Do health professionals / scientist really know?

[thyme4change]

Not to sound like Paul, but do we really understand much about nutrition and the human body?  It seems like no matter what, the "truth" about diet changes every 15 years.  

www.npr.org/blogs/thesalt/2013/05/15/183883415/eating-much-less-salt-may-be-risky-in-an-over-salted-world

Americans are repeatedly told to cut back on salt to reduce the risk of heart disease. But there are new questions being raised about the possible risks of reducing sodium too much.

So, how low should we go? Currently, the government recommends that Americans should aim for 2,300 milligrams per day. And people older than 50, as well as those with high blood pressure, diabetes or kidney disease are advised to reduce sodium even further, down to 1,500 mg per day.

But a panel of experts convened by the Institute of Medicine concludes in a new report that "the evidence on direct health outcomes does not support recommendations to lower sodium intake ... to or even below 1,500 mg per day."

Why? We asked the committee chairman, Brian Strom, a dean and professor of public health at the University of Pennsylvania, to summarize the panel's findings for us. "The net conclusion is that people who are eating too much sodium should lower their sodium, but it is possible that if you lower it too much you may do harm."

Strom says a lot more research is needed to better understand how ultra-low-sodium diets may be beneficial or harmful. Strom pointed to an Italian study of people with congestive heart failure as an example of research that has hinted that diets too low in sodium may be problematic for certain people.

"The people on the low-sodium diet actually did worse [compared to those on medium-sodium diets]," says Strom. "They had more hospital re-admissions and they had a higher mortality rate." He says it's unclear if the results would be the same for Americans with congestive heart failure, since treatments here are different than they are in Italy. But, he says, the findings raise questions.

The American Heart Association, which recommends a low-sodium (1,500 mg) diet for all Americans, released a statement stating that it disagrees with the key findings of the new report.

And some preventive health experts are critical, too. The World Health Organization has concluded that elevated blood pressure is the leading cause of preventable death, which suggests that staving off high blood pressure with low-sodium diets is an important strategy.

"Sodium reduction remains a critically important component of public health efforts designed to ... prevent cardiovascular disease," Lawrence Appel of Johns Hopkins University writes in an email.

Appel points out that the studies that suggest that low-sodium diets are harmful tend to focus on "sick populations in which illness leads to low sodium intake rather than the reverse."

Some groups of Americans, including older adults and African-Americans, are especially sensitive to the blood-pressure lowering effects of cutting sodium, Appel says. So the strategy of aiming for low-salt diets has "tremendous potential to reduce racial disparities in blood pressure-related cardiovascular disease."

The bottom line, according to Bonnie Liebman, director of nutrition for the Center for Science in the Public Interest, is that Americans are eating way too much salt, on average about 3,400 milligrams a day.

"And we know that much is harmful," she says. "It increases blood pressure, which increases the risk of heart attack and stroke."

And she says focusing on the potential risks of a very-low-sodium diet distracts from the more important conversation about how to get Americans to start consuming less.

To better understand just how much salt is found in the typical lunch out, I met Liebman at a food court.

Our first stop was McDonalds, where it turns out burgers have about twice as much salt as the fries: 1,000 mg, and up to 2,000 if you get the Angus bacon burger, Liebman says.

Put the burger and fries together and you've already reached the recommended daily sodium intake. Liebman says it's a similar story at every chain, from Subway to Chipotle to Pizzeria Uno. (McDonalds has pledged to reduce sodium 15 percent across its menu by 2015.)

So even though the new study raises questions about potential harms of ultra-low-sodium diets, with a food supply like ours, most of us consume way too much salt, not too little.

[swamp]

No, I don't think they do know.  

We previously were told to eat carbs and cut the fats.   For those of us who are insulin resistant, that diet is like the kiss of death.

We're now told to do paleo.  The japanese eat rice like it's going out of style and they live forever.

The french eat cheese and butter by the tons but seem to be doing OK. 

Everything in moderation, and try not to eat too much processed crap.

[thyme4change]

I will never give up dairy.  NEVER!

[Deleted]

Scientists work for the Illuminati in a vast conspiracy to keep us bloated and lethargic so they can steal all of the gold.

[swamp]

May 15, 2013 13:43:02 GMT -5 thyme4change said:

I will never give up dairy.  NEVER!

if you take my cheese, i will cut you.

[thyme4change]

May 15, 2013 13:43:34 GMT -5 swamp said:

May 15, 2013 13:43:02 GMT -5 thyme4change said:

I will never give up dairy.  NEVER!

if you take my cheese, i will cut you.

I said that - word for word - to a guy who was talking to me about weight loss.  He laughed and I said "This isn't funny."

[swamp]

May 15, 2013 13:45:03 GMT -5 thyme4change said:

May 15, 2013 13:43:34 GMT -5 swamp said:

if you take my cheese, i will cut you.

I said that - word for word - to a guy who was talking to me about weight loss.  He laughed and I said "This isn't funny."

I wouldn't take weight loss advice from someone who is missing a sense of humor. [img]http://images.proboards.com/new/wink.png[/img]

[movingforward]

I am still convinced that sitting on our asses all day long is much worse than what we eat IMHO.  I am certainly no expect

[hoops902]

I agree they probably don't know, but it is really in the same way that nobody knows anything about anything.  For all we really know in 20 years we'll find out that inhaling massive amounts of asbestos is actually the key to longevity, and it's only moderate ingestion that kills you. 

At the same time, in this case, sodium intake is way above where it should be.  So the advice that people should cut back to a specified level, and having that claim refuted by someone who thinks that level is too low isn't really a huge change in how people think about diet.

The other issue is that people don't really "know", they think.  If all evidence points to me saying that red meat should be consumed as 6 oz per day, but really ingesting 24 oz per day on a 1oz per hour basis is really the perfect amount, I'll probably never know that because there are limited ways to test every possible ingestion schedule of every single thing on the planet.

[movingforward]

Well, I personally feel very good about myself right now.  I only ate 1/2 a cupcake instead of a whole one

[thyme4change]

I want to know more about this new fad diet where you eat 1 oz of mean every hour!  

[midjd]

I don't think it's that they don't know, but that there's not a one-size-fits-all recommendation. Some people can handle 6000 milligrams of sodium a day and never struggle with blood pressure problems, but for most people that's probably a death sentence, so the RDA is much lower than that. 

Once you go much deeper than "eat right and exercise," advice given rarely applies to everyone and may actually be harmful to some - but the best they can do is give the advice that applies to most people. Since most people consume way too much sodium, rather than too little, the advice is geared toward them, even though it can be harmful to a few.

I do always enjoy the studies that tell me that drinking coffee and eating chocolate is good for my heart, though. Those CAN'T be wrong! 

[swamp]

I do always enjoy the studies that tell me that drinking coffee and eating chocolate is good for my heart, though. Those CAN'T be wrong

The red wine studies have to be right too. 

I do think there are different nutritional requirements for different people.  My parents have generally the same diet, same smoking history, similar levels of physical activity.  My mom as had 7 heart attacks and has clogged coronary arteries.  My dad's are completely clear.   And she probably ate better, as in had more fruits and veggies. 

[Jaguar]

All red wine studies in favor of drinking more are completely right.

[formerroomate99]

One reason the 'diet advice' keeps changing is because all these studies are filtered through reporters, who generally don't have a great science background and who reduce everything into soundbytes rather than giving the whole story. 

And you also have the fact that everybody is different, and what works for one person would be a disaster for another. 

[swasat]

Funny enough I was just reading about this new fad diet called "Intermittent Fasting". ANd Ic ome here and see this thread

Intermittent Fasting (IF) basically means you eat normally for 5 days of the week. And you consume fewere than 500 calories the other 2 days. The 2 days can be chosen as one wants i.e. they don't have to be consecutive days. People are swearing by it !!

I don't know. I can see some benefit out of it. It will definitely give the stomach and the digestive system some much needed rest. But there is always the worry of too few calories leading to fatigue, headaches etc.

[thyme4change]

People are swearing by it !!

Unfortunately, people are idiots.

[kittensaver]

Nature knows. Science just hasn't figured out Nature yet.

[swamp]

May 15, 2013 14:04:36 GMT -5 swasat said:

Funny enough I was just reading about this new fad diet called "Intermittent Fasting". ANd Ic ome here and see this thread

Intermittent Fasting (IF) basically means you eat normally for 5 days of the week. And you consume fewere than 500 calories the other 2 days. The 2 days can be chosen as one wants i.e. they don't have to be consecutive days. People are swearing by it !!

I don't know. I can see some benefit out of it. It will definitely give the stomach and the digestive system some much needed rest. But there is always the worry of too few calories leading to fatigue, headaches etc.

People also swore by the no fat all carb diet, and then the grapefruit diet, and the celery diet, and the soup diet, and the atkins diet and the paleo diet, and the white food diet.

And why does the digestive tract need to rest?   It's designed to work daily. 

[midjd]

To go along with the "no one-size-fits-all" idea, look at all the info they throw at pregnant women.

In the U.S., drinking is BAAAAAD. Many have posted that their doctor friends say drinking is actually OK, but they can't tell their patients that because someone will take it as the go-ahead to down a fifth of Crown before lunch and then sue them when their baby comes out in a velvety purple bag. So no drinking. But eat your fruits and veggies!

In France, fresh fruit is bad (listeria risk) and drinking after the first trimester (in moderation) is OK.

In Jamaica, it's not uncommon for pregnant women to smoke marijuana to deal with morning sickness.

I doubt American fetuses are any different from French and Jamaican ones, but depending on the social mores, criminal codes, and malpractice laws, medical advice can be pretty contradictory.

On another note, DH cooked steak the other night and I spent 30 minutes on the internet trying to figure out whether I would anger the fetus by eating it medium-rare rather than well-done. I'm still not sure

[swamp]

On another note, DH cooked steak the other night and I spent 30 minutes on the internet trying to figure out whether I would anger the fetus by eating it medium-rare rather than well-done. I'm still not sure

My theory is that if it makes momma happy, it would make baby happy. 

[milee]

"their doctor friends say drinking is actually OK, but they can't tell their patients that because someone will take it as the go-ahead to down a fifth of Crown before lunch and then sue them when their baby comes out in a velvety purple bag."

My OBGYN told me this.  She was very honest about which of the recommendations were based in actual science, which made sense to her and which were just to CYA because the general public are sue-happy idiots.

Drinking is a sticky subject not just in regards to pregnancy but also heart health.  Some studies have shown that moderate drinking (and that's the kicker - MODERATE= 1 drink for an average sized woman and 2 for an average sized man) is good for heart health, but doctors don't recommend that.  Why?  Because people are too dumb to be counted on to keep their drinking moderate and drink responsibly.  So once again, we gear everything towards the lowest common denominator and not share that data. 

[The Walk of the Penguin Mich]

Drinking is a sticky subject not just in regards to pregnancy but also heart health.

I had a professor who was on the scientific panel in determining what a pregnant woman could drink.  It really was quite interesting how they came about making their decision about totally abstaining, but she said that the vast majority of the scientists on the panel were that drinking a MODERATE amount during pregnancy isn't bad for you.  But the problem was, they were defining moderate no more than 2 drinks a couple times/week.

When push came to shove, they wanted to know what amount of alcohol could guarantee that the likelihood of FAS be 0 and the only way that you could get 0 is to say 0 alcohol.  So everything that is touted about abstaining from alcohol while pregnant is a CYA response.

The biggest issue she said was that everyone defines their drinks differently.  For most, a glass of wine equals a glass of wine.  For others, as long as you never finish the last swallow in your wine glass and keep topping it off, that counts as one glass of wine.  

That was a really interesting lecture, in learning how politics can define science.......

[whoisjohngalt]

May 15, 2013 13:43:34 GMT -5 swamp said:

May 15, 2013 13:43:02 GMT -5 thyme4change said:

I will never give up dairy.  NEVER!

if you take my cheese, i will cut you.

With your eyes?

[midjd]

My theory is that if it makes momma happy, it would make baby happy.

I like that theory! Will you be my doctor?

When push came to shove, they wanted to know what amount of alcohol could guarantee that the likelihood of FAS be 0 and the only way that you could get 0 is to say 0 alcohol. So everything that is touted about abstaining from alcohol while pregnant is a CYA response.

Mich, that's very interesting.  Makes you wonder what other health recommendations are CYA and not actually what doctors would recommend...

[swamp]

I like that theory! Will you be my doctor

I can't, but my sister can.  She's an OB/GYN. Are you willing to travel to FL for treatment?  She lives near milee, so maybe you can crash with her.

[swamp]

May 15, 2013 15:04:33 GMT -5 whoisjohngalt said:

May 15, 2013 13:43:34 GMT -5 swamp said:

if you take my cheese, i will cut you.

With your eyes?

no, with a cheese knife.

[milee]

May 15, 2013 15:08:07 GMT -5 swamp said:

I like that theory! Will you be my doctor

I can't, but my sister can.  She's an OB/GYN. Are you willing to travel to FL for treatment?  She lives near milee, so maybe you can crash with her.

Yep, Mid is welcome to visit.  I will even make her a nice boat drink (but only one...) if that's what she wants. 

[movingforward]

May 15, 2013 14:04:36 GMT -5 swasat said:

Funny enough I was just reading about this new fad diet called "Intermittent Fasting". ANd Ic ome here and see this thread

Intermittent Fasting (IF) basically means you eat normally for 5 days of the week. And you consume fewere than 500 calories the other 2 days. The 2 days can be chosen as one wants i.e. they don't have to be consecutive days. People are swearing by it !!

I don't know. I can see some benefit out of it. It will definitely give the stomach and the digestive system some much needed rest. But there is always the worry of too few calories leading to fatigue, headaches etc.

I have friend did this.  It was great until she passed out at work on day 4.  She continued to do it though.  She did lose weight but no way I don't think this is healthy.  She was tired and irritable all the time.  She said her doctor jumped all over her ass as well telling her that consuming only 500 calories a day slows your metabolism down way too much.  Your body thinks it is starving and starts to hoard the fat.  These crash diets are no good IMHO.

ETA:  I misread what this diet actually is.  My friend actually consumed 500 calories 5 days a week, not just 2 days.  I can actually see where doing it 2 days a week could probably be beneficial. 

[NomoreDramaQ1015]

I spent 30 minutes on the internet trying to figure out whether I would anger the fetus by eating it medium-rare rather than well-done. I'm still not sure

Don't worry after the kid is born the proper thing to do will be the exact opposite of what you did while pregnant.