Sodium intake has been a major issue in nutrition and public health for quite some time. The American diet (as well as those of many other nations) is notoriously high in sodium with staple foods like processed meat products, potato chips, and take-out food. It’s been widely communicated to the public that high sodium intake can cause high blood pressure, also known as hypertension. However, this message has often failed to reach many people who don’t currently suffer from hypertension and therefore believe that sodium reduction is not important to their health. Let’s explore the mechanism behind the link between sodium and hypertension as well as some of the other risks associated with a high sodium intake level.
Salt is extremely hygroscopic, meaning its molecules attract water from the surrounding environment. High dietary salt intake causes an increase in the concentration of sodium in the blood. In order to dilute the blood back to an appropriate level, water is pulled out of other areas of the body and into the bloodstream. The increase in blood volume stresses blood vessels, which respond by thickening their walls. As the blood vessel walls thicken, the space through which blood can flow decreases. The heart is forced to pump harder in order to get enough blood around the body, leading to high blood pressure.
One consequence of chronic hypertension is left ventricular hypertrophy (LVH). LVH is an enlargement of a portion of the heart muscle due to an increase in the pressure it is required to pump against. Studies investigating the direct link between LVH and sodium intake have shown that in people who have already developed LVH, decreasing dietary sodium can significantly lower left ventricular mass within one year. In addition, those with more severe LVH show the greatest benefit from sodium reduction. Clearly, there is a causative relationship here that may be able to help those suffering from dietary sodium-induced LVH.
High sodium intake can also put your bones at risk. As dietary sodium increases, so does urinary calcium excretion. Sodium and calcium compete for the same reabsorption mechanism in the kidneys. As sodium output due to overconsumption goes up, less calcium is able to reabsorbed, leading to greater than normal losses in calcium. Though there are other nutrients that can affect urinary calcium output, it has been shown that sodium is the primary nutritional factor. Low dietary calcium also tends to exacerbate the problem, so it may be wise for those with higher sodium diets to keep an eye on their calcium intake.
Not only does increased urinary calcium excretion cause problems for bones, but it also increases the risk of kidney stones. In fact, high salt levels are even implicated in rising rates of childhood kidney stones! For anyone who’s ever had a kidney stone can attest, it sucks. Don’t let salty food be the cause of this excruciating disorder.
Another more direct risk to the kidneys exists, as well. High blood pressure can damage the kidneys’ vascular system, resulting in what’s known as hypertensive nephrosclerosis (HN). HN accounts for at least 25% of patients suffering from end-stage renal disease (ESRD). It is the second most common cause of ESRD in Caucasians and the leading cause in African-Americans.
Beyond the heart, bones, and kidneys, even more bad news awaits for the heavy sodium consumer. A high salt diet has been shown to assist Helicobacter pylori, the bacteria associated with 90% of duodenal ulcers and 80% of gastric ulcers. A high salt environment increases the expression of two genes in H. pylori that produce proteins associated with the bacteria’s virulence. Essentially, your salt shaker lends a helping hand to the survival of the microorganism that’s most likely responsible for punching holes in your gut.
Even worse, high dietary sodium levels have been shown to be significant risk factors for both gastric and colorectal cancers. Whether or not H. pylori plays a role in the increased incidence of the former cancer remains to be determined. However, it’s clear that with or without the bacteria, chronically high salt intake will raise your chances of getting some very nasty cancers.
So, the upshot here is that sodium reduction is for pretty much everyone. Everyone, at least, who cares about their heart, bones, kidneys, stomach, or risk of getting cancer. There’s more to the salt-reduction campaign that hypertension. So, whether your blood pressure is high, low, or just right, keep in mind the other risks of a high salt diet and look for alternatives to those foods in your diet that are loaded with sodium.
The hCG diet is a protocol that combines extreme caloric restriction with injections of human chorionic gonadotropin, a hormone associated with pregnancy. The diet has been around for over 50 years and is currently promoted by many companies, mainly online. However, despite its enduring popularity, it has been proven by numerous well-executed studies, over the course of decades, to be not only ineffective as a long-term weight loss solution, but also dangerous.
The hCG diet prescribes an intake of just 500 calories per day, along with injections or, more commonly these days, drops that contain hCG. While it’s true that one will most definitely lose a ton of weight due to extremely low energy consumption, there are a number of significant risks involved in the practice.
Possibly the most serious complication is cardiac dysrhythmia. Heart-related disturbances have been noted following very low calorie diets since the 1970s. The risk of developing gallstones is also raised. In one study, 11% of subjects following a very low calorie diet developed gallstones. That is a very high percentage. Hyperuricemia (high uric acid levels in the blood) and gout are also a well-established risk when following a very low calorie diet.
One of the major problems with an extremely low calorie diet such as the hCG protocol is that they are generally unsupervised and provide almost no room for error. Consumption of only 500 calories per day would make it almost impossible for most people to maintain proper levels of essential amino acids, vitamins, minerals, and other micronutrients required for good health. Another common problem seen with these highly restrictive diets is the development of electrolyte imbalances. In fact, this issue may be at least partly to blame for the cardiac irregularities associated with very low calorie diets.
Besides major medical crises, deficits in essential nutrients can lead to a number of other problems. Hair loss, dry skin, and weak nails are just some of the symptoms likely to occur with an extremely limited diet. Antioxidant and other phytonutrient intakes will also be severely restricted. After all, food contains the compounds we need for health. How can one expect to maintain their body when consuming almost no food?
There’s also the claim that the hCG injections make the diet safer. Since the birth of the hCG diet in the 1950s, over twelve well-designed and properly executed studies have evaluated the effect of hCG supplementation in combination with an extremely low caloric intake. Without exception, they found that hCG was of no more use than an injection of saline. It did nothing to make the diet safer nor did it accelerate weight loss. That’s a pretty solid body of evidence.
While the studies in question used high-concentration hCG injections, most supplements on the market today contain relatively miniscule amounts of the hormone. When 50 years worth of research shows that even high doses of hCG do nothing to aid weight loss, why would anyone believe that low-concentration snake oil will do any better? Truly a scam, if there ever was one.
Finally, it’s worth noting that the FDA has come out and unequivocally stated that that “homeopathic” hCG supplements are fraudulent and are being sold illegally. While the FDA is often slow to react and sometimes wishy-washy when it comes to controversial issues, they spoke plainly on this one. If the FDA is willing to put its neck on the line to say something is completely bogus, it’s a pretty sure bet that it is.
Even before its recent statement aimed at low-dose, “homeopathic” hCG products, the FDA has long held a strong stance against the use of prescription hCG injections for the purpose of weight loss. All hCG products have been required since the mid-1970s to carry a warning statement informing the buyer that hCG is not approved by the FDA for the treatment of obesity or weight control and that there is no evidence indicating that it will increase weight loss, decrease hunger or discomfort while on a very low-calorie diet, or cause a more “normal” or attractive distribution of fat.
The hCG diet has been around for over 50 years. In reality, it is simply a very low calorie diet that companies have timelessly associated with an expensive snake oil. Decades of excellent research have proven that hCG does nothing to increase the safety or efficacy of a very low calorie diet.
In addition, the use of such an extreme diet, with or without hCG supplementation, has been shown to be a very risky proposition. Restricting calories under about 1200-1500 per day is rife with problems, from external problems with hair and skin to the potentially deadly malfunctions of multiple internal organs.
Finally, very low calorie protocols like the hCG diet have also been proven to be poor long-term solutions for weight control. Subjects almost always regain the lost weight, often with a higher proportion of fat to muscle.
The hCG diet is a money-making scheme that has successfully bilked thousands, if not millions, of honest consumers out of millions of dollars. It’s a diet based on fundamentally flawed science that uses unregulated, illegal, and useless dietary supplements. Don’t fall prey to this decades-old lie. Take responsibility for your life and make the right changes to lose weight in a healthy manner.
The concept of taxing certain food products more than others in order to sway consumers away from unhealthy products is an intensely controversial issue. Proponents of the food tax say it is necessary to protect the economy and public health. Interestingly, opponents of the concept claim that a food tax will HURT the economy and will do nothing to help counter the epidemic proportions of overweight and obesity that we are currently experiencing in this country and throughout the globe. So who’s right? Let’s sift through some of the arguments and apparently contradictory statistics quoted from both sides of the debate and look for the kernel of truth.
One argument for food taxes is simply that nothing else seems to be working. While many people from diverse locations on the political spectrum are wary of government intervening too deeply into the personal lives of citizens, it has become evident that the obesity train wreck in the US is not going away any time soon. Dr. William H. Dietz, director of the division of nutrition, physical activity, and obesity at the US Centers for Disease Control and Prevention, was quoted in 2010 as saying, “I don’t think we have in place the kind of policy or environmental changes needed to reverse this epidemic just yet.” Clearly, something needs to be done to fix the problem. Food taxes are one possible answer.
Another line of evidence in favor of a food tax comes from research studies looking at the interaction between the price of unhealthy foods and consumption patterns of those products.
One such study, published last year, evaluated how the price of pizza and soda affected the buying preferences of young adults. The researchers found that a 10% increase in the price of soda decreased its caloric contribution to the participants’ diets by over 7%, on average. In the case of pizza, a 10% increase in price led to an 11.5% drop in its caloric contribution. Additionally, soda and pizza prices were also found to significantly affect total caloric intake and body weight. That finding indicates that the calories NOT consumed by way of pizza and soda weren’t simply replaced by those from other sources. Instead, they were simply not consumed.
Another recent study from the Netherlands looked at how college students’ lunchtime preferences were affected by 25% and 50% taxes on high-calorie items. The research team found that the students decreased their overall caloric intake from the meal by 100-300 calories, depending upon the tax level.
A similar study actually put taxes like those seen in the Netherlands study to a real-world test. A Boston hospital instated a 35% tax on sugar-sweetened sodas sold in their cafeteria. The investigators found that sales of the taxed beverages fell by over a quarter and that consumers generally substituted coffee or diet sodas.
Finally, a study published last year by the USDA’s Economic Research Service (ERS) found that a 20% tax on sugar-sweetened sodas could reduce the prevalence of obesity by almost 10%. While that may seem like a relatively large tax for a relatively small decrease in obesity, consider that this study only evaluated the effect of taxing a single type of “unhealthy” food. If a similar tax was applied to other foods, an even greater decrease in obesity would be likely, as was observed in the Netherlands study of pizza and soda prices.
Clearly, there is scientific evidence supporting the institution of food taxes. However, as the saying goes, one can find statistics to support anything! Indeed, the opposition to food taxes has done a pretty good job at finding some numbers to support their view on this contentious issue.
One study referenced by the anti-food tax faction was performed at George Mason University (GMU) and examined whether the food tax would accomplish its goal of curbing obesity and how the economics of the tax would impact various demographic groups. The researchers concluded that sugar-sweetened soft drinks only accounted for a “trivial” amount of calories in the overall diet. They also pointed out that a tax on such beverages would likely be regressive, meaning it would negatively impact the poor more intensely than it would the rich. Because the poor spend a higher percentage of their earnings on food, any increase in food price will hit them harder.
There are a couple of problems with the GMU group’s analysis. First, what these researchers consider a trivial amount of calories may actually be enough to make a significant difference for many people on the border of overweight, obesity, or diabetes risk. In the GMU study, many of the examples given were of the tax’s effect on very overweight individuals. While a small tax on sodas will not be enough to solve serious problems like those, it can help people in less extreme, but still serious, situations. A study on overweight adults found that each kilogram of weight lost over a ten year period led to a 33% lower risk of diabetes in the subsequent ten years. In addition, each kilogram of weight gain was associated with a 49% increase in diabetes risk. Not so trivial, eh?
With regards to the claim of a tax on sugar-sweetened beverages being regressive, it’s true. Without any other considerations, such a tax would likely be relatively more injurious to lower-income individuals and families. However, in addition to the tax, a complimentary subsidy program has been proposed that would use the funds generated by the tax to make healthy foods more affordable. This subsidy could even be designed to primarily benefit the poor. With this offset taken into account, the regressive nature of the tax seems to be an economical non-issue.
Other studies cited by those opposed to the food tax note that physical activity is also imperative to maintaining proper body composition. Anti-food tax groups have proposed and even implemented a number of youth-oriented fitness and exercise programs to show their support for childhood exercise promotion. While they do make a valid point regarding the necessity of exercise for the maintenance of optimal health and fitness, they seem to use it as a reason for not also addressing nutrition in public health policy. The human body requires both proper nutrition and exercise, not only one or the other, to perform at its best, both physically and mentally. Playing one side of the coin against the other indicates either an extremely uninformed perspective on the subject of human health or simple bias. I’d tend to suspect the latter.
Besides the issues covered here, there are other considerations to address, such as food industry cooperation with the application of any new taxes. For the taxes to have the desired effect of lowering the public’s consumption of certain products, the industry would have to pass the increased cost onto the consumer. Unfortunately, food companies could instead choose to simply absorb it or distribute it evenly throughout their entire product line. Loopholes also exist through which local retailers may work to counteract the tax. In fact, there are many facets to this issue that demand further research and refinement in order to make the tax as efficient and fair as possible. But the potential problems with the implementation of a food tax should not stop us from considering it as a viable method to benefit public health.
Food taxes represent one potential tool to help turn the tide against obesity in the US. While attention needs to be paid to the method of implementation and the breadth of application, the research supports the realistic benefits of the concept. Research data show that a food tax, even a relatively modest and limited one, can make a significant and meaningful difference in the public health. Let’s not be afraid to try something different. Let’s not be swayed by the fear-mongering of those opposed to any sort of governmental action, even when it’s designed to counter the epidemic of our generation. Let’s instead commit to making changes that produce real results. A food tax can be a part of the obesity solution and it’s time to put forth effort to do it right.
Preservatives are chemical compounds that are added to both liquid and solid food products in order to stave off bacterial and mold growth, prevent oxidation of lipids, and stabilize aesthetic quality attributes like color. While opponents of preservatives argue that they are unnecessary and pose risks to human health, it is a fact that consumers typically evaluate a product initially by its appearance. If something looks bad, very few people will buy it.
The food industry has long incorporated preservatives into products, therefore, and has fiercely defended their use as safe and effective. So where does the real truth lie about preservatives? Well, as usual, it’s somewhere in the middle.
Let’s take a look at a few of today’s most popular preservatives, and we’ll see why they’re present and what risks they may pose to the average consumer.
Sodium benzoate is a common antimicrobial preservative in liquid products. When dissolved in water, sodium benzoate dissociates into a sodium ion and a benzoate ion, which picks up a hydrogen from a water molecule to become the active preservative molecule, benzoic acid. Under the acidic conditions of most drink products, benzoic acid interferes with the glucose metabolism of many microbes, helping to slow or prevent spoilage.
Three main health concerns surround the use of benzoates in food. The first is that sodium benzoate has been shown to exacerbate asthma symptoms in a small percentage of asthmatics who suffer from severe or uncontrolled symptoms.
Concern over this effect certainly is valid basis for extra care. Yet, the fact that a relatively tiny segment of the population is negatively affected is not justification for eradicating benzoates from the food supply.
A related phenomenon is benzoate allergy, which impacts on an even smaller portion of the population. Indeed, it is a very rare condition. As with any allergen, those who suspect a problem should avoid benzoates. The vast majority of the population will be just fine.
In light of the relatively rare, but potentially serious, incidences of benzoate hypersensitivity and allergy, I would support a more aggressive labeling requirement for benzoate ingredients. A small but noticeable warning statement, like those used for products that may contain peanut residue, could suffice. Such a label would require little from food producers and would give adequate warning to those few who might have good reason to avoid benzoates.
The second concern over benzoate preservatives stems from recent research suggesting a link between sodium benzoate and child hyperactivity. There are a few problems with this association, however.
First, the study in question also evaluated artificial colors for any connection to a hyperactivity response. Because the colors and the benzoate were in the same beverage, it is not possible to determine now what caused the observed effect.
In addition, many reports related to this study have over-generalized the results, claiming that “artificial ingredients” and “food additives” as a class are a cause of ADHD and hyperactivity in children. This hype is simply false, . It is an illustration of the fear-mongering that opponents of the food industry frequently dish up. In reality, the study in question highlights that more research is warranted to illuminate which of the beverage compounds studied, if any, may contribute to childhood hyperactivity.
The final health concern surrounding benzoates is benzene formation in drinks that contain ascorbic acid, which is vitamin C. It’s true that beverages with benzoate and ascorbic acid can produce benzene, a known human carcinogen. In almost all cases, however, the amount of benzene produced in is exceedingly low, well below the limit for drinking water (5 ppb).
If the benzene controversy still puts your paranoia into overdrive, then just buy drinks that contain vitamin C or benzoates but not both: an easy solution to a problem that probably amounts to nothing in the first place!
Potassium sorbate is another popular beverage preservative, often found paired with sodium benzoate. Potassium sorbate and other sorbate salts produce sorbic acid when dissolved in water. Sorbic acid prevents the growth of many mold and yeasts.
Sorbates have a great safety record and have not been implicated in any ill health effects in humans. In animal toxicity studies, potassium sorbate has been shown to be about as toxic as table salt. Even the Center for Science in the Public Interest (CSPI), the world leader in bloated, hyperbolic anti-food industry rhetoric, deems sorbates to be safe.
Next up are sulfites, which are prevalent in wines and dried fruits, as well as in some commercial shellfish. Commercial sulfiting agents include sulfur dioxide and the sodium and potassium salts of sulfite, bisulfite, and metabisulfite. Sulfites are used in wine production to halt fermentation at a desired time and to prevent bacterial growth. They are used in some dried fruit, most notably apricots and prunes, to prevent enzymatic browning and spoilage. They’re also used in some shellfish, especially shrimp, to reduce the incidence of “blackspot,” a discoloration of the flesh.
Sulfites are exceedingly useful commercial preservatives and are considered safe for almost everyone. Still, sulfites are known to increase asthma symptoms in about one out of every twenty asthmatics. Like benzoates, sulfites generally only cause problems for those with severe and/or uncontrolled asthma.
Avoidance of sulfites is relatively easy these days, given the amount of mandatory food ingredient labeling. One area where sulfites often remain incognito, however, is the wine industry. Luckily, an increased awareness of sulfite reactions has prompted many wineries to offer sulfite-free products, tailored to those sensitive to the preservatives.
There also are rare occurrences of sulfite hypersensitivity outside of the asthmatic population. Generally, symptoms are usually mild and include hives and nausea. The headache that some people get after drinking red wine was once thought to be caused by sulfites, but that explanation has been called into question. Though it is still poorly understood, other compounds in red wine, such as tannins, are suspected as well of causing the headache.
Nitrates and nitrites are another class of preservatives often found in processed meat products. Nitrites stabilize the red color of many meat products and, along with sodium chloride (table salt), also prevent the growth of the bacteria that produces botulism toxin. Nitrates are simply nitrites with another oxygen atom attached. In many foods, nitrates slowly degrade into nitrites over time, acting as a kind of “time-released” preservative.
Unfortunately, nitrites are known to react with secondary amine compounds, also found in many food products, to produce nitrosamines. Nitrosamines are found in tobacco smoke, too, and research has shown that about 90% of nitrosamines are carcinogenic. Clearly, not a good preservative byproduct.
Fortunately, all commercial cured meat producers in the US are required add vitamin E, vitamin C, or erythorbic acid along with nitrites. These ingredients prevent the formation of nitrosamines.
Opponents of nitrites in foods contend that the risk of nitrosamine formation still exists and that other common preservation methods, like refrigeration, could be employed in lieu of chemical preservatives. While there is really very little risk from nitrites in cured meats, they are almost always loaded with salt, fillers, and other non-meat additives. While an occasional hot dog isn’t going to kill you, it may well be the best course simply to swear off the unfortunately delicious creations that populate the processed meats section of your grocery.
Last in our review are butylated hydroxytoluene (BHT) and butylated hydroxyanisole (BHA). BHT and BHA have terribly scientific names that look horrendous on food labels. Nevertheless, many companies include BHA and BHT in their products because they are excellent antioxidants, effective in slowing the development of oxidative rancidity in high fat foods like potato chips.
There is no direct evidence that either BHA or BHT is carcinogenic in humans. But one widely cited group of studies on BHA showed an increased incidence of forestomach tumors in mice, rats, and hamsters.
There are a few problems in generalizing this evidence for carcinogenicity to humans. First of all, we don’t have forestomachs. Because the increase in tumors was seen only in this particular organ, the claim of heightened cancer risk in humans is a bit flimsy. Additionally, the higher incidence of forestomach tumors was only seen in the group of animals with the highest level of BHA consumption, at around 1% of their diet. That is a truly insane amount of BHA that no human would ever approach.
On the balance of present data, BHT and BHA are safe additives. They are used at very low levels in a relatively small number of foods and have little, if any, evidence for carcinogenicity in humans.
Furthermore, in recent years, many food companies have been moving away from BHT and BHA because they tend to “dirty” a product’s ingredients statement with their long, intimidating names. If you’re really worried about the presence of these two compounds in a favorite food, look around the grocery store a bit. You’ll very likely be able to find a similar product that uses alternative methods of preservation.
If you’ve read the review of food colors from a few months back, then you’ll see some common themes in this conclusion. Preservatives serve a necessary purpose in our modern food supply. Without their use, many products would spoil in a matter of days. It’s just a fact of life in this era that we demand foods that can be stored and still retain their fresh qualities.
Almost all of the preservatives in this review have been shown time and time again to be safe for nearly the entire population, but there will always be exceptions. If you’re a severe or uncontrolled asthmatic, it’s probably best to avoid sulfites and benzoates. If you find a random imported cured meat product with nitrates or nitrites but without vitamin E, ascorbic acid, or erythorbic acid added, don’t eat it.
Outside of these limited qualifications, preservatives are safe for almost everyone. Don’t buy into the hype of advertising, food package labels, or rabid anti-industry activists claiming all sorts of ill effects from preservatives. Read the science on these ingredients instead of biased reviews and hyperbolic, paranoid rhetoric.
As always, if you see an ingredient listing with which you’re not familiar, look it up. Find real data to support any positive or negative claims you hear. If you have trouble, email me and I’ll do my best to answer your question. You can be sure that you’re not the only one looking for those answers. While it’s important to always be watchful of what we put into our bodies, rational, scientific assessment of food ingredients is the best approach to maintain both health and sanity.