Do Salt Substitutes Help Lower Blood Pressure?

Yes, according to a meta-analysis in a recent AJCN. They drop systolic pressure about 5 units and diastolic only about 1.5 units (mmHg). Although modest, that may be enough to help reduce the need for blood pressure medications.

Steve Parker, M.D.

Could Smart Healthcare Reform Solve the U.S. Budget Deficit?

Karl Denninger makes the case that the U.S. federal budget deficit is the fault of medical monopolies that are exempt from the Sherman and Clayton anti-trust laws. In his 20-minute video, Karl mentions that a vial of scorpion antivenin costs $10,000 in the U.S., but only $100 across the border in Mexico.

In a free market, a buyer of a product or service can easily determine how much it costs, whether it’s a haircut or a house. If you think U.S. healthcare is anything near a free market, just call up your local hospitals and ask how much they charge for an uncomplicated hospitalization to have a baby or groin hernia repair. Go ahead, I’ll wait.

They won’t or can’t give you the numbers. Nor do they advertise the prices so you can be a smart shopper.

Have you noticed how advances in science and technology tend to lower the cost of most goods and services, such as computers, cell phones, food, and clothing? Why don’t we see that in healthcare? Because of monopolistic practices and other excessive governmental regulation and bureaucracy affecting not only healthcare providers but also Big Pharma and health insurers.

Unfortunately, I don’t see the situation changing anytime soon.

Steve Parker, M.D.

 

 

What’s the Healthiest Way of Eating?

Amby Burfoot has an article that asks, “what is the healthiest diet?” His answer comes from the Journal of Nutrition. Looks like there are four winners. Quoting Mr. Burfoot:

They differ slightly in the degree to which they favor, or disfavor, certain foods and food types, such as the following:

  • The Healthy Eating Index 2010: Considers low-fat dairy products a plus.
  • The Alternative Healthy Eating Index 2010: Considers nuts/legumes a plus, as well as moderate alcohol consumption. Trans fats, sugary beverages, salt, and red meat get a minus.
  • The Alternate Mediterranean Diet: Considers fish, nuts/legumes, and moderate alcohol a plus; red meat, a minus.
  • The DASH Diet: Considers low-fat dairy and nuts/legumes a plus; sugary beverages, salt, and red meat get a minus.

I think the Mediterranean diet has the most and best data to support it.

Steve Parker, M.D.

 

Recipe: Santa Fe Soup

We’ve been eating this for years at the Parker Compound. It’s one of my daughter’s favorites in autumn and winter. Can’t remember how we came up with it.

This soup is heavy with the musical fruit: beans. You’ll have to determine your own gas threshold level; most folks have no problem with a 1-cup serving.

Ingredients

1 lb (454 g) ground beef, raw, lean (85 percent lean, 15 percent fat)

½ (120 ml) cup onion, diced

1 garlic clove, diced

ground pepper

1 packet (2 oz or 57 g) Hidden Valley Original Ranch Salad Dressing and Seasoning mix

1 16-oz (454 g) can black beans (Bush’s Best)

1 16-oz (454 g) can light red kidney beans (Bush’s Best)

1 16-oz (454 g) can dark red kidney beans (Bush’s Best)

1 28-oz (790 g) can tomatoes, diced (Hunt’s)

2 packets McCormick Original Taco Seasoning Mix

1 15¼-oz (454 g) can white corn (Del Monte Fresh Cut)

1 15¼-oz (454 g) whole kernel yellow corn (Del Monte Fresh Cut)

4 oz (120 ml) water

½ tbsp (7 ml) sour cream per serving

1 sprinkle of fresh-cut chives per serving

Instructions

In a 5- or 6-quart (5 liter) pot, brown the crumbled ground beef (i.e., pan-fry without oil) along with the garlic, onion, and pepper to taste. When finished cooking, drain and discard the excess fluid. Add the Ranch Seasoning and Taco Seasoning, then mix well. Next add the beans, corn, and tomatoes along with all the juices in the cans. Add 4 oz water. Simmer for 1½ hours. Serve 1 cupful in a bowl with ½ tbsp sour cream in the center, then sprinkle with chives.

Yield

Servings per batch: 17 1-cup servings

Advanced Mediterranean Diet box breakdown: 2 veggies, ½ protein  (or simply count as 1 protein). 200 calories.

Laparoscopic Bariatric Surgery: Gastric Bypass Yields Greater Weight Loss But Higher Complications Compared to Banding

Click for details. Try the Advanced Mediterranean Diet first!

We’re Eating 500 More Calories Per Day Than We Did in the 1970s

The U.S. adult population in the 1970s ate an average of 2400 calories a day. By the 2000s, our calories were up to 2900.

Putting a face on the statistics

Putting a face on the statistics

What did average adult weight do as we increased daily calories by 500? Increased by 8.6 kg, from 72.2 to 80.6 kg. In U.S. units, that’s a 19 lb gain, from 159 to 178 lb.

Children increased their average intake by 350 cals/day over the same time frame.

If I recall correctly, I’ve seen other research suggesting the daily calorie consumption increase has been more like 150 to 350 per day (lower end for women, higher for men).

Details are in the American Journal of Clinical Nutrition.

The study authors don’t say for sure why we’re eating more, but offhand mention an “obesogenic food environment.”  They don’t think decreased physical activity is the cause of our weight gain; we’re fatter because we eat too much.

Steve Parker, M.D.

h/t Ivor Goodbody

Still Taking Fish Oil Supplements? Think Again

Salmon is one the the cold-water fatty fish loaded with omega-3 fatty acids

Salmon is one the the cold-water fatty fish loaded with omega-3 fatty acids

I’ve been sitting on this research report a few years, waiting until I had time to dig into it. That time never came. The full report is free online (thanks, British Medical Journal!). I scanned the full paper to learn that nearly all the studies in this meta-analysis used fish oil supplements, not the cold-water fatty fish the I recommend my patients eat twice a week. If you’re taking fish oil supplements on your doctor’s advice, don’t stop without consulting her.

Here’s the abstract:

Objective: To review systematically the evidence for an effect of long chain and shorter chain omega 3 fatty acids on total mortality, cardiovascular events, and cancer.

Data sources: Electronic databases searched to February 2002; authors contacted and bibliographies of randomised controlled trials (RCTs) checked to locate studies.

Review methods Review of RCTs of omega 3 intake for 3 6 months in adults (with or without risk factors for cardiovascular disease) with data on a relevant outcome. Cohort studies that estimated omega 3 intake and related this to clinical outcome during at least 6 months were also included. Application of inclusion criteria, data extraction, and quality assessments were performed independently in duplicate.

Results: Of 15 159 titles and abstracts assessed, 48 RCTs (36 913 participants) and 41 cohort studies were analysed. The trial results were inconsistent. The pooled estimate showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03) or combined cardiovascular events (0.95, 0.82 to 1.12) in participants taking additional omega 3 fats. The few studies at low risk of bias were more consistent, but they showed no effect of omega 3 on total mortality (0.98, 0.70 to 1.36) or cardiovascular events (1.09, 0.87 to 1.37). When data from the subgroup of studies of long chain omega 3 fats were analysed separately, total mortality (0.86, 0.70 to 1.04; 138 events) and cardiovascular events (0.93, 0.79 to 1.11) were not clearly reduced. Neither RCTs nor cohort studies suggested increased risk of cancer with a higher intake of omega 3 (trials: 1.07, 0.88 to 1.30; cohort studies: 1.02, 0.87 to 1.19), but clinically important harm could not be excluded.

Conclusion: Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer.

Steve Parker, M.D.

Reference: Hooper, Lee et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ  2006;332:752-760 (1 April), doi:10.1136/bmj.38755.366331.2F (published 24 March 2006).