DIETS HIGH IN SALT MAY INCREASE RISK OF AUTOIMMUNE DISEASES

Eating a diet high in sodium may do more than raise your blood pressure. Researchers report that it could also contribute to the development of autoimmune diseases, where the body's immune system mistakenly mounts an attack upon some part of the body.  Three new studies conducted on mice and human immune cell cultures, suggest salt may be a prime suspect in a wide range of autoimmune diseases, including multiple sclerosis (MS), psoriasis, rheumatoid arthritis and ankylosing spondylitis (arthritis of the spine).

Significant increases in the incidence of autoimmune diseases, especially multiple sclerosis and type 1 diabetes, suggests that environmental and lifestyle factors, and not just genetics, influence the onset of these diseases. Observational studies have shown that persons who eat more meals out and especially those who frequently eat fast food, have high levels of pathogenic helper T-cells (specifically helper T-cells 17),which are elevated in autoimmune diseases.  Helper T-cells 17 are a type of infection-fighting cell that is likely to become pathogenic, attacking tissues in the body rather than infectious agents. To investigate if high salt intake was possibly increasing these cell levels, Dr. David Hafler and his colleagues as well as researchers at other institutions, fed high salt diets to mice and exposed cultures of human T-cells to elevated levels of sodium.  In both cases, in the presence of sodium, helper T-cells differentiated into the pathogenic helper T-cells 17 at ten times the rate of those not exposed to high levels of sodium.  In fact,  the mice on high salt diets developed a severe form of multiple sclerosis, called autoimmune encephalomyelitis. 

While salt may play a role in autoimmune diseases, the researchers said the picture is most likely complicated. "We don't think salt is the whole story. It's a new, unexplored part of it, but there are hundreds of genetic variants involved in autoimmune disease and environmental factors, too," said Hafler.  In addition to salt, other factors have been shown to influence levels of pathogenic helper T-cells, including microbes, diet, metabolism, environmental factors and cytokines (proteins that help regulate inflammatory responses).

What to do:  While the relationship between salt and autoimmune disease has yet to be conclusively explored, there are plenty of other health benefits to limiting sodium intake.  High salt diets have been shown to raise blood pressure which increases risk for stroke, heart disease, and kidney disease.  High salt intake also is detrimental to bone health.   Daily sodium intake should be less than 2,300 mg of sodium a day (about 1 teaspoon of salt).  Limit your meals out because these are almost always high in sodium.  At home use lemon, herbs, and spices instead of salt to season foods.  Read labels to assess the sodium content of foods as most of our intake comes from salt added by manufacturers.  Deli meats, frozen dinners, boxed noodle and rice dishes, canned soups, canned vegetables, bottled dressings & sauces, bread, and snack foods all tend to be high in sodium. 

Adapted from article available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_134647.html

http://www.examiner.com/article/can-too-much-dietary-salt-set-families-up-for-developing-autoimmune-diseases

Sources: 

Kleinewietfeld M, Manzel A, Titze J, Kvakan H, Yosef N, et al.  Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells.  Nature (06 March 2013)|doi:10.1038/nature11868.  Available at: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature11868.html?WT.ec_id=NATURE-20130307

Wu C, Yosef N, Thalhamer T, Zhu C, Xiao S et al.  Induction of pathogenic TH17 cells by inducible salt-sensing kinase SGK1.  Nature (06 March 2013) | doi:10.1038/nature11984. Available at: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature11984.html

Yosef N, Shalek AK, Gaublomme JT, Jin H, Lee Y, et al.  Dynamic regulatory network controlling TH17 cell differentiation.  Nature (06 March 2013) | doi:10.1038/nature11981. Available at: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature11981.html

EVEN A DRINK A DAY BOOSTS RISK FOR CANCER AS WELL AS DANGEROUS IRREGULAR HEARTBEAT

Two new studies indicate that even very moderate alcohol intake can prove detrimental to our health.  In the first study, researchers found that intake as low as a drink a day increases the risk of dying from cancer, and, in the second, it was found that among those with heart disease, very moderate intake increases risk for atrial fibrillation, an irregular heart rhythm that can lead to stroke and/or heart failure.   

In the cancer study, researchers analyzed cancer mortality and alcohol intake data in the U.S. from 2009-2010 and found that 1 in every 30 cancer deaths can be attributed to alcohol consumption.  While heavy drinking increases cancer risk more than moderate intake, as much as 30% of all alcohol-related cancer deaths are linked to drinking 1 ½ or less drinks per day.   Alcohol appears to be an especially important risk factor for breast cancer where 1 in every 6 breast cancer deaths has been attributed to the increased risk that comes from alcohol consumption.  

Commenting on the study findings, lead investigator Dr. David Nelson stated “Alcohol is a cancer-causing agent that's in plain sight, but people just don't see it.  Moderate drinking has been associated with heart benefits, but, in the broader context of all the issues and all the problems that alcohol is related to, alcohol causes 10 times as many deaths as it prevents.  There is really no safe level of alcohol use.” 

Previous studies have shown drinking is a risk factor for cancers of the mouth, throat, esophagus, liver, colon, rectum and, in women, breast cancer.  It is believed alcohol acts as a chemical irritant to sensitive cells, impeding their DNA repair as well as increasing their vulnerability to other carcinogens such as tobacco smoke.  In women, alcohol’s impact on estrogen levels and estrogen receptors is believed to drive increases in breast cancer rates.   

Another recent study found that moderate alcohol consumption increases risk of experiencing atrial fibrillation (a-fib) among those with heart disease or diabetes.  Binge drinking has long been known to increase episodes of a-fib but the effect that moderate alcohol consumption has on rates of a-fib has been debated. 

Several studies have suggested that moderate alcohol intake - up to one drink a day for women, up to two for men can help to prevent coronary heart disease - where cholesterol-containing "plaque" builds up in the arteries.  However, this latest study suggests that when people already have heart issues, moderate drinking is actually tied to more A-fib cases. For five years, the study tracked more than 30,000 older adults who either had clogged arteries, a history of stroke, or diabetes with heart health problems. Most had coronary heart disease.  Researchers found that even after controlling for age, weight, and cigarette smoking, compared to those who abstained, those who were moderate alcohol consumers had a 14% increased risk for a-fib. 

Commenting on the findings, lead researcher Dr. Yan Liang wrote, “In general, experts say that if you're already a moderate drinker it's probably okay to keep it up.  But, for people with certain chronic health problems, the new results may question that guidance.  Our findings suggest that older individuals with cardiovascular disease or diabetes should probably limit their alcoholic beverages to no more than 1 drink per week".

What to do:  If you already abstain, continue to do so.  If you already have irregular heartbeat, a-fib, a history of stroke, congestive heart failure, or advanced heart disease it is usually advised that you avoid alcohol.  If you do not have advanced heart disease and you choose to drink alcohol, do so in moderation.  Even infrequent binge drinking has been shown to detrimental.  Moderate drinking means having up to one drink a day for women and up to two for men.  One drink is defined as 0.6-fluid ounces of pure alcohol which translates into about 10-ounces of beer, 4-ounces of wine or 1 ¼ ounces of liquor.  The antioxidants in red wine, believed to confer some of its associated heart health benefits, are also found in grapes, grape juice, blueberries, blackberries, mulberries, peanuts, and pistachios.

Adapted from articles available at:

http://vitals.nbcnews.com/_news/2012/10/03/14204194-moderate-drinking-linked-to-abnormal-heart-rhythm?lite

http://www.reuters.com/article/2012/10/03/us-moderate-drinking-idUSBRE89213L20121003

http://www.nlm.nih.gov/medlineplus/news/fullstory_134037.html

Sources:

Nelson DE, Jarman DW, Rehm J, Greenfield TK, Rey G, Kerr WC, Miller P, Shield KD, Ye Y, Naimi TS. Alcohol-attributable cancer deaths and years of potential life lost in the United States. American Journal of Public Health, Feb. 14, 2013, doi: 10.2105/AJPH.2012.301199

Available at: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301199?journalCode=ajph

Liang Y, Mente A, Yusuf S, Gao P, Sleight P, Zhu J, Fagard R, Lonn E, Teo KK, Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease.  CMAJ October 1, 2012, doi:10.1503/cmaj.120412  Available at http://www.cmaj.ca/content/early/2012/10/01/cmaj.120412.abstract

MANY VITAMIN D SUPPLEMENTS DO NOT CONTAIN LEVELS CLAIMED ON LABEL

Unlike prescription medications, the U.S. Food and Drug Administration does not routinely test to verify that nutritional supplements such as vitamins and minerals actually contain what their labels claim.  Numerous studies that have analyzed the contents of mainstream brands of supplements have found significant differences between the nutrient levels actually in the supplement and the amounts listed on labels.  A recent study that focused on vitamin D supplements again found that some contained a lot more vitamin D than the label stated while others contained markedly less.

In the new study, researchers analyzed 55 over-the-counter bottles of vitamin D supplements from 12 major manufacturers. They also tested vitamin D pills made at a compounding pharmacy, which creates individualized drugs. The manufacturers were unidentified.  Overall, the amount of vitamin D found in the supplements ranged from 9% to 146% percent of what was listed on the label.

The study found that the supplements produced by the compounding company were the least reliable while the manufacturers with the USP seal (which means their supplements’ contents are verified by the non-profit U.S. Pharmacopeial Convention) had the most reliable supplements. 

In recent years, use of vitamin D supplements has been rapidly growing.  It has been increasingly recognized that many Americans are deficient in vitamin D.  Low vitamin D is a concern because research has linked low levels to bone disease and a likely increased risk of diabetes, heart disease, low thyroid function, poor immune function, and some cancers.  Vitamin D is made naturally when our skin is exposed to the sun but too much sun exposure increases risk of skin cancer.  Some vitamin D is also available in foods such as milk and other fortified products, fatty fish oil, and sardines and other fish that contain bones.  Most at risk for low vitamin D are those who are elderly, obese, have dark skin, and/or live in locations farther from the equator (such as New York). 

What to do:  Vitamin D levels can be tested with your routine bloodwork.  Follow your doctor’s advice on supplementation.  If you have been taking a supplement for several months and do not see a rise in your vitamin D level, you may need to switch supplements.  When choosing supplements, opt for widespread brands because they are more likely to be tested than smaller brands.  Notably, in tests by Consumer Labs, price does not appear to correspond with quality.  Also, consider looking for the USP seal.  Some supplements that are USP certified include Sunmark, TruNature, Kirkland, Nature Made, and Berkley & Johnson.

Source:  LeBlanc ES, Perrin N, Johnson JD, Ballatore A , Hillier T.  Over-the-counter and compounded vitamin D: Is potency what we expect? JAMA Intern Med,  Feb 11, 2013; doi:10.1001/jamainternmed.2013.3812.  Available at: http://archinte.jamanetwork.com/article.aspx?articleid=1570096

Adapted from article available at:  http://www.nlm.nih.gov/medlineplus/news/fullstory_133910.html

POTASSIUM CITRATE IN FRUITS AND VEGETABLES PROMOTES BONE HEALTH

Two recent studies indicate that intake of potassium citrate, found primarily in fruits and vegetables, helps preserve bone density.  Poor bone health is a major problem in the US where over 10 million people have osteoporosis (very low bone mass) and another 18 million have osteopenia (low bone mass).

In the most recent findings, Swiss researchers gave 169 people who were over 65 either a placebo or enough potassium citrate to supplement their diets with 2,400 mg of potassium a day. Both groups also got calcium (500 mg) and vitamin D (400 IU) every day. None of the participants had bone density low enough to require treatment for osteoporosis.   After two years, the potassium citrate takers had higher spine, hip, arm, and leg bone density than those taking a placebo.

A recent U.S. study also found that potassium citrate helped to preserve bone density.  In this study researchers gave 52 men and women over age 55 either a placebo, 2400 mg of potassium citrate, or 3600 mg of potassium citrate each day.  Each participant also took a 630 mg calcium supplement and 400 IU of vitamin D.  Researchers did not assess bone density directly but did evaluate pre- and post-study biomarkers of calcium turnover in the body.  After six months, those on supplementation had significantly less bone turnover rates and lower levels of calcium losses compared to those taking the placebo.   The higher level of supplementation, 3600 mg, appeared to offer greater bone health benefits than the 2400 mg supplements.

Why does potassium citrate promote better bone health?  The digestion of grains and animal proteins, both large parts of the typical American diet, increases acidity in the blood.  In order to neutralize this acidity, the body releases calcium from the bones, leading to a potential loss of bone mineral density.  When one consumes plenty of foods rich in potassium citrate, the potassium citrate can neutralize acidity created by grains and meats, allowing the body to preserve more of its bone calcium.  

What to do: Eat more fruits and vegetables.  Because potassium is lost through cooking, the raw ones are the best sources.  Fruits and vegetables richest in potassium citrate include  bananas, citrus, apricots, melons, kiwis, tomatoes, Swiss chard, Romaine, turnip greens, spinach, collard greens, kale, broccoli, and Brussels sprouts.  Protein sources beans and fish are also a good source of potassium citrate.  Compared to meat and poultry, these proteins are believed to be less acidifying because they are rich in potassium citrate.  You can also consider taking a potassium citrate supplement but, in order to get an amount comparable to the doses used in these studies, you would have to take 6-9 tablets daily, so might as well just load up on fruits and veggies.  They can replace less healthy choices and also are packed with other important minerals, vitamins, phytonutrients, and fiber.

Sources:  J. Clin. Endocrin. Metab. DOI: 10.1210/jc.2012-3099 & J. Bone Miner. Res. DOI: 10.1002/jbmr.1764.

Adapted from articles available at: http://www.nutraingredients.com/Research/Study-backs-acidity-regulator-for-bone-health-benefits & The Nutrition Action Healthletter,  Jan/Feb 2013, pg. 8.  

EATING PLENTY OF BERRIES CUTS HEART ATTACK RISK

A large 18-year study has found that while eating plenty of all fruits and vegetables is good for heart health, getting three or more servings per week of berries especially reduces heart attack risk.

The study included nearly 94,000 young and middle-aged women who took part in the Nurses' Health Study II. Participants who ate the most blueberries and strawberries were 32% less likely to have a heart attack, compared to women who ate berries once a month or less – even among women who otherwise ate a diet rich in other fruits and vegetables. This benefit was independent of other heart risk factors such as advancing age, high blood pressure, family history of heart attack, body mass index, exercise, smoking, and caffeine and alcohol intake.

Blueberries and strawberries are believed to be especially heart healthy because they contain high levels of flavonoid phytonutrients called anthocyanins which are believed to promote healthy blood vessel elasticity and prevent arterial plaque build-up and the coronary arterial blockages that lead to heart attacks.   

What to do:  Eat plenty of foods rich in anthocyanins.  These are naturally present in dark red- and blue-colored fruits and vegetables, so, in addition to blueberries and strawberries, they are also found in high amounts in cherries, cranberries, grapes, black currants, plums, raspberries, blackberries, beets, and red cabbage.  Aim for 3 or more cups of these foods per week.  Even in winter this is not hard to do.  Roasted beets or borsht soup are great wintertime favorites.  Frozen berries retain most of the nutrients of fresh berries and can be easier to keep on hand and more economical.  Make berries a part of your daily intake by adding them to smoothies, cereal, oatmeal, or lowfat yogurt.  And, they are also great as a snack by themselves!

SOURCE: Cassidy A, Mukamal KJ, Liu L, Franz M, Eliassen M.  High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women.  Jan. 14, 2013, Circulation online.  Available at:  http://circ.ahajournals.org/content/127/2/188.full

Adapted from articles available at:

http://newsroom.heart.org/news/strawberries-blueberries-may-cut-heart-attack-risk-in-women

http://www.nlm.nih.gov/medlineplus/news/fullstory_133063.html

http://consumer.healthday.com/Article.asp?AID=672494

ARTERIES DAMAGED EACH TIME YOU HAVE A MEAL HIGH IN UNHEALTHY FAT AND SODIUM

New research is demonstrating how making an unhealthy meal choice not only has implications for your long-term health but also how well your body functions in the present.  The findings of two recent Canadian studies illuminate how each unhealthy meal you eat, not only puts you at risk for weight gain but reduces your blood vessels’ capacity to dilate and achieve healthy blood flow.   However, a healthy Mediterranean diet-type meal, if the portions are not in excess of needs, may help blood flow.    

In both studies, the researchers assessed how meals affected the inner lining, the endothelium, of the blood vessels. Endothelial dilation -- widening of the vessels -- enables the vessels to deliver needed oxygen to the body’s cells. Healthy blood vessels are elastic and able to dilate but as heart disease develops the blood vessels stiffen and lose their capacity to adequately expand, so endothelial function is a strong predictor of the risk for heart disease. 

In the first study, out of the Montreal Heart Institute, researchers compared how arterial blood vessels responded when persons were fed either a healthy Mediterranean-style meal or a fast food-type meal.  The fast-food type meal, comprised of a sandwich made with sausage, egg and cheese as well as three hash browns, was laden with unhealthy saturated fats and sodium.  In contrast, the Mediterranean meal was rich in healthy fats and antioxidants and included salmon, almonds, and vegetables cooked in olive oil. 

After eating the fast food-type meal, the participants' arteries dilated 24% less than they did when they had not eaten or when they had eaten the Mediterranean-style meal.  Researchers also analyzed how the vessels of persons with healthy and unhealthy levels of blood triglycerides responded to the two meals.  Triglycerides are a fat in the blood that, when too high, cause health problems such as clogging of the arteries and the development of fatty deposits in the liver.  Interestingly, researchers found that among those with high triglycerides, the Mediterranean-style meal helped to improve endothelial function while the fast-food meal decreased endothelial function even more than it did for those with healthy blood triglycerides. 

Similarly, in another study, conducted by a team in Calgary, Alberta, researchers examined how blood vessels responded after the consumption of two ham, egg, and cheese breakfast sandwiches with a total of 50g of fat and 900 calories.   Sure enough, compared to the participants who had not eaten recently, the blood vessels of those who ate the two breakfast sandwiches worked less effectively and dilated significantly less two hours after the meal.

Why did these meals impair arterial function?  Foods containing high levels of saturated fat are believed to increase inflammation and raise circulating blood cholesterol that can build up on the walls of the blood vessels.  Meals high in sodium can increase blood pressure which also stresses the arteries' healthy functioning.

What to do:  You already know!  Make healthy choices.  Stay away from foods high in sodium (salt) and unhealthy saturated fat found in fatty meats and creamy dairy foods such as cheese.  Next time you eye a thick hamburger, remember each and every unhealthy meal you have is doing real time damage to your cardiovascular system.   

Adapted from articles found at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_130857.html

http://www.nlm.nih.gov/medlineplus/news/fullstory_130819.html

Source:

Todd Anderson, M.D., director, Libin Cardiovascular Institute of Alberta, University of Calgary, Canada; Chris Fahs, graduate assistant, department of health and exercise science, University of Oklahoma, Norman, Okla.; Oct. 30, 2012, presentation, Canadian Cardiovascular Congress meeting, Toronto

LESS FILLING! BRAIN SCANS REVEAL FRUCTOSE NOT AS SATIATING AS OTHER SUGARS

New research suggests that fructose, a simple sugar added to many foods as part of high-fructose corn syrup, does not dampen appetite nearly as much as another simple sugar, glucose.  Researchers posit that consuming foods rich in fructose, which contribute less to fullness, contributes to overeating and weight gain.

For this study, Yale University researchers fed 20 healthy adults drinks with either pure fructose or pure glucose.  Before and after consuming each of the sugars, researchers took brain scans of the participants to assess appetite-related changes in blood flow in the appetite-center, the hypothalamic region, of the brain. When people consumed glucose, levels of hormones that play a role in feeling full were high.  However, when participants consumed fructose, they showed smaller increases in the hormones that are associated with satiety. Thus, these results suggest that fructose does not dampen appetite as much as glucose.  In response to these findings, obesity expert, Dr. Louis Aronne at New York-Presbyterian stated, "Things as subtle as a change in sweetener can have an impact on how full somebody feels, and could lead to an increase in calorie intake and an increasing pattern in obesity seen in this country".

Still, obesity experts cautioned that while these findings are intriguing, it is important to keep in mind that, in the real world, most foods contain a combination of sugars.  Glucose and fructose are both simple sugars that are naturally found in fruits, grains, and sweeteners.  Table sugar is equal parts glucose and fructose.  Dairy contains glucose but not fructose.  High-fructose corn syrup, a common sweetener in soda, usually has a formulation of 55% fructose and 42% glucose. 

What to do:  Regardless of how fructose compares to glucose, minimize your intake of highly sweetened foods and beverages.  To satisfy your sweet tooth, opt for whole-foods that have sweetness such as fruits and starchy vegetables like squash and yams.  Foods such as fruits that contain sugars bound up in plant fibers contain less total sugar and raise blood sugar more slowly than concentrated sources of sugars such as soda, juice, candy, and sweets.  

Adapted from article found at:

http://consumer.healthday.com/Article.asp?AID=672039

http://www.medicalnewstoday.com/articles/254512.php.

Sources:

"Effects of Fructose vs. Glucose on Regional Cerebral Blood Flow in Brain Regions Involved With Appetite and Reward Pathways"; Page KA, Chan O, Arora J, and others; JAMA 2013;309(1):63-70; DOI:10.1001/jama.2012.116975.
"Fructose Ingestion and Cerebral, Metabolic, and Satiety Responses"; Purnell JQ, Fair DA. JAMA 2013;309(1):85-86; DOI:10.1001/jama.2012.190505