Salt

The popular press has regular articles about health issues and salt in the diet. A typical message is that 20-25% of people are salt sensitive: they have a rise in blood pressure after eating more than minimal salt. Often a suggestion is made to test for salt sensitivity by checking blood pressure after a high salt meal. If sensitive, limit salt; otherwise eat salt as you please.
This is an incorrect message since excess salt causes serious problems for everyone. A high salt meal depresses endothelial function, the ability of blood vessels to dilate when necessary. The effects of a high salt diet build up over years with resultant vascular and kidney damage.

https://www.ncbi.nlm.nih.gov/pubmed/24401240
Excess salt also interferes with immune function and some studies have shown improvement in asthma with salt restriction. 
https://www.ncbi.nlm.nih.gov/pubmed/17109669
Scientific studies are unequivocal- excess salt is a problem for everyone and is a major cause of preventable disease and death.
The food industry has an enormous interest in promoting salt use. Most prepared and fast foods have large amounts of salt. For most people the primary source of salt is food eaten outside the home. Many meats have salt water injected to increase weight and improve storability. 

Most of us are use to and like salty food, but eliminating salt at the table and when preparing food will allow a change in preference. After two weeks of a low salt diet most prefer low salt foods and enjoy other flavors salt was masking. It's not a hard transition and it's much better for health. Deb and I now prefer food prepared with little or no salt. Restaurants often will prepare low salt meals on request.

            Preventing Breast Cancer

Dr. Graham Colditz is a professor at Washington University Medical School where he is the chief of public health sciences and the lead investigator of a National Cancer Institute research center focused on cancer prevention. Dr. Colditz's research shows that breast cancer is a largely preventable disease controlled by lifestyle. By far the most important factor is diet. A whole food plant based (WFPB) diet which is mostly or entirely whole plant foods with little or no animal products or vegetable oils controls cancer development and growth rates even in women with the BRCA 1 and 2 gene mutations. He estimates that 68% of breast cancer will be prevented by starting this lifestyle in childhood and 50% by starting as an adult. He labels milk as an especially dangerous food, and advises an early start on good dietary habits for greater effect and also because peer pressure becomes more important than parental input after age 8 or 9. This is not the advice of one of the writers on diet; this is the advice of "an internationally recognized leader in cancer prevention." 

onlinelibrary.wiley.com/doi/10.3322/caac.21225/full 
(This website requires scrolling down to get to text. The top area is blank.)

Dietary fat and animal proteins control the development and growth of breast cancer in laboratory animals. Excess body weight and higher levels of serum estrogen are also potent breast cancer stimulators. A WFPB diet decreases all these critical factors.

Women with diagnosed breast cancer, even metastatic disease, also do much better on this diet. When cancer cells in a laboratory petri dish are exposed to serum of women with breast cancer who are eating a WFPB diet most are killed; this is not true for serum from those eating the standard high fat and animal protein western diet. Read the story of Ruth Heydrich, a long term survivor of metastatic breast cancer.

allfor-health.blogspot.com/2013/01/interview-with-dr-ruth-heydrich.html

Diet is as important in breast cancer prevention as smoking is in lung cancer. It is similarly critical in prostate and colorectal   cancers.

                   Interval Training

Several physiology labs study interval training, a form of exercise which varies intensity of an activity during a cardio workout. Any activity like running, swimming, cycling etc. can be used but exercise bikes are often the most practical for many people.
Regular cardio workouts increase cardiopulmonary reserve, help reach or maintain optimal weight, support good sleep and increase longevity. There is good evidence that high levels and more time spent provide better results but that even modest brisk walks several times a week are very helpful.
A Danish research lab documented excellent results from this regime:
   short warmup
   30 seconds of normal exertion
   20 seconds of greater exertion 
   10 seconds of maximal exertion
   short cooling off

  https://www.ncbi.nlm.nih.gov/pubmed/25439558

This is repeated up to a total of 10-15 times in sets of five separated by two minutes of very light activity. Three times a week is more effective than daily workouts just as is true for building strength through weight training. As with all workout programs numbers and intensity of the workout should be gradually increased until 10 to 15 reps can be done comfortably. 
Their comparison with other cardio training methods showed superior conditioning results with relatively little time invested.
I use this method and find it easy to follow- not too painful or or time consuming.
Mayo Clinic researchers tried different exercise regimes (vigorous weight training; light weight lifting plus moderate intensity exercise bike; interval training) on young and older subjects who allowed muscle biopsies to monitor results. All activities improved fitness and ability to regulate blood sugar. Cellular genetic mitochondrial changes reflecting cellular health and younger apparent age were much greater in those who did interval training. Remarkably, these effects were much more in older people. Interval training can now be called "a fountain of youth." 

http://newsnetwork.mayoclinic.org/discussion/mayo-clinic-discovers-high-intensity-aerobic-training-can-reverse-aging-processes-in-adults/

                       Modern Medical Care and Dietary Confusion

Medical schools and teaching hospitals control medical education. Curriculum content is determined by licensing requirements together with the preferences and knowledge of medical school deans and faculty. My working medical career was spent at several of these schools where I got to know many other faculty members. Most were intelligent, hard working and ambitious, but we were all specialists in a small corner of medicine with no or limited knowledge of other important aspects of medical science. Many faculty members are also constrained by the need to obtain funding for research projects that are the focus of their career and the determinant of salary, promotion and recognition. Increasingly, more research funding is coming from the drug and other medical industries. Professors have rarely been trained in diet and nutrition; they also have no time or motivation to learn this material. Even worse, there is often a conflict when diet information would devalue the benefits of medications- the bread and butter of medical research and medical schools. It’s no surprise that physicians and other medical workers have little or no training or interest in diet and nutrition.
This crisis in medical research and practice has been decried by some of the most respected leaders in medicine but medical institutions want money and medical businesses have the money.  Business effectively controls research, faculty priorities and medical education. Physicians come out of school and residency poorly trained except in writing prescriptions and performing complicated procedures. But health depends on lifestyle choices much more than it does on other factors. Reliance on medical professionals to give optimal guidance in health care has led to epidemics of preventable conditions: heart attacks, strokes, cancer, dementia, auto-immune diseases. The large majority of these are avoidable with proper lifestyle choices, particularly diet.
Another big problem is misinformation about best dietary choices. Everyone has dietary preferences based on family tradition and past eating habits. Human nature is to look for support for our preferences. For decades some physicians advocated cigarettes and smokers were delighted to hear that “Doctors prefer Camels,” even if they themselves smoked Luckies. The tobacco industry spent lavishly to support this misinformation just as agribusinesses, fast and processed food industries are doing now. Healthy foods are whole plant foods but billions of dollars in spending are dependent on people believing that other choices- animal products, processed and refined foods are as good or better options.
Modern medical centers are dependent on high volume to pay for expensive facilities and equipment. They often advertise these services and encourage medical providers and patients to use them. Dr. H. Gilbert Welch, a Dartmouth Medical School professor, and his colleagues have done extensive research documenting the harm from over-utilization of diagnostic and treatment options. Welch’s work has been the subject of several NY Times op-ed pieces and he has written many scientific articles published in top peer reviewed journals plus several excellent books on this topic. Medical care is big business and uses the techniques of other businesses to encourage over-utilization. The unfortunate result is often poor health for patients and huge amounts of wasted money.

                   Value of Screening Mammography

Several months ago I sent an email which described recent studies questioning the value of screening mammography. Replies from radiologists who do mammography expressed surprise, unhappiness and even convinced disagreement.

One of the problems with the evaluation of studies on mammography is that they are often done or sponsored by those with financial or professional advantage from the examination. The big pushers are usually radiologists who have devoted their careers to mammography. Evaluations of studies on drugs done or sponsored by drug companies have showed strong bias towards advocating their product.

JOURNAL WATCH has a review of a recent study from OBSTETRICS AND GYNECOLOGY, a major peer reviewed journal, which did a paired study of Sweden vs. Norway, Ireland vs. No. Ireland and The Netherlands vs. Belgium. In each of these pairs nationwide mammography was implemented by 1990 in one and substantially later in the other. All 6 countries showed a substantial decrease in breast cancer mortality between 1989 and 2006. For example -24% in Norway and -16% in Sweden but the decreases were no more in the fully screened countries (Sweden started full screening much earlier than Norway.) A similar study of cervical cancer screening in the Nordic counties showed that nationwide screening was highly correlated with decrease in mortality from cervical cancer. Countries which implemented earlier screening showed a much greater decrease in cervical cancer mortality. The reviewer concludes that a decrease in mortality from breast cancer due to mammography has not been shown, and that recent decreases in mortality from breast cancer in developed countries can be explained by changes in treatment, not by earlier diagnosis through mammography.

Mammography screening is very expensive nationally, leads to many unnecessary work ups with anxiety, biopsies and even surgery, radiation or chemotherapy for those who don't need it. Every radiologist, surgeon, clinician can cite examples of early diagnosis of breast cancer through mammography followed by appropriate therapy with long term survival, perhaps cure. The problem is that this does not show that this test is of any value. My suggestion to women is to get screening mammograms if they will be anxious or unhappy without them, but not to get them because they believe that mammography is definitely shown to improve their chance of not dying due to breast cancer. Mammography may be of value but the large number of studies done on the subject has not shown it convincingly. Those who get screening mammograms are guaranteed a much greater chance of unnecessary expensive and, perhaps dangerous, work ups with the associated anguish involved.

               

          Diet, Longevity and Quality of Life

Longevity is the gold standard for evaluating diet and other lifestyle choices since there are strong correlations between longevity, overall health and quality of day-to-day life. According to researchers at the New England Centenarian Study “The older you are, the healthier you’ve been. “ Studies of long-lived Adventists confirm this. Most who live into their late 80’s and beyond have compressed end of life morbidity (morbidity defined as significant sicknesses.) The argument “I don’t care how long I live; I just want to enjoy life” doesn’t work since enjoying life with decades of painful and expensive chronic illnesses is very difficult. Using longevity to compare different dietary choices is much simpler and more accurate than using other parameters like weight, blood sugar, or cholesterol. Normal blood sugar is no consolation to a diabetic who dies prematurely after several years of living paralyzed by a stroke or dialysis due to chronic kidney disease.

Many advocates of different diets and medications use weight, blood sugar or serum cholesterol results to support their choice. Using longevity is simpler and much more accurate. Longevity studies are unequivocal. The only diets associated with longevity are those consisting mainly or entirely of whole plant foods. Nutrition experts debate how much fish, lean white meats or non-fat dairy should be included but agree that an optimal diet is filled with whole grains and other unrefined starches, vegetables, legumes, fruits, seeds and nuts. The bulk of calories should come from unrefined starches, not fat and protein as it is in the typical American diet.

Several excellent studies confirmed the value of this type diet in China, Okinawa, and the Mediterranean area. Since many Adventists are vegetarian or vegan the diets of Adventists in southern California have been the subject of hundreds of scientific studies. These studies confirm that the fewer animal products in the diet, the longer you live and the healthier you are. It is not the climate or some other variable in the Mediterranean area, China or Okinawa, it’s the food!

The New England Centenarian Study has examined characteristics of long-lived people and concluded that most people can live into their late 80’s through a healthy life style that includes not smoking and a diet that is mainly whole plant foods. Genetics determines who will live past that age. Some reach very old age in spite of poor life style but these people are rare exceptions with unusual genetics. Even those with good genes usually need a healthy life style to reach 100 or more.

                                        More on Osteoporosis

In my first post about osteoporosis I discussed calcium and vitamin D, the commonly prescribed and sometimes necessary nutritional supplements for bone health. Since bone is a very active, complex organ system it requires many other nutrients.

Protein is essential to develop and maintain strong bones. Fortunately, protein deficiency is a rare problem which is only seen with severe malnutrition. Starvation, a diet composed entirely of junk food, and major intestinal disorders are the common situations where there can be protein deficiency. Totally plant-based diets have no problem with protein lack. Almost everybody can ignore this basic nutrient since virtually all diets have plenty.

Three vitamins essential for bone health are associated with dangers from supplementation. These are vitamin A, vitamin E, and folic acid. A diet which includes a variety of vegetables, nuts and seeds will have plenty of these three vitamins. Supplementation is dangerous.

People who eat mainly plants may be deficient in vitamin B12 or zinc. Vitamin B12 should be regularly supplemented by those with this diet. Zinc levels should be checked in the laboratory and supplements taken if necessary.

A wide range of other important bone nutrients are present in virtually any reasonable diet. These include potassium, magnesium, silica, phosphorus, manganese, copper, boron and vitamin C. Supplementation is not necessary for most people.

In recent years interesting research has been done on vitamin K2. Vitamin K, unlike most other vitamins, has no minimum daily requirement recommended by the USDA and it is found in many foods. Two forms of vitamin K have been identified: vitamin K1 which is present in many vegetables, particularly green vegetables; and vitamin K2, found in some legumes, meat and dairy. Biologic activity of vitamin K is typically assessed by its effect on blood clotting where both K1 and K2 have similar effects. But vitamin K is also important for bone health and vitamin K2 appears to be more important than K1 in this regard.

Studies have been done in Japan where people in a certain area frequently eat a fermented soybean called natto which has very high levels of vitamin K2. Those who eat this food have less than half as many fractures as those who do not. I asked a Japanese friend about natto and she made a face. Apparently, it is an acquired taste which if you haven't developed makes natto an unpleasant dietary option.

Fortunately, supplements of vitamin K2 derived from natto are available in a soft gel. This is called MK-7 vitamin K2. There is also a laboratory created form of K2 called MK-4. Both forms of vitamin K2 appear to help bone health and prevent fractures. The MK-7 lasts longer in the body and needs be taken only once a day. MK-4 is shorter acting and must be taken three times a day. Although some osteoporosis experts advocate taking both forms I have chosen to only use the MK-7. Standard dosage is a soft gel containing 90 µg a day. This is available from Jarrow Formulas via Amazon at modest cost.

In summary, I suggest a supplement of MK-7 for those with osteoporosis or osteopenia. Plant-based eaters should supplement vitamin B12 and perhaps zinc. Except in unusual circumstances other supplements are a waste of money and some of them are potentially harmful.