggs and other oils like coconut and palm oil.

Even though U.S. dietary guidelines released last year removed previous recommendations to limit cholesterol, the current research review still advises against eating too many eggs because they are associated with higher cholesterol levels in the blood.

Coconut oil and palm oil may be trendy, but there isn’t much data to show they’re healthy for routine use, the study also concludes. Olive oil does have proven benefits, but should be consumed in moderation because it’s high in calories.

When it comes to antioxidants, another diet fad, there’s no evidence that supplements can help the heart and some evidence that they may have harmful health effects. But the science does support eating whole fruits and vegetables to get these nutrients.

Juicing, too, may not be as good for the heart as whole fruits and vegetables if people end up drinking too many calories, the researchers note. Juices without added sugar may, however, make sense for people who don’t eat enough fruits and vegetables.

“The problem with juicing is that many individuals who drink these tend to consume more calories from added sugars (fruit, yogurt, milk) than they realize,” Dr. Daniel Rader of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia said by email. He wasn’t involved in the study.

Gluten-free diets that avoid ingredients like wheat, barley and rye are necessary for people with celiac disease or gluten allergies, but don’t have proven benefits for anyone else, the study concludes.

It’s possible that fad diets avoiding gluten without a medical reason to do this might appear to be successful because people who try eating this way to improve their health also do other things that are healthy like getting plenty of exercise and sleep and avoiding smoking and junk food, said Alvaro Hernaez, a researcher at the Hospital del Mar Medical Research Institute in Barcelona.

“They feel better because of the general improvement in their lifestyle habits,” Hernaez, who wasn’t involved in the study, said by email.

Fads diets, especially those that load up on meat or restrict too much food, should be avoided, said Samantha Heller, a nutritionist at New York University Langone Medical Center who wasn’t involved in the study.

“We would all benefit from eating fewer foods that come from animals such as ham, beef, cheese, butter and pork, and eating a lot more plant foods,” Heller said by email.

Marathon Running May Cause Short-Term Kidney Injury

by Dr Alex Jimenez | Diets, Fitness

Any marathoner will tell you that the grueling 26-mile races can do a number on the hips, knees, ankles and feet.

Now, a small study suggests that these tests of endurance are also tough on the kidneys.

“Marathon runners demonstrate transient or reverse short-term kidney injury,” said Dr. Chirag Parikh, professor of medicine at Yale University.

In his study of 22 participants in the 2015 Hartford, Conn. Marathon, Parikh found that 82 percent showed acute kidney injury after the race. In this condition, the kidneys fail to filter waste from the blood.

The good news is that the kidney injury seems to clear up within two days of the race, he said.

“On day 2, they are all fine,” Parikh said.

Runners likely don’t even know they’ve had this transient injury, Parikh said. “For the short term, I don’t think they would notice anything,” he said.

Parikh isn’t certain why the strenuous event is linked with kidney injury. But some potential causes include the sustained rise in core body temperature, dehydration, or the decreased blood flow to the kidneys that occurs during a marathon, he explained.

When the blood is pumped to the skin and muscles while running, he said, the kidneys may not get as much blood as they normally do.

Nor can Parikh say whether the effect might be cumulative, getting worse with more marathons run. It may be that the kidney adapts over time instead, he noted.

To evaluate this type of kidney injury, his team looked at blood and urine samples collected before and after the marathon. These tests included measuring blood creatinine levels and proteins in the urine, along with looking at kidney cells on a microscope. Creatinine is a waste product excreted by the kidneys; measuring it in the blood helps assess kidney health.

In a previous study, published in 2011, Dr. Peter McCullough, vice chief of medicine at Baylor University Medical Center in Dallas, and colleagues evaluated 25 men and women marathoners. They found 40 percent of the runners met the definition of acute kidney injury based on their blood creatinine levels.

In the new study, Parikh’s team also “performed an in depth evaluation of the urine and found evidence of injury,” McCullough said.

“The larger question looming is: do these repeated bouts of injury in endurance athletes lead to chronic kidney disease years later? Can anything be done about the injury at the time including hydration strategy?” McCullough said. More study is crucial, he added.

Parikh said additional research is also needed to assess whether certain people may not recover as quickly. For now, those with a family history of kidney disease should let their physician know they run marathons, he suggested.

Dr. Cathy Fieseler said marathoners who want to reduce their risk of kidney injury should avoid anti-inflammatory drugs before the race. Those drugs include over-the-counter ibuprofen (Advil, Motrin IB) and naproxen (Aleve), Fieseler said. Acetaminophen (Tylenol) is cleared through the liver.

Fieseler is a primary care sports medicine doctor at Christus Trinity Mother Frances Health System in Tyler, Texas. She’s also medical director of the American Running Association.

The study was published March 28 in the American Journal of Kidney Diseases.