The Problem With Salt Restriction

Every once in a while, you read something that just restores your faith in humanity. For me, a recent article in the New York Times did just that. Entitled "No Benefit Seen in Sharp Limits on Salt in Diet", the article makes the case that the latest sodium recommendations are too low, and that reducing sodium intake to such low levels could be dangerous.

Amen. It's about damn time. The newest sodium guidelines are ridiculously, stupidly, just absurdly low. How absurdly low you ask? The 2010 Dietary Guidelines set the upper limit at 2300 mg per day for healthy individuals, about one teaspoon of salt, and 1500 mg for those with hypertension or cardiovascular disease. Even more extreme, the American Heart Association feels that EVERYONE should shoot for 1500 mg. 

Maybe you don't know how low that is; if you've never tracked your sodium intake or read a food label then maybe you can't quite grasp it. So let me put it to you this way... the guidelines are so low, one study reports that only 0.12% of the population is eating a diet that meets the standards (1). That's 1 in every 833 of us! The average American eats about 3700 mg of sodium per day and has for the past 50 years (2). And our salt intake may have been even higher than that in the past (3). Hmm I wonder how we've all survived this long as a species when we're so blatantly overconsuming salt!?

Nope, these new recommendations just never made sense to me. But regardless of whether the guidelines are attainable, this New York Times article makes the case that a sodium intake that low can be downright dangerous. Interesting eh?? I thought so. So interesting that I spent the majority of my day at my food service rotation looking into it.

The Coca-Cola Polar Bears

Welp, looks like all those years of drinking Coke has finally caught up to the polar bears.




That is all.

Whole Grain Destruction

Bread... destroyed

Aaand back to the sciencey posts.  I do like the more philosophical rant posts, but truthfully, I get my jollies off in two ways... reading about scientific research and drinking endless coffee (take note ladies).  Consider both covered.  Big nerd?  Probably.  Bored because the weather is shitty and everyone I know is at work?  Absolutely.

Today’s topic is grains.  More specifically, whole grains.  Many of you may know my stance on grains; I think they’re nutritionally useless, potentially harmful, and they often displace the more nutritious foods we could be eating (ie. fruits, vegetables, meats, seafood).   But today, I offer more convincing evidence against grains in the form of randomized, controlled scientific research.  Yup, the gold standard.

Let’s go over the levels of scientific evidence, just briefly so no one's confused.  For my purposes today, I’ll be talking about two types of study designs: epidemiological research and randomized, controlled trials.  The weaker of the two is epidemiological research.  In this type of study, participants are recruited, asked about their dietary patterns, and followed for a period of time to see who lives and who gets sick and/or dies.  It's observational in nature, and you can't infer cause and effect.  Blah, blah, blah, etc, etc, etc... the best you can do is to find a connection between two variables.  For instance, you might see that people who eat more whole grains tend to have less incidence of cardiovascular disease (1,2).  That doesn’t mean eating whole grains caused a reduction in heart disease; it just means the two happened at the same time.  It could be, instead, that people who consume more whole grains are typically more health conscious.  So in addition to eating whole grains, they exercise more, eat more fruits and vegetables, and choose not to smoke.  Maybe the grains were just along for the ride, while the other variables were what really mattered.  There's no way to know for sure.  

What you can do, though, is use this information to set up a randomized, controlled trial. In this type of study, you can isolate one variable that you think is important, like whole grains, so that you can determine cause and effect.  You need a control group, which would eat refined grains (or no grains), and an experimental group, which would eat whole grains.  Then, you can measure the difference in health outcomes; maybe vitamin/mineral status, blood sugar control, or risk of heart disease.  The key, in this case, is that you have a much clearer idea of causality. 

The point is, randomized, controlled trials trump epidemiological research.  Which is why I'm so glad I found this article by Anthony Colpo, in which he discusses all of this randomized, controlled research on grains.  There's a reason why the only research you hear to support whole grains is observational... because the controlled trials destroy them.  In fact, whole grains may be even worse than the refined variety.  Feast your eyes on this here research...

The Ridiculousness of the Diabetes Diet

Well, now that the spring semester at UConn is in full swing, and I'm frequently busy spreading the word that skim milk is the dietary solution to everything, I haven't had time to blog much.  And I definitely haven't had time to put together any type of science-intensive post.  But I've had this one on the brain for a while now, and I think it's time to put it to paper.  Or virtual paper.  And this one really fires me up.  Begin rant...

So last semester in my Medical Nutrition Therapy class, we discussed type 2 diabetes extensively.  That's the type that's acquired later in life because of a shitty diet, not the type that you get when you're younger and require insulin injections.  Type 2 diabetes used to be called "Adult-Onset Diabetes", until it started showing up in younger people, and that name sort of went out the window.  I'd rather they kept the name though; it'd be pretty embarrassing to be a 12-year-old and have adult-onset diabetes wouldn't it?  Maybe that would have helped stress to those kids just how god-awful it is that they have diabetes at such a young age.  But that's neither here nor there.

What I want to talk about today is the standard diabetes diet the conventional wisdom folks recommend.  In case you didn't know, diabetes is a disorder of carbohydrate metabolism.  When you're diabetic, your body stops responding to insulin, the hormone that normally gets those carbs into your cells so they can be used for energy.  Well diabetics can't process those carbs so well.  As a result, the glucose just hangs out in the bloodstream, and high blood glucose is extremely toxic.  Given the fact that diabetics have to deal with this carbohydrate metabolism issue, it would seem to follow that they should reduce their carbohydrate consumption, right?  Nope.  Not according to the conventional wisdom.  In fact, the standard diabetes diet doesn't reduce carb consumption at all, and in some cases it may even suggest more carbs; they simply recommend that you spread your carb intake evenly throughout the day.  Doesn't make any sense does it??  But why on earth would any sane person not recommend a low-carb diet for diabetics?  Answer:  because if you eat fewer carbs, you have to eat more fat and protein.  And increasing your fat would give you heart disease, something that diabetics are at much higher risk for.

The Diabetes Diet:  eat more bread