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Tuesday, May 28, 2013
People have fought over salt for thousands of years. In both the Old World and the New, these were sometimes pitched battles that took human lives. Venice and Genoa went to war over the control of salt in the 14th century. Access to salt played a critical role in both the Revolutionary and Civil wars.
Today, the clash over salt is a war of words. For decades, public health experts have exhorted Americans to slash salt consumption. Organizations such as the American Heart Association and the Centers for Disease Control and Prevention recommend that people over 50 as well as anyone with high blood pressure or diabetes limit sodium intake to 1,500 mg a day (less than half the average daily sodium consumption in the U.S.).
Scientists knew that some people with hypertension could control it by cutting back on salt, although a meta-analysis of studies revealed that salt restriction also raised LDL cholesterol and the stress hormones such as noradrenaline, renin and aldosterone (JAMA, May 6, 1998).
It comes as a shock to most Americans to learn that epidemiological studies have shown that people consuming the least sodium are at the highest risk of premature death (American Journal of Medicine, March 2006; JAMA, May 4, 2011). If there are downsides to lowering sodium intake, public health experts might need to be careful about urging everyone to avoid salt.
The universal warning that Americans need to limit sodium in their diets took a blow, metaphorically speaking, when the Institute of Medicine (IOM) brought out its evaluation of how much sodium restriction is desirable and safe (IOM, May 14, 2013). This prestigious group advises the CDC on health policy. In reviewing recent research, it concluded that lowering excessive sodium intakes would benefit public health, but that the research does not clearly show that limiting sodium to less than 2,300 mg daily would save lives. The IOM’s most controversial conclusion was stated cautiously: “The evidence on health outcomes is not consistent with efforts that encourage lowering of dietary sodium in the general population to 1,500 mg/day.”
Now, everyone agrees that a diet heavy on lunchmeat, bacon, cheese and french fries provides more salt and fat than is good for us. The scientists are really arguing about realms of salt restriction most people don’t even approach. But does it make sense to try to get everyone to struggle toward a diet that is difficult to achieve unless we are sure the rewards will be significant?
It might be better to figure out who is salt-sensitive and learn how to help those people reduce their sodium consumption. Researchers at the University of Virginia have just developed a urine test that can identify salt-sensitive individuals (Clinica Chimica Acta, June 5, 2013). About one out of four adults will develop high blood pressure if they consume too much sodium. For these people, salt restriction makes sense, though scientists might continue to argue about just how low they should go.
One-size-fits-all recommendations are no longer appropriate in an age of personalized medicine. The IOM’s report recognizes this and should be taken seriously by public health authorities.
Q: I have tried all types of antibiotics and topical acne prescriptions on the market. Nothing has worked as well as applying Listerine morning and night.
A: Listerine was first brought out as a surgical antiseptic sold to doctors starting in 1879. By the early 20th century, it was being promoted to consumers as a mouthwash. It also was touted for dandruff and “bad skin.”
The herbal oils and alcohol in Listerine have antimicrobial properties, and many readers have reported success using it for fungal infections such as jock itch, dandruff and nail fungus. Other readers also have found, as you did, that it helps clear blemishes.
Q: I am a 16-year-old girl who has had bladder problems since I was 8. I was taken to the hospital for pain in my left hip, and the doctor prescribed two pills (500 mg each) of naproxen to be taken twice daily.
I had pain in my stomach and back, and I couldn’t sleep. Then my urinary system shut down completely. I had taken the drug for almost three weeks before another doctor took me off. I was in the hospital for seven weeks and was just released with no improvement.
I know the drug did this to me. Has anyone else had this severe reaction?
A: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen can harm the kidneys (Pharmacoepidemiology and Drug Safety, October 2009). A recent study of marathon runners found that those who took ibuprofen before the race to ward off muscle soreness were more likely to develop temporary kidney failure as a result (BMJ Open online April 19, 2013). Your story is a reminder that pain relievers may have serious side effects.
Q: My husband suffered from frequent canker sores for years. I read in your column that eating kiwi fruit might help prevent them.
When I passed it along to him, he was extremely skeptical. He still decided that it couldn’t hurt to try.
After getting on a regimen of eating one kiwi fruit every other day for breakfast, the canker sores stopped completely! On the rare occasions when he can’t eat kiwis for an extended period because of travel, a sore starts up. Eating kiwis for a few days straight heals it up quickly. This might not work for everyone, but it helped him.
A: Others report that kiwi fruit is helpful against canker sores.
“The People’s Pharmacy with Joe and Terry Graedon” airs Saturday at 7 a.m. on WVTF (89.1 FM) and at 4 p.m. Saturdays and Sundays on RADIO IQ (89.7 FM). Joe and Teresa Graedon’s column runs in Tuesday’s Extra.
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