Disease Proof : Disease Proof : Health & Nutrition News & Commentary : Dr. Joel Fuhrman

The practice of chicken “plumping” by the industry has many consumers outraged. Plumping is term used to refer to injection of salt water, chicken stock, seaweed extract, or some combination of these into chickens – this increases the weight and price of the chicken – plumped chicken can be up to 15% salt water by weight. Of course, cost is important, but even more important is that this practice can also increase the sodium content of the chicken by up to 700%. About 30% of the chickens sold in the U.S. are plumped.

Sodium is not only associated with hypertension – high sodium intake contributes to heart disease, hemorrhagic stroke, kidney disease, osteoporosis, and stomach cancer as well. Conscientious consumers or those with elevated blood pressure who are restricting salt intake to avoid these dangerous outcomes are not expecting there to be anything other than chicken in the package of chicken. The industry is taking advantage of that fact, and adding even more salt into the diets of Americans in the process. Chicken producers say that consumers prefer the taste of plumped chicken, that adding salt water increases moistness and enhances taste - of course it tastes better to most Americans – it’s full of salt!

Taking into account the popularity of chicken among most Americans, this is a serious concern – especially since reducing salt intake in the U.S. by approximately one-third has been estimated to reduce cases of heart attack and stroke by tens of thousands each year. The last thing Americans need is more salt in their diets.

Of course, I recommend minimizing animal products. But if you do occasionally eat chicken, it is simple to make sure that you are paying for only chicken and not salt water. First, remember that “100% Natural” and even “Organic” does not mean that the chicken has not been injected with salt water. Check the ingredient list and the sodium content - chicken meat contains approximately 75 mg sodium per 4-ounce serving – plumped chicken may list up to 440 mg sodium for the same serving size.

References:

1. Salt-Water-Soaked Chicken Not at all Natural, Says CSPI: http://www.cspinet.org/new/201002241.html
2. Lifescript: Is Your Chicken too Fat? http://www.lifescript.com/Body/Diet/Eat-well/Is%20Your%20Chicken%20Too%20Fat.aspx?utm_campaign=2010-03-06-46296&utm_source=healthy-advantage&utm_medium=email&utm_content=healthy-well-wise_Is%20Your%20Chicken%20Too%20Fa&FromNL=1&sc_date=20100306T000000

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On Wednesday, January 20th, about a week after NYC Mayor Bloomberg proposed his controversial salt reduction initiative, evidence was presented in the New England Journal of Medicine that salt reduction truly can save lives.

Using mathematical models, the authors were able to make estimates of cardiovascular disease rates based on a population-wide 3 g decrease in salt consumption (1200 mg sodium). 

By their projections, a 3 g salt reduction would result in 60,000 fewer cases of coronary heart disease, 32,000 fewer strokes, and 54,000 fewer heart attacks each year. This is comparable to the cardiovascular benefit from smoking cessation efforts.   These estimates don’t even take into account the beneficial effects on other diseases related to salt excess, like osteoporosis, kidney disease, and stomach cancer.

Health care costs were predicted to decrease by $10 billion to $24 billion, making this type of intervention much more cost-effective than medicating people who have hypertension. With health care reform at the forefront of American politics, this study highlights the value of prevention in bringing down costs. Since about 80% of salt in the diet is already in the food when it is purchased, this intervention must occur at a national policy level rather than a personal responsibility level – hopefully, these data will not be ignored by policymakers.

A 1200 mg decrease in sodium consumption would represent a 34.3% drop in sodium consumption of average Americans, somewhat more ambitious than the 25% reduction proposed by Mayor Bloomberg. But based on the above figures even a 25% reduction is likely to bring cardiovascular benefits.

References:

Bibbins-Domingo K et al. Projected Effect of Dietary Salt Reductions on Future Cardiovascular Disease. NEJM. Published at www.nejm.org January 20, 2010 (10.1056/NEJMoa0907355)

Appel LJ and Anderson CAM. Compelling Evidence for Public Health Action to Reduce Salt Intake. Published at www.nejm.org January 20, 2010 (10.1056/NEJMe0910352)

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First New York City banned trans fat, then required chain restaurants to post calorie counts, then warned about weight gain from sugary sodas, and now it’s taking on salt.

Mayor Bloomberg has called for a nation-wide initiative to reduce sodium content of packaged and restaurant food by 25% over the next five years. The program would be voluntary for the food manufacturers and restaurant chains.

Of course, cutting sodium by 50% would be even better, but this is a respectable first step.   A reduction in sodium intake by 50%, according to a recent meta-analysis, is estimated to reduce the rate of stroke by 23% and cardiovascular disease by 17%.¹

A similar voluntary salt reduction program has been in action in the U.K. since 2003, and has so far has managed to reduce the average salt consumption consumption from 9.5g (approx. 3,800 mg sodium) to 8.6g (approx. 3,400 mg sodium). This year, the U.K. has set more challenging salt reduction goals for 2012.

Salt is dangerous - I have always warned people about excess salt consumption - here are some facts:

• The human diet, for millions of years, did not contain any added salt – only the sodium present in natural foods. This equates to less than 1000 mg of sodium per day. 

• Today, according to the CDC, Americans typically consume 3500 mg of sodium per day.

• Excess salt contributes to hypertension, kidney disease, heart disease, osteoporosis, stroke, hemorrhagic stroke, ulcers, and stomach cancer.²

• Americans have a 90% lifetime probability of having high blood pressure

• 80% of sodium in the American diet comes from processed and restaurant foods. As NYC health commissioner Dr. Thomas Farley said, “Most of the salt we consume is in the food when we buy it.”  The Center for Science in the Public Interest has found several chain restaurant meals that contain over 6,000 mg of sodium!

• And finally, sea salt is not healthier than table salt – all salt comes from the sea, and it doesn’t matter if it’s pink or gray or white, it’s still about 98% sodium chloride. It’s salt, and it’s dangerous. 

Many people interpret public health policies such as these as the “food police” telling us what we can and cannot eat. I see it as the opposite – progress in consumer freedom. By putting a limit on the amount of salt in foods that can be sold to us, we now have the choice. We, not the corporations that sell food to us, are in control of our salt intake. We are able to purchase packaged food and eat at restaurants without consuming dangerous levels of sodium. For those who prefer to ignore the risks of high sodium intake, no one is outlawing salt shakers.

Even more troubling, others see this as an ‘insignificant’ issue compared to health care reform, the economy, unemployment, etc...

Our health and quality of life are insignificant? Heart disease, stroke, kidney disease – insignificant? I don’t think so. People who die from diseases of nutritional ignorance are not around to worry about the economy.

But won’t cutting salt make the foods bland? First, the program plans to reduce salt gradually so that foods will not appear to be bland. And actually, excess salt deadens the sense of taste - if you cut down your salt intake, your taste buds will adjust over time, becoming more sensitive to salt. By avoiding salty foods, you regain your ability to detect and enjoy the subtle flavors in natural foods.

What do you think about this new push in New York City to improve people’s diets? I think it is great.

References:

1. Strazzullo P et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies BMJ 2009;339:b4567 ; http://www.diseaseproof.com/archives/osteoporosis-sodium-acidbase-balance-and-bone-health.html

2. Tsugane S, Sasazuki S. Diet and the risk of gastric cancer. Gastric Cancer 2007;10(2):75-83

http://www.nytimes.com/2010/01/11/business/11salt.html

http://www.cnn.com/2010/HEALTH/01/11/new.york.salt/index.html

http://www.nypost.com/p/news/opinion/opedcolumnists/as_salt_on_science_t5MDuh3FqtTWpMS5bs282J 

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We’ve known for years that excessive sodium intake contributes to hypertension, and a new meta-analysis of 13 studies has confirmed that high sodium intake is associated with increased risk of stroke and overall cardiovascular disease.¹ Salt consumption is also associated with kidney disease, and a new study suggests that reduced sodium intake could benefit bone health.

Women 45-75 years old with prehyptertension or stage 1 hypertension were assigned to one of two diets.  Both diets supplied the same amount (800 mg) of calcium.  One diet was a high-carbohydrate, low-fat diet.  The other diet was a low-sodium diet (1500 mg), which included red meat but was designed to have a low acid load.² 

Western diets, generally high in animal protein, produce acid in the body, forcing the body to buffer this acid in part by the release of alkalizing salts from bone (e.g. calcium citrate and calcium carbonate) – this is associated with urinary calcium loss and is thought to contribute to osteoporosis. Fruits, vegetables, and legumes have favorable effects on acid-base balance, since the acid-forming effect of their protein content, which is lower than that of animal products anyway, are balanced by their mineral content.^3-4

After 14 weeks, the women on both diets increased markers of bone formation and reduced their calcium excretion – those on the low sodium diet had a greater reduction in calcium loss. The authors concluded that this diet was protecting the mineral reserves in bone, and that this could have long-term implications for bone health. Future studies will likely measure bone mineral density and fracture incidence in response to these diets.²

The average daily consumption of sodium for Americans is around 4000mg, almost double the U.S. recommended maximum of 2300mg. The low sodium diet in this study provided a maximum of 1500mg of sodium per day, but included up to six servings of red meat per week, limited the consumption of nutrient-rich legumes to 4-5 per week, and was based on high-calorie, nutrient-poor grain products - 7-8 servings per day.⁵ The high-carbohydrate low-fat diet was likely based on grain products as well.

Although both of these diets had favorable effects when implemented in place of a standard western diet, they both have room for improvement. By minimizing the high-protein, high-saturated fat animal products, and replacing grain products with mineral- and phytochemical-rich vegetables, fruits, and legumes as the base of the diet, both acid load and sodium would be further reduced, presumably leading to further benefits on bone health.

References:

1. Strazzullo P et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 2009;339:b4567

2. Nowson CA et al. The effects of a low-sodium base-producing diet including red meat compared with a high-carbohydrate, low-fat diet on bone turnover markers in women aged 45-75 years. Br J Nutr. 2009 Oct;102(8):1161-70. Epub 2009 May 18.

3. Welch AA et al. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and

Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008 Jun;99(6):1335-43. Epub 2007 Nov 28.

4. Massey LK. J Nutr. Dietary animal and plant protein and human bone health: a whole foods approach. 2003 Mar;133(3):862S-865S.

5. http://dashdiet.org/

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Two studies presented at the American Society for Nephrology’s annual meeting earlier this month are beginning to build data on the links between diet and kidney disease. The researchers used data from the Nurses’ Health Study to correlate intake of sodium and sweetened beverages with kidney function in 3,000 women over an 11-year period.

In the first study, the authors found that higher dietary sodium intake was associated with a greater decline in kidney function over that 11-year time frame.  Excessive sodium intake is already well-known to promote hypertension and consequently heart disease, and now we have one more reason to avoid it.

In the second study, women who drank two or more servings per day of artificially sweetened soda doubled their odds of kidney function decline.

Sure, we save a few calories drinking a diet soda, but does that really help us? Scientific studies have linked artificial sweeteners and/or diet soda to weight gain, diabetes, cancer, and heart disease.

As a society, we disregard these possible dangers to the detriment of our health. We have grown accustomed to the intense saltiness of restaurant meals and processed foods, and the intense artificial sweetness of aspartame, acesulfame K, and sucralose. By cutting these harmful substances out of our diets, we can begin to enjoy the more subtle flavors of natural whole foods, and benefit our kidneys in the process.

Reference:

American Society of Nephrology (2009, November 2). Diets High In Sodium And Artificially Sweetened Soda Linked To Kidney Function Decline. ScienceDaily. Retrieved November 17, 2009, from http://www.sciencedaily.com/releases/2009/11/091101132543.htm

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Editor’s Note: This is a guest post from Bloggy McBloggenstein of Stop Being So Fat! and does NOT necessarily represent the opinions of DiseaseProof or Dr. Fuhrman.

If I don't have one everyday I feel incomplete. I couldn't think of a better snack to have while on the go that doesn't leave me feeling like I've overloaded on salt or sugar, which most snacks do.

Bananas are the ultimate convenience food! As far as fruit goes (or for that matter any "snack" food) bananas require no washing, cutting, peeling, storage, or packaging. They come in their own biodegradable wrapper that can be removed by hand! What more could you ask for in a convenience food?

Just don't leave the peel lying on the ground. Comedy and/or bodily injury may occur!

And they're so cheap! At least in my neck of the woods, they are usually around $.50 a pound, which can get me 3 or 4, depending on the size. That sure beats spending a dollar at the vending machine for a candy bar that will probably make me feel poorly afterward.

The influence of the Western diet in the past few decades has lead most people's diets to become lacking in enough highly nutritious foods to thrive, especially fruit. Bananas are notably helpful in combating the typical Western way of eating in that they are good sources of several vitamins and minerals that actually help reverse the negative effects of eating too many processed, and not enough whole foods.

Those nutrients include Vitamin C, the great antioxidant; vitamin B6, important for amino acid metabolism as well as even reducing depression for some that are deficient. The minerals potassium and magnesium help to reduce blood pressure, which is great since hypertension rates are skyrocketing mostly due to high sodium intake. Oh, and we can't forget fiber!

With all of these good things to say about bananas, there's really no excuse to not have some on hand.

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Presented at the 2009 American Heart Association’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference, experts claim switching to a low sodium diet is the most important lifestyle change people with heart problems can make, but many people ignore their doctor’s recommendation. Scientists surveyed 116 heart patients on what they ate for three days, finding 70% of sodium intake comes from processed foods such as deli meats and fast food; HealthDay News reports.

Boxed breakfast cereals are another high-salt culprit, especially kids’ cereals. Salt is bad news for your heart. Sodium decreases levels of a helpful enzyme that helps blood vessels relax and lowers blood pressure. And consuming a lot of salt worsens metabolic syndrome, which is a known precursor to cardiovascular disease.

As for meat, a recent study revealed men eating too much red or processed meat had a 27% higher risk of dying from heart disease and women had a 50% greater risk. Eek!

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Irish consumers aren’t paying attention. A new survey by Ireland’s Nutrition and Health Foundation claims 61% of men and 40% of females never read nutrition labels before making a purchase. Experts questioned 536 people in local supermarkets and determined only 32% of those surveyed knew the difference between salt and sodium and only 10% understood the difference between energy and calories; Food Navigator reports.

Read nutrition facts carefully. Labels on many processed foods, like potato chips, are deceptive and sometimes contain too much salt even though they say sodium or contain trans-fat when the package reads trans-fat free. Scoundrels!

Ireland is consumed with national health, especially obesity. The government wants to limit the amount of Subway sandwich shops, saying their food is too high in calories.

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A new study in Environmental Health discovered mercury in citric acid, sodium benzoate and high fructose corn syrup (HFCS). An analysis of HFCS from three different manufacturers revealed mercury levels ranging from under the detection limit of 0.005 to 0.570 micrograms of mercury per gram of high fructose corn syrup. The researchers claim average daily consumption of HFCS in America is 50 grams per person, spelling possible danger for children and sensitive populations; Reuters investigates.

But back in October, the lunatics at the U.S. Food and Drug Administration ruled that high fructose corn syrup is natural, prompting an ad campaign by corn refiners insisting that HFCS is the same as sugar. Yeah, because that’s something to brag about!

Sorry sugar pushers. Previous reports have linked high fructose corn syrup with diabetes and obesity and soft drinks with cardiovascular disease.

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Salt’s a bad guy! Dr. Fuhrman says consuming salt boosts stroke risk and previous studies show sodium leads to hypertension, i.e. high blood pressure. Even sea salt is a bad idea. When he was on Studio 10 TV in St. Petersburg, Florida, this past November, Dr. Fuhrman explained the supposed health benefits of sea salt don’t out weigh the negatives.

And now, a new study in Archives of Internal Medicine claims high sodium intake and low potassium consumption increases heart disease risk by 24%. Scientists collected data from 2275 participants, ages 30 to 54, with pre-hypertension. After examining urine excretion, researchers determined those people peeing out more sodium and less potassium were more likely to develop cardiovascular disease; from FoodNavigator-USA.

Fruits and vegetables are packed with a myriad of nutrients and vitamins. And foods like strawberries and plums are excellent sources of potassium. So, go buy some!

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