Hidden Harbingers of Weight: Salt Intake and Obesity
In Healing, Meaning and Purpose, I discuss some of the evidence for four previously little recognized causes of obesity:
- Stress
- Salt intake
- Pesticides
- Viruses
Each of these has been widely discussed in the professional literature, but little has percolated out into the general population except in advertisements for agents like Cortislim. I remain skeptical about these products. Tinkering with just one of the 260 hormones and neurotransmitters implicated in the control of weight is unlikely to be crowned with success. And their ingredients may also have the potential for causing problems. Recent advertisements have also mentioned that one of these products may elevate mood. Sad to say, in the last year we have seen two people who developed manic symptoms after taking one of the supplements. We are urging colleagues to see if there are any other cases, or whether these two were just coincidental.
I recently mentioned some of the evidence for viruses as a cause of weight gain.
Now a new publication from the Universities of Helsinki and Kuopio is out in this month’s journal Progress in Cardiovascular Diseases, that provides powerful support for the salt hypothesis.
The researchers report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with an extraordinary 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.
As expected, reducing salt intake has a beneficial effect on blood pressure.
But in my view the most interesting finding of the study is the close link between salt intake and obesity.
As bartenders, pub landlords and tavern owners have known since the beginning of time, increasing a person’s intake of sodium produces a progressive increase in thirst. (You didn’t think that those peanuts on the bar were put there out of the goodness of the establishment’s heart did you??!)
The progressive increase in the average intake of salt explains the observed increase in the intake of sugar-containing beverages which, in turn, has caused a marked net increase in the intake of calories during the same period in the United States.
Here is an extraordinary statistic: Between 1977 and 2001, energy intake from sweetened beverages increased on the average by 135 % in the United States. During the same period, the energy intake from milk was reduced by 38 %. The net effect on energy intake was a 278 kcal increase per person a day. The American Heart Association has estimated that, to burn the average increase of 278 kcal a day and avoid the development or worsening of obesity, each American should now walk or vacuum 1 hour 10 minutes more every day than in 1977. As we all know, that has not happened.
In the decade from 1976-1980 to 1988-1994 the overall prevalence of obesity increased 61 % among men and 52 % among women. During 1999 to 2002, the prevalence of obesity was 120 % higher among men and 99 % higher among women as compared with the 1976 to 1980 figures. The increased intake of salt, through induction of thirst with increased intake of high-energy beverages has clearly made a significant contribution to the increase of obesity in the United States.
It is also of note that until 1983 the use of salt did not change or even showed a continuous decreasing trend in the United States. The prevalence of obesity was relatively low and remained essentially unchanged from early 1960s to early 1980s.
This new study suggests that a comprehensive reduction in salt intake, which would reduce the intake of high-energy beverages, would be a potentially powerful means in the so far failed attempts to combat obesity in industrialized societies.
There is now conclusive population-wide evidence that indicates that we could achieve powerful beneficial health effects simply by reducing our overall salt intake. These benefits include a decrease in obesity.
As an aside, the population-wide long-term experience from Finland indicated that a remarkable decrease in the salt intake has not caused any adverse effects.
A number of years ago we were engaged in some experiments in which we replaced regular table salt – sodium chloride – with potassium chloride. For the first three weeks food seemed rather tasteless. But then we all suddenly discovered a new universe of flavors that had previously been hidden under a thick coating of salt. So a dietary change does have a temporary effect on your taste buds.
Although the paper doesn’t say so, there is also some data that salt may itself increase cortisol release.
The bottom line?
We now have clear, empirical data to support three out of the four points that I made in Healing, Meaning and Purpose, and there is some less robust data for the fourth.
I urge you to try gradually to reduce your personal intake or salt, and to encourage your family and friends to do the same. I mentioned that food may initially seem a little less flavorful, but then things change rapidly and for the better.
And your body will love you for the change!
Another Reason to Eat Your Greens
“Health requires healthy food.”
–Roger Williams (Indian-born American Chemist who did pioneering work on the Vitamin B Complex, 1893-1988)
Earlier this year several news outlets including Time picked up a story that has been causing a great deal of discussion in medical circles.
Most of us have been extolling the virtues of fruits and vegetables for decades, but it’s always nice to have an extra piece of evidence to support what we’ve been saying. The question has been how to go from large-scale epidemiological studies proving the benefits of vegetables to the inner workings of a person’s arteries.
Investigators from Wake Forest University School of Medicine in Winston-Salem, North Carolina published an important study in the Journal of Nutrition. What they did was to study genetically altered mice, who had been bred to have a very high risk of developing rapid arteriosclerosis: the formation of fatty plaques in the arterial wall that can eventually block blood flow and lead to heart attacks and stroke.
Half the mice were fed a vegetable-free diet and half the mice were fed a diet that included broccoli, green beans, corn, peas and carrots.
After 16 weeks, the researchers measured the cholesterol content in the blood vessels and estimated that plaques in the arteries of the mice were 38% smaller. Cholesterol, and particularly the “bad” cholesterols VLDL and ILDL fell markedly in the mice on the healthy diet, but these improvements were not on their own enough to explain the improvement in the blood vessels: the anti-atherogenic effects of the vegetable diet remained largely unexplained by the variation in plasma lipoproteins or body weight.
There was a 37% reduction in serum amyloid – a marker of inflammation in mice – suggesting that consuming vegetables may inhibit inflammatory activity. This is line with data from other studies indicating that fruit and vegetables should be key components of an inflammation-lowering program. This is very important: in the last twenty years it has become very clear that arteriosclerosis is intimately associated with inflammation in the arterial wall.
Many inflammatory conditions including rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus and psoriasis, are all associated with an increased risk of developing arteriosclerosis.
Interestingly some years ago Dean Ornish presented evidence indicating that diet and exercise could reverse arteriosclerosis. I’ve always found Dean’s work interesting, well done and persuasive. It surprises me to see how many people remain unconvinced. This new research provides indirect support for his work.
The average person only eats three portions of fruit and vegetables a day: we should all be eating at least five, and they should be of as many different colors and types as possible: there is excellent evidence that combinations of fruits and vegetables are much better for your health than just eating one or two types.
As an aside, I must admit that I’m no fan of animal experiments: I don’t and won’t do them. And every time that I hear about them, I think that we need to say a sincere thank you to the animal kingdom for their sacrifice in helping us.
“God, in His infinite wisdom, neglected nothing and if we would eat our food without trying to improve, change or refine it, thereby destroying its life-giving elements, it would meet all requirements of the body.”
–Jethro Kloss (American Nutritionist and Writer 1863-1943)
“In fresh fruit and vegetables and nuts are all the vitamins and minerals and high grade proteins the human body needs to bring it to a state of physical perfection and to MAINTAIN it in that state indefinitely.”
–Herbert Shelton (English Evolutionary Philosopher, 1820-1903)
“Nothing will benefit human health and increase the chances for survival of life on earth as much as the evolution to a vegetarian diet.”
–Albert Einstein (German-born American Physicist and, in 1921, Winner of the Nobel Prize in Physics, 1879-1955)
Banquo’s Ghost
“Chess is the game which reflects most honor on human wit.” — Voltaire (a.k.a. François-Marie Arouet, French Writer and Philosopher, 1694-1778)
For anyone with even a passing interest in chess, a re-unification match for the World Championship is currently taking place in Elista, the capital city of Kalmykia, a small region of the Russian Federation that is Europe’s only Buddhist country. Though I’m sure that some would quibble about whether it should be in Europe or Asia.
The beginning of the match between two of the world’s top Grandmasters – the aggressive Bulgarian gambler Veselin Topalov and the conservative Russian, Vladimir Kramnik – has led to and 2-0 score in favor of the Russian.
So why am I mentioning this is a blog dedicated to Personal Growth, Healing and Wellness? Because the current one-sided score line has a lot to do with each of these topics. This match is not just about chess playing ability: it is also about psychological and emotional strength, character and resilience.
There was a time when chess masters were unfit, often over-weight and the majority smoked. When I first started playing in tournaments in England, it was quite normal to have ashtrays beside most of the boards.
Oh how things have changed!
Now the players prepare physically, psychologically and some even spiritually with prayer and meditation:
- Very few players smoke, not just because of long-term health risk, but because the deleterious effects of lowered oxygen levels on cognition outweigh the short-term improvement in attention caused by nicotine.
- Aerobic exercise is essential to ensure that the brain is perfused with oxygen, and if you are physically unfit you cannot expect to survive a number of games that may each last for five or six hours.
- Strength training is also essential to overall fitness and physical and the maintenance of psychological resilience. Topalov is going to need that now.
- Posture is extremely important. According to Chinese and Ayurvedic physicians and chiropractors, bad posture results in a restriction in the flow of Qi, Prana, or blood. Whether or not you believe in the flow of Qi in the body, it is easy to demonstrate that bad posture has bad effects on cognition.
- Flexibility is also an essential part of physical wellness that affects you psychologically as well as physically. Daily stretching should be part of everyone’s life.
- Relaxation and meditation: one or other or both are essential tools for maintaining your balance while under stress, and for building resilience.
- Diet: a carefully balanced nutritious diet rich in omega-3 fatty acids (without any added mercury!) and fiber is essential for optimum mental functioning.
- Fluid intake: the current recommendations are for a healthy person to drink between 80 and 120 fluid ounces of pure water each day.
- Avoid alcohol: A former World Champion – Alexander Alekhine – lost his title after turning up drunk on a number of occasions during a match to defend his title.
Looking at the pictures from the match, in both games Topalov looked intense and Kramnik far more relaxed. It could have been an illusion: I would need to be in proximity to be sure. In the first game Topalov took a needless risk in a dead level position. In the second, he had an absolutely won game. I’m no grandmaster, but even I spotted a win in three moves. How could he have failed to find it and then lost?
What is the explanation? Chess players have to play a certain number of moves in a specified time, so not only are they playing their opponent, they are also playing against the clock. The biggest prize in the game is on the line, for which both players have been preparing since childhood. And there are hundreds of thousands of people who are watching and analyzing their every move.
I know from personal experience that it can be hard enough to be interviewed on a television show being watched by millions of people, where any false statement would haunt me forever. Imagine having a battle of wits with one of the finest chess players in the world in the knowledge that every move will be analyzed for the next century, and computers are already analyzing every permutation of every move that the two players have made.
The stress on the players is unbelievable. Both have prepared for it, but it is also a matter of who has prepared best: that is a mixture of temperament and training. Just today I read an article talking about ways of avoiding stress. This is silly: stress is part of life and it can provide the motor in motivation. The trick is how we learn to respond to stress.
There is also another stressor that has only been felt by world championship contenders on two or three previous occasions. This match is being played in the shadow of the retirement of Garry Kasparov, who, in the opinion of most people, is the strongest player who ever lived, with the possible exception of Bobby Fischer. The difference is that Bobby became World Champion all by himself, with little help and by inventing a new approach to chess. It is a great tragedy that his life has apparently been blighted by mental illness, and that he has played only a few recorded games in the last 34 years.
By contrast, Garry was the strongest player in the world for twenty years, and in the opinion of most experts would probably still beat both of the current contenders. So whoever wins wants to prove himself a worthy champion. Garry’s specter remains like the ghost of Banquo in the Scottish play.
The final essential is that both players have to detach from the results of the first two games. Kramnik will obviously have his tail up now, but he is too smart and too experienced to give in to complacency. Topalov has to completely forget about the first two games and focus on what lies ahead: I’m sure that he has someone on his team working on simple techniques to stop the past from populating his psychological present.
Whatever lies ahead for these two men in the next few weeks, we shall see that chess is a microcosm of life in general.
“What is needed, rather than running away or controlling or suppressing or any other resistance, is understanding fear; that means, watch it, learn about it, come directly into contact with it. We are to learn about fear, not how to escape from it.”
–Jiddu Krishnamurti (Indian Spiritual Teacher, 1895-1986)
Restless Legs Syndrome and Integrated Medicine
In the last entry we looked at RLS: what it is, and some of the conventional approaches to treating it. I now want to spend a moment talking about some of the other approaches that we have tried. For most of these there is very little evidence, so we use them in conjunction with conventional medicine.
If you want to try any of them, discuss them with your health care provider, so that he or she can guide you toward the best ways of putting treatments together.
- Diet: A low sugar diet helps some people, and it is always worth keeping a food diary for a week to see if there’s any association between something that you’ve eaten and a worsening of your symptoms.
- If you like juicing, there have been a number of anecdotal reports of the use of carrot, celery and spinach juices helping some people. (I am writing this while we are still in the middle of the spinach/E. coli scare, so leave this one out until the FDA has given us the all clear.
- There have been publications about the use of vitamins E and B and folic acid in RLS. Vitamin E can cause a GI upset in some people and if used in too high a dose (above 800IU/day) may elevate blood pressure; folic acid has to be used with caution in people on anticonvulsants. If you try these options, bear in mind that no supplement is likely to work unless it is taken for at least a month.
- Acupuncture sometimes helps: there are three acupuncture points in the legs that come up in the prescription: Urinary bladder 57, Spleen 6 and Stomach 36.
- Homeopathic remedies have been reported to help, and I’ve had some success. The precise remedy always depends on the precise characteristics of the individual, but the most common ones have been Rhus Toxicodendron, Causticum, Tarentula Hispanica and Zincum Metallicum. If you live in a place in which there are good homeopaths available for consultation, it’s another option.
- Several herbal remedies have been reported to help: Passion Flower, Cimicifuga, Valerian, Black Cohosh and Piper Methysticum. Just remember that some of the herbs sold in health food stores don’t contain what they should, and Valerian and Black Cohosh have recently been associated with liver toxicity in some people.
- Here is an old trick from China: take a one inch piece of fresh ginger root and grate it into a bowl of warm water. Then soak your feet in the water for about ten minutes. I’ve never seen that one work myself, by some people whom I respect have.
I also think it important not to neglect the psychological aspects of this problem, and sometimes some psychotherapy can be a helpful adjunct.
Finally, ask yourself what the RLS is trying to teach you.
These are all options that have been tried and have helped some people. If you are not having success from conventional medicine alone, or if you don’t care for conventional medicine, then discuss these options with a professional, use your intuition, and let us know if you have success.
Prostate Cancer, Shift Work and Vitamin D
One out of six American men will develop prostate cancer and more than a third of them will experience a recurrence after undergoing treatment, putting them at high risk to die of the disease.
A study from Japan in this month’s issue of the American Journal of Epidemiology, reports prospective research that examined the association between shift work and the risk of prostate cancer incidence among 14,052 working men. Compared with day workers, people who worked rotating shifts were significantly at risk for prostate cancer whereas fixed-night work was associated with a small and non-significant increase in risk. This report is the first to reveal a significant relation between rotating-shift work and prostate cancer. Previous research has found that shift work may be linked to an increased risk of breast and colon cancer.
It’s important not to jump off the deep end: we are long way from saying that sleep disturbance is linked to prostate cancer. But it is another piece of evidence suggesting a link between environmental factors and genes, since there are a number of genes that may increase a man’s risk for prostate cancer.
However, there have now been several reports that disturbances in normal body rhythms might be linked to some cancers and this report adds to that evidence. It has never been shown that the actual sleep disturbance itself is responsible for the slight increase in risk seen in these studies. It could also be that people with abnormal sleep patterns are more likely to be doing something else, for instance smoking or eating junk food that would interfere with sleep and increase people’s cancer risk.
But here’s something to think about: shift workers have been found to have reduced secretion of the sleep-inducing hormone melatonin. Melatonin has also been shown in some studies to have some potential anti-cancer effects. The studies are controversial and certainly not conclusive, despite what one or two melatonin manufacturers may say. But something that is true is that reduced secretion of melatonin has been linked to increased production of sex hormones, which play a role in regulating prostate tissues.
Under normal circumstances, secretion of the hormone is low during daytime, increases soon after the onset of darkness, peaks in the middle of the night, and gradually falls until morning. In shift workers the melatonin cycle becomes disrupted.
There has been some recent evidence that maintaining adequate levels of vitamin D may reduce a man’s risk of prostate cancer.
Another study, this time on pancreatic cancer and led by Northwestern University in Illinois has indicated that taking the US Recommended Daily Allowance (RDA) of vitamin D (400 IU/day) reduces the risk of pancreatic cancer by 43%. It is published in this month’s issue of Cancer Epidemiology Biomarkers & Prevention. This does not mean that we should start taking vitamin D supplements to reduce our cancer risk. But it ties in with research indicating that some exposure to sunlight might actually reduce the risk of some cancers. But all things in moderation: malignant melanoma and basal cell carcinoma of the skin have been increasing with increased exposure to sunlight.
Curry and Cognition
During a visit to Singapore a couple of years ago, I heard about some interesting research that’s just been published in the American Journal of Epidemiology.
The authors did something fairly simple. They took a group of 1,010 people with no evidence of dementia aged 60-93 years, and correlated their consumption of curry with their cognitive performance. Studies like this are not easy: what if more intelligent people like eating curry to begin with? What if sick people can’t get out to the local curry house? And so on.
But the researchers did this all very carefully: they took into account all the known sociodemographic, health, and behavioral determinants of performance on a simple cognitive test. So they controlled for many of the other factors that can accelerate cognitive decline, like depression, smoking, drinking alcohol, high blood pressure, glucose and lipids.
The result was that people who occasionally or often ate curry had significantly better cognitive function than people who "never, or rarely" ate curry.
Is there any logic to this?
Well in fact there is. Curcumin, from the curry spice, turmeric, has been shown to possess potent antioxidant and antiinflammatory properties and to reduce beta-amyloid and plaque burden in experimental studies. There have been serious suggestions about using active constituents of tumeric to try and prevent the development of Alzheimer’s disease.
This research is all very encouraging. The amount of curcumin used in the experimental studies is similar to the amount ingested by having a couple of curries a week, and now the epidemiological study from Singapore suggest that those couple of curries may have a clinically measurable effect. That’s not to say that eating curry three times a day is going to be even better.
All things in moderation: too much curry can play havoc with your digestive processes.
And your relationships….
