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No Association Between Salt And Blood Pressure, Study Finds

• lincolnq 12y ago
  The state of nutrition science is pathetic. The science is conflicted over a simple question of fact -- whether or not a trivially measurable short-term effect occurs when you eat one of the most common food additives in the world. If we can't even answer THIS -- it seems like it should be incredibly easy to answer -- I don't see why people can claim anything at all about diets and macronutrients. Nutrition science needs a fundamental breakthrough and I don't know where it's going to come from but I desperately hope it happens quickly. Because a lot of people are suffering and dying of poor nutrition and we don't know basic things about what's good and bad for us.
  • bronbron 12y ago
    > we don't know basic things about what's good and bad for us. Errr, I think we know these 'basic' things quite fine. Energy burned needs to be >= energy taken in. It's just complicated for other reasons. There are a lot of incentives to stay unhealthy. There're the biological incentives (eating a shitload and packing on a few pounds is good if you're in the jungle and might not eat again for a few weeks), and the incredible cultural pressures that prey on those biological incentives (taco bell spends a lot of money to encourage you to make bad health decisions). Salt, cholesterol, fat, carbs - these are distractions from being healthy. People who eat healthy amounts of reasonable food (although even then, there's that guy who ate twinkies for a year and managed to lose weight by keeping his calories in check) rarely suffer from poor nutrition. Yeah, everyone knows that guy who was a vegan and ran every day for 40 years and keeled over at 45 from a heart problem. He's the exception.
    • DougWebb 12y ago
      Energy burned needs to be >= energy taken in. Neither of which have any direct or consistent correlation to physical activity or food consumed. And that's the problem; everyone's body responds differently to a host of factors, and we don't understand the factors or the responses.
      • bronbron 12y ago
        Not to sound like a dick, but: > Neither of which have any direct or consistent correlation to physical activity or food consumed. is almost always bullshit. People who truthfully track their calories and err on the side of caution (did I eat 1 cup of yogurt or 1.5?) rarely end up surprised. Sure, some people have thyroid conditions. If you do, you're the minority and you should get it treated. Otherwise, your body is pretty much the same as everyone else's with respect to metabolic rates (when age is factored in).
        • pessimizer 12y ago
          Nutrition isn't exclusively (or even primarily) about weight loss. To say that all of the health effects from everything we consume are well known and settled is silly. edit: I shouldn't even say "health" effects; just systemic effects period. Not only is nutrition not exclusively about weight loss, it isn't even about self-improvement. Rather, it's about a basic understanding of the construction and functioning of the human body.
          • bronbron 12y ago
            > Nutrition isn't exclusively (or even primarily) about weight loss. Maintaining a healthy weight is the primary health problem for the vast majority of people concerned about their personal nutrition.
            • lukeschlather 12y ago
              Keeping weight low is the primary metric that people currently track and associate with their health, but that doesn't mean weight is the primary problem, just that people think it is.
              • bronbron 12y ago
                > Keeping weight low is the primary metric that people currently track and associate with their health, but that doesn't mean weight is the primary problem, just that people think it is. It absolutely is the primary problem for most people concerned with nutritional issues in developed nations. Obesity (which is quickly becoming the epidemic it's made out to be) carries all sorts of nasty side-effects that are well documented.
    • superuser2 12y ago
      Except that energy burned is not by any means a 1:1 correlation with exercised performed. We are inefficient machines, and our efficiency characteristics vary wildly in ways we don't fully understand. Two people consuming the same quantity of energy and exerting the same number of joules on exercise equipment do not see identical or even necessarily related physiological effects. There are many, many factors - other nutrients, genetics, timing, the distribution of work over time (short intense exercise vs. long less intense exercise, etc.) and they all matter. There are skinny people who have never been inside a gym. There are fat people who work harder than you. Obviously you can still influence your outcomes, but "energy out >= energy in" is a gross oversimplification.
      • bronbron 12y ago
        > Except that energy burned is not by any means a 1:1 correlation with exercised performed. We are inefficient machines, and our efficiency characteristics vary wildly in ways we don't fully understand. Your basal metabolic rate is not much different from the guy next to you of similar age and weight, barring some extremely rare circumstance. I don't know what to tell you, other than that. > Two people consuming the same quantity of energy and exerting the same number of joules on exercise equipment do not see identical or even necessarily related physiological effects. There are many, many factors - other nutrients, genetics, timing, the distribution of work over time (short intense exercise vs. long less intense exercise, etc.) and they all matter. Exercise is probably the least important part in proper weight maintenance, because of all the reasons you listed. Most people promoting the 'calories calories calories' mantra will tell you the exact same thing. Your diet, and specifically how much you're consuming (regardless of carbs/fats/salt/etc.) is critical, the rest is secondary. > There are skinny people who have never been inside a gym. There are fat people who work harder than you. Obviously you can still influence your outcomes, but "energy out >= energy in" is a gross oversimplification. Not really. Those skinny people are eating less (in aggregate) than the fat people, again barring some very rare metabolic condition. Guaranteed.
        • JoeAltmaier 12y ago
          I was with you until the last sentence. I'm from a whole family of skinny people. We eat like horses, just to maintain our weight. Nobody gets even a little tummy bulge until they're 45 or 50. My middle son is currently 6'3" and 150 lbs and eats constantly, the highest-calorie foods available to him, as much as several other people. Always has. When in high school for an after-school snack we baked one frozen pizza for the family, one for him. This is clearly some genetic thing - I was the same way; my nieces are the same way (one getting married in a size 2, that had to be taken in). Eats ice cream by the quart, as often as she can get it.
    • tbrownaw 12y ago
      Errr, I think we know these 'basic' things quite fine. Energy burned needs to be >= energy taken in. Very long term, energy burned will be == energy taken in. If that's consistently out of balance by... say 100 Kcal/day, that's 0.2 lb/week every week or 10 lb/year or 100 lb/decade. How many 50-year-olds do you know who are 300 pounds heavier (or lighter) than they were at 20?
      • bronbron 12y ago
        > Very long term, energy burned will be == energy taken in. Not really, unless we're counting death. Most people gain weight as they get older. > If that's consistently out of balance by... say 100 Kcal/day, that's 0.2 lb/week every week or 10 lb/year or 100 lb/decade. How many 50-year-olds do you know who are 300 pounds heavier (or lighter) than they were at 20? You're phrasing that the wrong way. Your BMR changes depending on your current weight. If you weigh 180 pounds at 20 and you eat 2700 calories a day, eventually you'll reach a point where 2700 calories is what you require to maintain your body weight (probably somewhere in the 220-240 lb range). To gain 300 pounds over 30 years would require you to constantly be consuming more and more as time goes on. You're also completely negating the fact that most people would (and probably do) have a 'reality check' once they get into the 200+ range, and reduce their caloric intake (though unfortunately most likely only to resume their high caloric intake once they've dropped in weight a little).
        • Dylan16807 12y ago
          >If you weigh 180 pounds at 20 and you eat 2700 calories a day, eventually you'll reach a point where 2700 calories is what you require to maintain your body weight You're agreeing with the post then, that very long term it's pretty even.
          • bronbron 12y ago
            Oh, sure, after reading your post I think I see what that post was getting it. I didn't originally. Originally I thought the poster meant "it can't be that simple because otherwise everyone would be 500 pounds", but yes, over time it does become true.
    • chc 12y ago
      If you take in 500 calories per day and burn 1600, that will fit the "energy burned needs to be >= energy taken in" rule, but you'll still die. Even that basic question is more complicated than you're making it out to be. I feel like you're trying to grind some axe relating to weight loss here, but in doing so you are obviously oversimplifying the field of nutrition.
      • bronbron 12y ago
        > If you take in 500 calories per day and burn 1600, that will fit the "energy burned needs to be >= energy taken in" rule, but you'll still die. In most developed nations (which, admittedly I assume HN is largely composed of), people have problems with overconsumption as opposed to underconsumption. You're right though, your ideal scenario is energy burned === energy taken in an appropriate weight range for your height and muscular stature. > Even that basic question is more complicated than you're making it out to be. It's really, really not. > I feel like you're trying to grind some axe relating to weight loss here, but in doing so you are obviously oversimplifying the field of nutrition. I'll repeat what I said in another comment: Maintaining a healthy weight is (or should be, at least) the primary concern of the vast majority of people concerned with their personal nutrition.
    • Padding 12y ago
      > Energy burned needs to be >= energy taken in. I guess that's the equivalent of Stroustrup's "If you understand int and vector you understand C++", for nutritionists.
  • tmod 12y ago
    I'd recommend this book by Ronald Gaucho It's Great! Oops, No It Isn't: Why Clinical Research Can't Guarantee The Right Medical Answers "The truth is, few people know the first thing about clinical research. The public reads about a medical research project that announces unbelievable results for a miraculous drug. Some years later, another investigation completely wipes out those initial favorable findings. Hormones Cut Women’s Risk of Heart Disease (San Francisco Chronicle, 1994) Hormones Don’t Protect Women from Heart Disease, Study Says (Washington Post, 2001) The people are confused because we do not understand the process behind these conflicting results. Our health, and in fact, our very lives are dependent on clinical trials, but we know little about them. This book explains the issues the public needs to be aware of when it comes to clinical research. It uncovers the problems in medical investigations that can not be overcome no matter how much care and diligence medical researchers bring to a research project. The basic premise that drives the writing is that it is impossible for medical researchers to guarantee that they can get all the right answers from a single study. No matter how good the investigators are, no matter how well a study is planned, no matter how carefully the plans are executed and no matter how conscientiously the results are analyzed and interpreted – the answer may still be wrong. The deck is stacked against medical researchers and the public – you – should be skeptical of the results no matter how impressive they seem on the surface."
    • tedunangst 12y ago
      I've decided to eat eggs every other day, to balance out the reports that they're good and bad.
      • DigitalJack 12y ago
        But do you eat the big endian first? Or the little endian?
        • FLUX-YOU 12y ago
          Grade A Jumbo Endian
      • enraged_camel 12y ago
  • haberman 12y ago
    Relevant: http://kill-or-cure.herokuapp.com/ http://kill-or-cure.herokuapp.com/
  • fidotron 12y ago
    I think this is the big area big data analysis will end up revolutionising. The only problem is really getting reliable data into the system. Sensors in your mouth (probably in the teeth) are more obvious - sensors at the other end might be a harder sell. And what goes for nutrition will work for drug interaction monitoring too.
    • khc 12y ago
      What if the sensors are inside the toilet?
      • andy_ppp 12y ago
        I have to log into my toilet :-(
        • thaumasiotes 12y ago
          I feel sure that a smart toilet shouldn't have trouble detecting who you are.
          • khc 12y ago
            I am sure poop can be used as a form of biometric ;-)
  • scottlocklin 12y ago
    Dean Edell broke the salt "news" decades ago. Apparently the misapprehension all dates back to some diet of peaches and rice (high in potassium) which helped regulate blood pressure of people with kidney disease. People have been quoting it as a fact since then. The reality is, people with healthy kidneys can excrete excess salt, and sodium/potassium balance is what is actually important. Since most people are eating processed garbage, they don't get enough potassium.
  • Lost_BiomedE 12y ago
    It takes a while to change conclusions. The important thing is that they do change in the face of evidence. Personally, I do take some risks by changing early with what I consider sufficient evidence. Like Feynman said about the viscosity issue, many will steer towards what is currently the norm but slowly the data will correct.
    • lutusp 12y ago
      > ... but slowly the data will correct. ITYM people's conclusions will slowly adjust to accumulating evidence. The entire process is ultimately steered by experimental evidence.
      • Lost_BiomedE 12y ago
        Right, but the evidence is affected by both past evidence and preconceived notions. Because of this, and outliers, it takes time.
  • laichzeit0 12y ago
    I read something interesting about high GI vs low GI foods that I didn't know [1]. The TL;DR "The GI value of a food is determined when it’s eaten in isolation after an overnight fast. As in, this is how this food will affect your blood sugar when it’s the FIRST and ONLY thing you’re eating after a full night of not eating anything." So the whole high GI is bad thing taken to the extreme e.g. clean eating, is probably completely blown out of proportion. It's measured in a very isolated ring-fenced setting that most likely doesn't apply to how you eat food anyway. Put bluntly: don't fret too much about eating white rice instead of brown rice (especially if you're counting macros). http://www.aworkoutroutine.com/brown-rice-vs-white-rice/ http://www.aworkoutroutine.com/brown-rice-vs-white-rice/
    • equoid 12y ago
      Don't be silly. That measurement technique is to allow you to isolate and measure the effect. You seem to want to infer that the effect does not occur in any other circumstances. That is as inane as disregarding crash test dummy results because they take place in a controlled environment which is not the same as 'real life'.
      • rfrey 12y ago
        It's not silly, at least not on the face of it to a complete duffer in nutritional science (me). Intuitively it seems like nutrition is a highly interdependent system of variables. The effect of a food on your body and blood chemistry might be completely different when consumed in combination with other foods. Or it might not. Testable! Give subjects the same combinations of foods (maybe scaled by body weight) a set time before consuming the test food, and measure blood sugar delta. In any case, it might be wrong but it's not silly.
        • equoid 12y ago
          I stand by my verdict. He was stating that ring fenced measurements are blown out of proportion because they do not reflect real life behaviour. I'd expect a citation otherwise I am happy to dismiss it as silly.
  • bitJericho 12y ago
    We know a lot about nutrition and healthy eating. You shouldn't believe everything you hear. Go talk to a dietician.
    • frou_dh 12y ago
      Bring a trailer for the Heart Healthy Whole Grains®
    • Padding 12y ago
      I'm genuinely curious. Is there any evidence that dieticians are more than just cargo-cultists? Talking to them usually results in "more of this and less of that and exercise and being thorough and blah blah blah". That sounds a lot like "I have no real idea of what's going on, but something in this broad spectrum of measures is bound to eventually pay off". That's very different from an answer that one would expect from a true professional, which would be more along the lines of "In this long and complex chain of events, this point here is the one that you need to affect in order to experience the effect you're looking for".
      • leephillips 12y ago
        Dieticians are not health professionals in the sense that doctors, RNs, or physician assistants are. The typical state requirement to be a dietician is a single multiple-choice test with some basic questions about health and nutrition. You might not even need a college degree.
        • bitJericho 12y ago
          I didn't mean walk into Dietician's-R-Us and start believing every word they're saying. My point is that we are very knowledgable about what needs to be done to stay healthy, go talk to someone who knows, and don't go to your local herbel remedies and dieting fad store expecting anything but mock confusion towards the scientific research.
• coldcode 12y ago
  Nutrition hasn't much since I took some nutritional chemistry classes in college decades ago. It's still a very complex system which is almost impossible to study because you can't easily isolate different the different bits from each other. The only thing even less settled is how the brain operates and stores information.
  • Lost_BiomedE 12y ago
    Yes and no, IMO. For the layman, yes, it seems like a mish-mash of failed conclusions. But, I think there is a solid direction that can be found with some knowledge. We punish those who push the boundaries too quickly. This bias really needs to be thrown out and instead solid and rigorous studies should be done and confirmed. Way too many will conclude for food studies/scientists out there right now. If you are not one, you meet a lot of hostility unless you are big name. Also, don't be too old as you will be labeled as jumping the shark.
• skylan_q 12y ago
  The orignal study that caused the salt scare didn't claim that increased salt intake caused increased blood pressure. The claim was that a sodium intake on the high end of regular sodium intake was closely correlated with increased mortality rates in heart attack victims. There was no claim made about sodium intake and blood pressure, nor was there a claim about sodium intake and heart attack rates. This is why I hate the intersection of journalism, science, and the public.
  • nazgulnarsil 12y ago
    The entire salt->CVD claim has rested for years upon the assumption that the causal pathway is salt->BP->CVD. The IOM and FDA both talk about this extensively in their recommendations.
• sparkzilla 12y ago
  The latest health scare is that sitting causes all kinds of trouble. Expect articles in 10 years saying it was all a lie.
  • ddrmaxgt37 12y ago
    I love that people say that sitting for a day is as bad as smoking a cigarette.
  • snogglethorpe 12y ago
    Hmm, aren't those warnings about sitting talking about a sort of ridiculous extreme though, sitting in one position for most of the day? You maybe get that on long-distance airplane flights (and even then, you take bathroom trips etc), but even people with desk jobs almost never really sit all day like that.... [And in the of long-distance airplane flights, the whole deep-vein-thrombosis thing does actually seem to be a documented problem, if a pretty rare one...]
  • cheepin 12y ago
    I mean the alternatives (standing and lying down) in excess are already known to be bad.
• jpmattia 12y ago
  Scientific American was beating this drum a while ago: > It's Time to End the War on Salt > http://www.scientificamerican.com/article/its-time-to-end-the-war-on-salt/ http://www.scientificamerican.com/article/its-time-to-end-th...
• nazgulnarsil 12y ago
  I decided to go through the IOMs Sodium Intake in Populations report[1] when the FDAs new DRIs were released. The FDA guidelines pushing for 1500mg a day stand in contrast to the findings of the Cochrane review meta-analysis(summary[2]). After looking over all the studies reviewed by both the IOM and the Cochrane review I can't figure out how the FDA are justifying their recommendations of very low intake. The only truly consistent finding seems to be that below around 2g and above about 4g is clearly harmful in that it definitely results in more hospital visits. In between is a lot more shaky. The FDA basically asked the IOM to write the bottom line first and still the IOM wasn't able to come up with any evidence that lowering sodium intake below that range was helpful. It is important to note that the vast majority of sodium studies additionally do not control for a very important confounder which is potassium intake, and that those that do seem to agree strongly with the conclusions of the Cochrane Review. IOM makes note of this shortcoming but does not draw any conclusions from it. MealSquares (http://mealsquares.com http://mealsquares.com) will be sticking with the Cochrane Review conclusions for now, but of course we will update and inform our customers based on the recommendations with the strongest evidence behind them. It's interesting to note that Soylent 1.0 went with around 1g of salt/day and was forced to change this when people started getting dizzy. it will be interesting to see what they change it to. 1. http://books.nap.edu/openbook.php?record_id=18311&page=R1 http://books.nap.edu/openbook.php?record_id=18311&page=R1 2. http://www.nhs.uk/news/2011/11November/Pages/cochrane-review-salt-blood-pressure.aspx http://www.nhs.uk/news/2011/11November/Pages/cochrane-review...
• smegel 12y ago
  > those patients who were hypertensive consumed significantly more salt than those without hypertension Doesn't that mean there is a causative effect, or are they saying it just a correlation? People with high blood pressure tend to eat more salt? Or if it is not statistically significant, why mention it at all?
  • nmjohn 12y ago
    > Doesn't that mean there is a causative effect, or are they saying it just a correlation? Unless causality is clearly articulated, it never should be assumed. Also, it never would be stated if there was not statistically significant data supporting it - keeping in mind this is a Time article and not the original source [0] so you're dependent on the writer knowing what they're talking about as well. [0]: http://ajh.oxfordjournals.org/content/early/2014/09/03/ajh.hpu164 http://ajh.oxfordjournals.org/content/early/2014/09/03/ajh.h...
• pbreit 12y ago
  Does the headline square with "patients who were hypertensive consumed significantly more salt than those without hypertension"?
  • lutusp 12y ago
    Yes, because correlations don't prove causation. One might want to argue that people who are hypertensive consume more salt as an effect, not a cause. Not to argue that that is proven either, only that it should be on the list of possibilities that merit investigation.
    • pbreit 12y ago
      The headline used "association". Plus, the article seemed to indicate it was a causation, just not universal.
      • lutusp 12y ago
        It's important to understand that, until a cause-effect relationship is explained instead of being merely measured, it's not science. A more complete explanation is here: http://arachnoid.com/science_of_mind/ http://arachnoid.com/science_of_mind/
        • pbreit 12y ago
          I was making a simple observation that the headline clashed with the article.
• delinka 12y ago
  Oxygen is bad for us. It oxidizes and damages all kinds of organic chemicals in our bodies that are required for use to live. Oxidization, however, is exactly what provides us with the energy that supports life. Salts are electrolytes. (Electrolytes are salts?) You need them in your body so that your nervous system can conduct signals and keep things going - like your heart. We live. We grow. We hurt. We heal. We get sick. We recover. We age. We wear out. We die. Rather that avoiding "omg sugar" or "omg salt" or "omg fat," we should just be eating well-rounded diets. Have some beef today. And some pork tomorrow. And some fish after that. Have some fruit. And veggies. And a bit of dessert. And a spoonful of honey. And some powdered sugar on that syrup'd French toast. Just don't eat large piles of stuff for a meal. And don't eat the same thing every day. Life's gonna kill you. Just don't clog up your body with excessive amounts of the same thing and you probably won't die early.
  • montecarl 12y ago
    I really like the general philosophy behind what you are saying. It has a nice ring to it. But saying to eat a well-rounded diet is not advice. Nobody has any good idea what a well rounded diet is. You must eat fat (to obtain essential fatty acids). You must eat protein (to obtain essential amino acids). There are certain vitamins you must eat. And there are certain elements that you must consume. The real question is how much of the required nutrients is enough and how much is too much? What ratio of macronutrients (carbohydrates, protein, and fat) is ideal for maximizing health? Are there trade off for different ratios? For example, carbohydrates are not required for life, but most diets obtain a large portion of daily caloric intake from them. What percent of calories should be from carbohydrates? Nobody yet knows what a well balanced diet is. In absence of that information, your advice is pretty good. Eat lots of different stuff.
    • eitally 12y ago
      It's pretty good, but not as good as it could be. There's no disputing the fact that we're better off if most of our carb macros don't come from refined flours and sugars, that we shouldn't eat trans-fats, and that we should eat a lot more fresh produce than most people do. I like Michael Pollan's often quoted statment: “Eat food. Not too much. Mostly plants.”
• calvinbhai 12y ago
  This article is BS. I mean, its a FUD advertorial. I say that based on my personal experience: A nurse in the clinic checked my BP (as a routine) when I went to get checked for some eye infection. And she was shocked that it was 170/100 (normal is 120/80). It was shocking for her (and of course me) because: I was 25 I looked healthy and lean (not too thin). I showed/experienced no signs of hyper tension. My eating habits, was to go on a Frozen Prepared Food diet (for lunch and dinner) because that was the cheapest tasty food I could afford along with cereals for breakfast, for about 3 months before my BP was checked. I dropped this diet since that day, reduced salt intake considerably. And it took about 9 months for my BP to come down to normal levels, without any medication, and with a little extra exercising. I'd have taken this article with a pinch of salt. But, I have cut down on salt intake. So I prefer to not take it :)
  • jasallen 12y ago
    Which is why for so long people believed that salt was the cause. But in your situation salt is also a proxy for a lot of other things that were wrong with your diet. Gobs of processes carbs, no 'good' cholesterol, a lack of protein, just to get started. Since anything that cuts processed salt considerably almost assuredly improves those other metrics, I'm not sure why you believe your anecdotal evidence is so convincing.
    • calvinbhai 12y ago
      "Anecdotal evidence" is acceptable if everyone said salt is healthy and I claimed otherwise. btw, my diet, even though had a lot of frozen food, wasn't loaded with carbs, and was sufficient in protein. Back to the point: When doctors I trust say that I'm better off cutting salt and sodium intake, I'll cut down on it. And because its the trusted doctors that say so, I consider it as non Anecdotal Evidence
  • upofadown 12y ago
    It is well known that restricting salt intake can reduce blood pressure. This is a different question: does high salt intake cause high blood pressure?
  • 12y ago
• svsaraf 12y ago
  I'm a medical student who actually read the paper this article refers to. I would be very careful trying to draw conclusions from a study like this. I don't think many people in the healthcare community would be very surprised by it. 1) All clinically treated hypertensive patients were excluded - that means if you have kidney or vascular disease (hypertension) and are being treated for it, you aren't counted here. Doctors WILL care about your salt intake if you have these conditions, as they should! It is very common to prescribe something called the DASH diet to lower sodium intake and increase potassium intake. 2) If you're healthy, it means your kidneys are healthy (simplifying). One of the purposes of the kidneys is to maintain homeostatic blood pressure by excreting a combination of salt and water. To put it simply, if you eat a huge load of NaCl, say in a dominoes pizza, your blood pressure WILL NOT be affected for a very long time. I'd guess 20 minutes or so after the salt enters your bloodstream. Which means these folks can't measure that blood pressure change by testing blood pressure yearly. 3) Either medical doctors or the press that listens to them have a nasty habit of taking treatments that often work for very sick people - morbidly obese, type 1 diabetics, bed-ridden centenarians - and applying it to normal healthy folks. I will go out on a limb and say that these unilateral recommendations are almost all BS, and should be ignored. If you're healthy: eating eggs will not affect your cholesterol, eating cheesecake will not give you diabetes, sitting in a chair will not misalign your spine. It would be prudent for you to be skeptical when you hear these claims, often on daytime television or on the internet.
  • graeme 12y ago
    Number 3 is very interesting. I understand why the press would make silly claims. But why would medical doctors apply those claims to normal people? Assuming they're not generally considered valid for those who are healthy.
    • DanBC 12y ago
      Medical doctors are just people and are subject to the same biases as everyone else.
  • Pxtl 12y ago
    For #3 the reverse is also true. If Omega 3s do anything to prevent heart disease, it's too late to help if you start gobbling fish-oil once you've got heart disease - study demonstrated no improvement in outcomes for that.
• elchief 12y ago
  Or is there? Nutrition "Science" is fucking Phrenelogy
• seesomesense 12y ago
  Low Sodium Intake — Cardiovascular Health Benefit or Risk? Suzanne Oparil, M.D. N Engl J Med 2014; 371:677-679 August 14, 2014DOI: 10.1056/NEJMe1407695 "In response to controversy about the health effects of low sodium intake, the Institute of Medicine convened an expert committee to evaluate the evidence for a relation between sodium and health outcomes.4,5 The committee concluded that most evidence supports a positive relation between high sodium intake and risk of cardiovascular disease but that results from studies with health outcomes were insufficient to conclude whether low sodium intake (<2.3 g per day or <1.5 g per day, as recommended in current dietary guidelines6,7) is associated with an increased or reduced risk of cardiovascular disease in the general population. The committee found limited evidence that low salt intake may be associated with adverse health effects in some subgroups, including some patients with heart failure or other forms of cardiovascular disease, diabetes, or chronic kidney disease. Results from three studies, reported in this issue of the Journal, bear on this matter. The Prospective Urban Rural Epidemiology (PURE) study provides new evidence about the association between sodium and potassium intake, estimated from morning urine specimens, and blood pressure, death, and major cardiovascular events.8,9 The procedure for estimating electrolyte excretion was validated elsewhere.10 The PURE study included more than 100,000 adults sampled from the general population of 17 countries that varied in their economic development and acculturation to an urban lifestyle. Approximately 90% of the participants had either a high (>5.99 g per day) or moderate (3.00 to 5.99 g per day) level of sodium excretion; approximately 10% excreted less than 3.00 g per day, and only 4% had sodium excretion in the range associated with current U.S. guidelines for sodium intake (2.3 or 1.5 g per day). Across this broad range of populations, the relation between sodium excretion and blood pressure was positive but nonuniform: it was strong in participants with high sodium excretion, modest in those in the moderate range, and nonsignificant in those with low sodium excretion. The authors concluded from the findings that a very small proportion of the worldwide population consumes a low-sodium diet and that sodium intake is not related to blood pressure in these persons, calling into question the feasibility and usefulness of reducing dietary sodium as a population-based strategy for reducing blood pressure. There was also an interaction between sodium excretion and potassium excretion: high sodium excretion was more strongly associated with increased blood pressure in persons with lower potassium excretion. The authors suggested that the alternative approach of recommending high-quality diets rich in potassium might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction alone. After a mean of 3.7 years of follow-up, the composite outcome of death and cardiovascular events occurred in 3317 participants (3.3%). As compared with those who had a moderate level of sodium excretion, those with a higher or lower level of sodium excretion had an increased risk of cardiovascular-disease outcomes. The authors attempted to rule out residual confounding or reverse causation as explanations for their findings by showing that participants with a low level of sodium excretion had a similar mean INTERHEART Modifiable Risk Score and higher intake of fruit and vegetables, as compared with those with a moderate level of sodium excretion, and that more than 90% of the cohort was free of antecedent cardiovascular disease. The findings were not altered by the exclusion of participants with prior cardiovascular disease, cancer, or use of blood-pressure medication, by the exclusion of outcome events occurring in the first 2 years of observation, or by adjustment for all identifiable confounders. The major weaknesses of the PURE study, inherent in its study design and scope, include the absence of direct measurement of 24-hour urinary excretion on multiple occasions, which is the accepted model for assessing electrolyte intake, and the lack of an intervention component to assess the direct effects of altering sodium and potassium intake on blood pressure and cardiovascular-disease outcomes, thus making it impossible to establish causality. Nevertheless, this large study does provide evidence that both high and low levels of sodium excretion may be associated with an increased risk of death and cardiovascular-disease outcomes and that increasing the urinary potassium excretion counterbalances the adverse effect of high sodium excretion. These provocative findings beg for a randomized, controlled outcome trial to compare reduced sodium intake with usual diet. In the absence of such a trial, the results argue against reduction of dietary sodium as an isolated public health recommendation. The authors of the third article, from the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group (NutriCode),11 used modeling techniques to estimate global sodium consumption and its effect on cardiovascular mortality.12 The investigators quantified global sodium intake on the basis of published surveys from 66 countries and used a hierarchical Bayesian model to estimate global sodium consumption. They then estimated the effects of sodium on blood pressure in a meta-analysis of 107 published trials and estimated the effects of systolic blood pressure on cardiovascular mortality by combining the results of two large international pooling projects that included individual-level data. They found a strong linear relationship between sodium intake and cardiovascular events and estimated that 1.65 million cardiovascular deaths in 2010 were attributable to excess sodium consumption. The NutriCode investigators should be applauded for a herculean effort in synthesizing a large body of data regarding the potential harm of excess salt consumption. However, given the numerous assumptions necessitated by the lack of high-quality data, caution should be taken in interpreting the findings of the study. Taken together, these three articles highlight the need to collect high-quality evidence on both the risks and benefits of low-sodium diets."
• fasteo 12y ago
  Analyzing the effects on health of a single nutritional item - salt in this case - in pretty useless IMHO. The more I read about nutrition, the more I come to realize that it is the ratio of different nutrients what is key to our health. Take Omega3 for example: It´s much healthier to reduce the content of Omega 6 in your diet than popping a couple of Omega 3 pills a day. This is so because our current diet has screwed up this optimal ratio [1] Same applies to salt: The problem is not Sodium, but refined salt, that has a mineral composition so unbalanced that makes Sodium problematic. Just eat unprocessed food. [1] Optimal ratio Omega6/Omega3=around 1. Typical ratio in western diets: 15/1 http://www.sciencedirect.com/science/article/pii/S0753332202002536 http://www.sciencedirect.com/science/article/pii/S0753332202...
• zmmmmm 12y ago
  Did they really prove there was 'no association' or did they just fail to reject the null hypothesis that there is no association? These are diabolically different things!
  • lutusp 12y ago
    Indeed they are, but according to the null hypothesis precept, without persuasive contradicting evidence, there is no association. The burden is on experimental evidence to contradict that assumption, and if positive evidence isn't present, then the default assumption is correct. Think about what proving no association actually means. That would require proof of a negative, which is a widely recognized logical error, an impossible burden. To see why, imagine that I believe in Bigfoot and I will continue to believe until someone proves he doesn't exist. But no one can prove Bigfoot isn't hiding under some rock on a faraway planet, therefore I am justified in my belief. My belief is supported by an impossible evidentiary burden. This is why scientists rely on the null hypothesis -- contradicting it requires positive evidence. Its opposite requires negative evidence.
    • zmmmmm 12y ago
      > if positive evidence isn't present, then the default assumption is correct What you have said above is horribly wrong and is exactly the point I am making. If it is true then I can prove anything I like just by designing a bad enough experiment. For example, suppose I want to prove that the moon is made of green cheese. I can start with a null hypothesis that it IS made of green cheese. Then I can point my telescope in the wrong direction and find no evidence that it is not made of green cheese. Using your logic I am free to then conclude that my null hypothesis is true. You cannot just make any null hypothesis you want and then when you fail to prove it untrue, claim it is true. If you want to make a positive claim about the null hypothesis (for example, claim there is no association between salt and blood pressure) then you have to test it directly with positive evidence in its own right.
      • lutusp 12y ago
        >> if positive evidence isn't present, then the default assumption is correct > What you have said above is horribly wrong and is exactly the point I am making. If it is true then I can prove anything I like just by designing a bad enough experiment. You obviously do not understand the null hypothesis. Under the null hypothesis, a claim is assumed to be false unless and until persuasive evidence shows otherwise. Only psychologists think a bad experiment contradicts the default assumption of no effect. Serious science must pass muster with other equally serious scientists, who will call out anyone trying to cheat. > For example, suppose I want to prove that the moon is made of green cheese. I can start with a null hypothesis that it IS made of green cheese. That is certainly not what "null hypothesis" means -- your utterly mistaken view asserts its opposite, the alternative hypothesis. Please learn anything at all about this topic before assuming you understand it. > You cannot just make any null hypothesis you want and then when you fail to prove it untrue, claim it is true. Honestly. Learn what it means before trying to discuss it. http://en.wikipedia.org/wiki/Null_hypothesis http://en.wikipedia.org/wiki/Null_hypothesis Quote: "In statistical inference of observed data of a scientific experiment, the null hypothesis refers to a general statement or default position that there is no relationship between two measured phenomena. Rejecting or disproving the null hypothesis – and thus concluding that there are grounds for believing that there is a relationship between two phenomena or that a potential treatment has a measurable effect – is a central task in the modern practice of science, and gives a precise sense in which a claim is capable of being proven false."
• graycat 12y ago
  To me, it sounds like poor, little, old, suffering 'Time' magazine is trying to get eyeballs. The article sounds like a total yawn to me, that is, just old and obvious. So, I long understood: If eat some food with some table salt, that is, NaCl, then within an hour or so likely the salt concentration in blood will increase and then blood pressure will increase. But, the body has a system that regulates salt concentration; so, if the salt concentration is too high, then the body will lower the salt concentration, and the usual way is to flush out the extra salt in urine. So, net, likely within a few hours, the salt concentration will be back to where the body wants it. Typically, for reasonably healthy people, no biggie. Somewhat separately there is a disease called hypertension which means high blood pressure, and such blood pressure can be dangerous, e.g., cause blood vessels to break and leak, say, in the brain -- not good. If a person has this disease, then extra salt that further increases blood pressure, even just for a few hours, can be not good. So, for such a person, a standard recommendation is to reduce input of salt: So, e.g., don't sit around eating salted peanuts, potato chips, etc. But does eating salt cause the disease hypertension? Nope. Then, bingo, presto, wonder of wonders, the mass media, always eager for getting eyeballs, often by grabbing people, by the heart, the gut, below the belt, always below the shoulders, never between the ears, comes out screaming about salt suggesting that salt, exploiting really simplistic thinking, is somehow bad. Or, since people are sensitive to suggestions or symptoms of danger, suggesting that salt is bad can get eyeballs. Then companies that manufacture and want to sell food products, say, bread, may see a selling opportunity, lower the amount of salt in their products, and then scream on their product labels that their products are healthy because they are low salt. We can see how the mass media and their food product advertising customers have a common interest: The media raises fears about salt, and the food companies scream that their products are healthy because they are low in salt. It's deliberate confusion and deception, that is, in a word, a scam, all in an attempt to get money from ordinary people. This scam has been going on for decades. E.g., back in the 1980s I was in the house of some friends; they were in their 20s and in perfect health, with perfect weight, etc. The husband was a good athlete, and his wife was drop dead gorgeous. But the wife was cooking with low salt based on the scam, i.e., that salt would cause hypertension, which of course it would not. Or, as in the title here, "No Association Between Salt And Blood Pressure", of course not. There never was any such association. Salt does not cause hypertension; there's never been any competent claim that salt did cause hypertension. So, now Time gets another way to grab eyeballs -- debunk the scam that for at least three decades has had way too many people thinking the total nonsense that salt causes hypertension. For the media, there's a pattern here: To get eyeballs, create a scam. Then, later, maybe decades later, to get more eyeballs, debunk the scam. Then continue with more scams -- there are many possible scams. So, net, salt does not cause the disease hypertension, and the media likes to use scams to get eyeballs. Virginia, if you didn't already know this, then listen up and learn. I mean, by now, we expected something else?
• illumen 12y ago
  This title is more misleading than the article. Notice the question in the headline? That almost always means No.
• eik3_de 12y ago
  Can't confirm. Whenever I use salt, my blood pressure goes up fairly quick. That's why I use Ansible instead.
  • amorphid 12y ago
    "eik3_de is controlled by the cook's union, and is merely a puppet for the chef industry." --C. F. Engine
    • eik3_de 12y ago
      haha n1
• crusso 12y ago
  Sadly, the unsettled or contradicted nature of the science won't stop politicians like Bloomberg from trying to force the behavior he wants through legislation.
  • base698 12y ago
    http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt_show_up.html http://thelastpsychiatrist.com/2012/09/the_nanny_state_didnt... The vast majority of the people complaining about the Big Soda ban don't buy big sodas, and those most enraged about the Buckyballs ban either already have them or would never want them. So the reaction has nothing to do with the products themselves, the rage is on a theoretical level, "I don't want government intruding in my private choices." But they already do this in a gazillion different ways, bigger, more important intrusions. The difference is that those are invisible. You know you can't value the risks in airplane safety or radiation leaks so you trust them to do it, but you think you can value the risks of a soda and hate that they try to do it for you. I know you are thinking, "but I can resist soda; I understand the risks"-- never mind you don't even know the ingredients of soda, the point here is you are starting from you and multiplying by 6 billion. When you say, "personal responsibility!" you are really saying "this is safe enough for it to be a question of personal responsibility." But you must ask yourself the question: how do you know Buckyballs and soda are safe enough for them to be about personal responsibility? Because "some other omnipotent entity" allowed them to exist. How do you know that Entity can be trusted? Because it even tries to ban silly things like Buckyballs and soda. The system is sound.
    • crusso 12y ago
      vast majority of the people complaining about the Big Soda ban don't buy big sodas Isn't that a bit like saying that only African Americans are allowed to stand up to racism? the rage is on a theoretical level If individual liberty and personal responsibilities are only theories. I don't happen to agree. But they already do this in a gazillion different ways So because they get away with it in harder-to-grasp and harder-to-politically-oppose ways, we should just submit to all of it? I know you are thinking, "but I can resist soda; I understand the risks" You obviously have no idea what I'm thinking. I think about the bigger picture of a society of sheep that elects wolves to make all their decisions for them because the sheep are too busy watching the NFL and Miley Cyrus to be bothered to make decisions for themselves and take responsibility for those decisions. I ponder the paradox of a populace too stupid to decide whether or not to drink a soda but smart enough to elect angels who will protect them from themselves. Because "some other omnipotent entity" allowed them to exist You're totally and completely wrong yet again. I'm an atheist. How does that affect your rationalization of letting others use force to make the smallest decisions in life for you?
• nickbauman 12y ago
  In recent years oncology is seeing there might be a connection between lack of iodine and increase risk of cancer. So when people curb their salt intake for long periods of time they may be risking cancer since it is one of the only ways inlanders get enough of it.
• nakedrobot2 12y ago
  ALL NUTRITION SCIENCE IS A BUNCH OF GODDAM LIES. EAT FOOD THAT TASTES GOOD. STAY AWAY FROM PROCESSED FOOD. GET OFF YOUR ASS AS MUCH AS POSSIBLE. THAT IS ALL! /rant
• nuh777 12y ago
  The results section of the paper has some possibly contradictory information: 1. "Salt intake was positively associated with SBP in men but not in women." 2. "Salt intake was not associated with SBP in either sex after multiple adjustments." Also isn't this kind of journalism and article titles unethical? There should be some kind of regulatory board for articles in any media. Anyone can write anything and can cause serious harm.