Hypertension: Factors Far More Relevant Than Salt
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Hypertension: Factors Far More Relevant Than Salt
Firstly, what is high blood pressure vs normal, and what do those blood pressure readings mean?
Rather than take up undue space here, we’ll just quickly link to…
Blood Pressure Readings Explained (With A Colorful Chart)
More details of specifics, at:
Hypotension | Normal | Elevated | Stage 1 | Stage 2 | Danger zone
Keeping Blood Pressure Down
As with most health-related things (and in fact, much of life in general), prevention is better than cure.
People usually know “limit salt” and “manage stress”, but there’s a lot more to it!
Salt isn’t as big a factor as you probably think
That doesn’t mean go crazy on the salt, as it can cause a lot of other problems, including organ failure. But it does mean that you can’t skip the salt and assume your blood pressure will take care of itself.
This paper, for example, considers “high” sodium consumption to be more than 5g per day, and urinary excretion under 3g per day is considered to represent a low sodium dietary intake:
Sodium Intake and Hypertension
Meanwhile, health organizations often recommend to keep sodium intake to under 2g or under 1.5g
Top tip: if you replace your table salt with “reduced sodium” salt, this is usually sodium chloride (regular table salt) cut with potassium chloride, which is almost as “salty” tastewise, but obviously contains less sodium. Not only that, but potassium actually helps the body eliminate sodium, too.
The rest of what you eat is important too
The Mediterranean Diet is as great for this as it is for most health conditions.
If you sometimes see the DASH diet mentioned, that stands for “Dietary Approaches to Stop Hypertension”, and is basically the Mediterranean Diet with a few tweaks.
What are the tweaks?
- Beans went down a bit in priority
- Red meat got removed entirely instead of “limit to a tiny amount”
- Olive oil was deprioritized, and/but vegetable oil is at the bottom of the list (i.e., use sparingly)
You can check out the details here, with an overview and examples:
DASH Eating Plan—Description, Charts, and Recipes
Don’t drink or smoke
And no, a glass of red a day will not help your heart. Alcohol does make us feel relaxed, but that is because of what it does to our brain, not what it does to our heart.
In reality, even a single drink will increase blood pressure. Yes, really:
And smoking? It’s so bad that even second-hand smoke increases blood pressure:
Get those Zs in
Sleep is a commonly underestimated/forgotten part of health, precisely because in a way, we’re not there for it when it happens. We sleep through it! But it is important, including to protect against hypertension:
Short- and long-term health consequences of sleep disruption
Move your body!
Moving your body often is far more important for your heart than running marathons or bench-pressing your spouse.
Those 150 minutes “moderate exercise” (e.g. walking) per week are important, and can be for example:
- 22 minutes per day, 7 days per week
- 25 minutes per day, 6 days per week
- 30 minutes per day, 5 days per week
- 75 minutes per day, 2 days per week
If you’d like to know more about the science and evidence for this, as well as practical suggestions, you can download the complete second edition of the Physical Activity Guidelines for Americans here (it’s free, and no sign-up required!)
If you prefer a bite-size summary, then here’s their own:
Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans
PS: Want a blood pressure monitor? We don’t sell them (or anything else), but for your convenience, here’s a good one you might want to consider.
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America’s Health System Isn’t Ready for the Surge of Seniors With Disabilities
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The number of older adults with disabilities — difficulty with walking, seeing, hearing, memory, cognition, or performing daily tasks such as bathing or using the bathroom — will soar in the decades ahead, as baby boomers enter their 70s, 80s, and 90s.
But the health care system isn’t ready to address their needs.
That became painfully obvious during the covid-19 pandemic, when older adults with disabilities had trouble getting treatments and hundreds of thousands died. Now, the Department of Health and Human Services and the National Institutes of Health are targeting some failures that led to those problems.
One initiative strengthens access to medical treatments, equipment, and web-based programs for people with disabilities. The other recognizes that people with disabilities, including older adults, are a separate population with special health concerns that need more research and attention.
Lisa Iezzoni, 69, a professor at Harvard Medical School who has lived with multiple sclerosis since her early 20s and is widely considered the godmother of research on disability, called the developments “an important attempt to make health care more equitable for people with disabilities.”
“For too long, medical providers have failed to address change in society, changes in technology, and changes in the kind of assistance that people need,” she said.
Among Iezzoni’s notable findings published in recent years:
Most doctors are biased. In survey results published in 2021, 82% of physicians admitted they believed people with significant disabilities have a worse quality of life than those without impairments. Only 57% said they welcomed disabled patients.
“It’s shocking that so many physicians say they don’t want to care for these patients,” said Eric Campbell, a co-author of the study and professor of medicine at the University of Colorado.
While the findings apply to disabled people of all ages, a larger proportion of older adults live with disabilities than younger age groups. About one-third of people 65 and older — nearly 19 million seniors — have a disability, according to the Institute on Disability at the University of New Hampshire.
Doctors don’t understand their responsibilities. In 2022, Iezzoni, Campbell, and colleagues reported that 36% of physicians had little to no knowledge of their responsibilities under the 1990 Americans With Disabilities Act, indicating a concerning lack of training. The ADA requires medical practices to provide equal access to people with disabilities and accommodate disability-related needs.
Among the practical consequences: Few clinics have height-adjustable tables or mechanical lifts that enable people who are frail or use wheelchairs to receive thorough medical examinations. Only a small number have scales to weigh patients in wheelchairs. And most diagnostic imaging equipment can’t be used by people with serious mobility limitations.
Iezzoni has experienced these issues directly. She relies on a wheelchair and can’t transfer to a fixed-height exam table. She told me she hasn’t been weighed in years.
Among the medical consequences: People with disabilities receive less preventive care and suffer from poorer health than other people, as well as more coexisting medical conditions. Physicians too often rely on incomplete information in making recommendations. There are more barriers to treatment and patients are less satisfied with the care they do get.
Egregiously, during the pandemic, when crisis standards of care were developed, people with disabilities and older adults were deemed low priorities. These standards were meant to ration care, when necessary, given shortages of respirators and other potentially lifesaving interventions.
There’s no starker example of the deleterious confluence of bias against seniors and people with disabilities. Unfortunately, older adults with disabilities routinely encounter these twinned types of discrimination when seeking medical care.
Such discrimination would be explicitly banned under a rule proposed by HHS in September. For the first time in 50 years, it would update Section 504 of the Rehabilitation Act of 1973, a landmark statute that helped establish civil rights for people with disabilities.
The new rule sets specific, enforceable standards for accessible equipment, including exam tables, scales, and diagnostic equipment. And it requires that electronic medical records, medical apps, and websites be made usable for people with various impairments and prohibits treatment policies based on stereotypes about people with disabilities, such as covid-era crisis standards of care.
“This will make a really big difference to disabled people of all ages, especially older adults,” said Alison Barkoff, who heads the HHS Administration for Community Living. She expects the rule to be finalized this year, with provisions related to medical equipment going into effect in 2026. Medical providers will bear extra costs associated with compliance.
Also in September, NIH designated people with disabilities as a population with health disparities that deserves further attention. This makes a new funding stream available and “should spur data collection that allows us to look with greater precision at the barriers and structural issues that have held people with disabilities back,” said Bonnielin Swenor, director of the Johns Hopkins University Disability Health Research Center.
One important barrier for older adults: Unlike younger adults with disabilities, many seniors with impairments don’t identify themselves as disabled.
“Before my mom died in October 2019, she became blind from macular degeneration and deaf from hereditary hearing loss. But she would never say she was disabled,” Iezzoni said.
Similarly, older adults who can’t walk after a stroke or because of severe osteoarthritis generally think of themselves as having a medical condition, not a disability.
Meanwhile, seniors haven’t been well integrated into the disability rights movement, which has been led by young and middle-aged adults. They typically don’t join disability-oriented communities that offer support from people with similar experiences. And they don’t ask for accommodations they might be entitled to under the ADA or the 1973 Rehabilitation Act.
Many seniors don’t even realize they have rights under these laws, Swenor said. “We need to think more inclusively about people with disabilities and ensure that older adults are fully included at this really important moment of change.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Do We Need Sunscreen In Winter, Really?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝I keep seeing advice that we shoudl wear sunscreen out in winter even if it’s not hot or sunny, but is there actually any real benefit to this?❞
Short answer: yes (but it’s indeed not as critical as it is during summer’s hot/sunny days)
Longer answer: first, let’s examine the physics of summer vs winter when it comes to the sun…
In summer (assuming we live far enough from the equator to have this kind of seasonal variation), the part of the planet where we live is tilted more towards the sun. This makes it closer, and more importantly, it’s more directly overhead during the day. The difference in distance through space isn’t as big a deal as the difference in distance through the atmosphere. When the sun is more directly overhead, its rays have a shorter path through our atmosphere, and thus less chance of being blocked by cloud cover / refracted elsewhere / bounced back off into space before it even gets that far.
In winter, the opposite of all that is true.
Morning/evening also somewhat replicate this compared to midday, because the sun being lower in the sky has a similar effect to seasonal variation causing it to be less directly overhead.
For this reason, even though visually the sun may be just as bright on a winter morning as it is on a summer midday, the rays have been filtered very differently by the time they get to us.
This is one reason why you’re much less likely to get sunburned in the winter, compared to the summer (others include the actual temperature difference, your likely better hydration, and your likely more modest attire protecting you).
However…
The reason it is advisable to wear sunscreen in winter is not generally about sunburn, and is rather more about long-term cumulative skin damage (ranging from accelerated aging to cancer) caused by the UV rays—specifically, mostly UVA rays, since UVB rays (with their higher energy but shorter wavelength) have nearly all been blocked by the atmosphere.
Here’s a good explainer of that from the American Cancer Society:
UV (Ultraviolet) Radiation and Cancer Risk
👆 this may seem like a no-brainer, but there’s a lot explained here that demystifies a lot of things, covering ionizing vs non-ionizing radiation, x-rays and gamma-rays, the very different kinds of cancer caused by different things, and what things are dangerous vs which there’s no need to worry about (so far as best current science can say, at least).
Consequently: yes, if you value your skin health and avoidance of cancer, wearing sunscreen when out even in the winter is a good idea. Especially if your phone’s weather app says the UV index is “moderate” or above, but even if it’s “low”, it doesn’t hurt to include it as part of your skincare routine.
But what if sunscreens are dangerous?
Firstly, not all sunscreens are created equal:
Learn more: Who Screens The Sunscreens?
Secondly: consider putting on a protective layer of moisturizer first, and then the sunscreen on top. Bear in mind, this is winter we’re talking about, so you’re probably not going out in a bikini, so this is likely a face-neck-hands job and you’re done.
What about vitamin D?
Humans evolved to have more or less melanin in our skin depending on where we lived, and white people evolved to wring the most vitamin D possible out of the meagre sun far from the equator. Black people’s greater melanin, on the other hand, offers some initial protection against the sun (but any resultant skin cancer is then more dangerous than it would be for white people if it does occur, so please do use sunscreen whatever your skintone).
Nowadays many people live in many places which may or may not be the places we evolved for, and so we have to take that into account when it comes to sun exposure.
Here’s a deeper dive into that, for those who want to learn:
Take care!
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How We Age: The Science of Longevity – by Dr. Coleen Murphy
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The author is not a glossy “name brand” and has nothing to sell (besides her book). This shows, because it’s clearly not a book that was rushed out as a marketing ploy. Indeed, she begins with the words:
❝This book took me several years to write and is largely based on information I gathered while teaching my class, “Molecular Mechanisms of Longevity: The Genetics, Genomics, and Cell Biology of Aging,” at Princeton University.❞
~ Dr. Coleen Murphy
Thus, as you may imagine, it’s a thorough book, thoughtful, with conscientious attention to detail. As a reader, you are essentially getting the knowledge of a Princeton genomics class.
She covers what’s going on in our genes, in our cells, and in our bodies, when we age; why some animals don’t, and what things affect that. She talks biomarkers of aging and the industry gold standard “Health-Related Quality of Life” metrics. We learn about insulin signalling and FOXO targets; the role of caloric restriction or intermittent fasting, topics such as molecular homeostasis in the regulation of longevity (hello senolytics and chaperone-mediated autophagy), the microbiome and epigenetics, as well as mitochondrial management, cell replacement (including induced pluripotent stem cells), and even DNA repair. And yes, a lot about cognitive aging and how to slow it too.
The style is academic and/but perfectly readable; she explains everything as we go. We’ll note, though, that it’s not dry academic—her personality comes through throughout, in a good way that makes it a pleasant read as well as an informative one.
Bottom line: if you’d like a much deeper understanding of the mechanics of aging than we have room to get into in our articles at 10almonds, this book is a highly recommendable perfect opportunity.
Click here to check out How We Age, and learn about the science of longevity!
PS: we’ve reviewed a few books about the science of aging/longevity recently, and they’ve each been good, but if you’re going to get only one, we recommend this one, as in this reviewer’s opinion, it’s the best 😎
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Unprocessed 10th Anniversary Edition – by Abbie Jay
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The main premise of this book is cooking…
- With nutritious whole foods
- Without salt, oil, sugar (“SOS”)
It additionally does it without animal products and without gluten, and (per “nutritious whole foods”), and, as the title suggests, avoiding anything that’s more than very minimally processed. Remember, for example, that if something is fermented, then that fermentation is a process, so the food has been processed—just, minimally.
This is a revised edition, and it’s been adjusted to, for example, strip some of the previous “no salt” low-sodium options (such as tamari with 233mg/tsp sodium, compared to salt’s 2,300mg/tsp sodium).
You may be wondering: what’s left? Tasty, well-seasoned, plant-based food, that leans towards the “comfort food” culinary niche.
Enough to sate the author, after her own battles with anorexia and obesity (in that order) and finally, after various hospital trips, getting her diet where it needed to be for the healthy lifestyle that she lives now, while still getting to eat such dishes as “Chef AJ’s Disappearing Lasagna” and peanut butter fudge truffles and 151 more.
Bottom line: if you want whole-food plant-based comfort-food cooking that’s healthy in general and especially heart-healthy, this book has plenty of that.
Click here to check out Unprocessed: 10th Anniversary Edition, and… Enjoy!
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Fennel vs Onion – Which is Healthier?
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Our Verdict
When comparing fennel to onion, we picked the fennel.
Why?
First note, in case you didn’t see the picture: we are talking about white onions here (also called brown onions, by virtue of their attire).
Looking at the macros, fennel has nearly 2x the fiber and a little more protein, while onion has more carbs. An easy win in this category for the fennel.
In the category of vitamins, fennel has more of vitamins A, B2, B3, B5, B9, C, E, K, and choline (most of them by generous margins and some by especially large margins, we are talking, for example, 480x the vitamin A, 29x the vitamin E, and 157x the vitamin K), while onions have more of vitmains B1 and B6. Another clear win for fennel.
When it comes to minerals, fennel has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while onion is not higher in any minerals. No prizes for guessing: fennel wins this category too.
You may be curious as to how they add up on the polyphenol front, and the answer is, they don’t, much. Wonderful as these two vegetables are, an abundance of polyphenols is not amongst their strengths; fennel has some lignans and onion has some flavonols, but we’re talking tiny numbers here (in contrast, red onion would have aced it with 120mg/100g quercetin, amongst others, but red onion wasn’t on trial today).
Adding up the sections makes a clear win for fennel today.
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
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Each year, more and more Victorians become sick with a flesh-eating bacteria known as Buruli ulcer. Last year, 363 people presented with the infection, the highest number since 2004.
But it has been unclear exactly how it spreads, until now. New research shows mosquitoes are infected from biting possums that carry the bacteria. Mozzies spread it to humans through their bite.
What is Buruli ulcer?
Buruli ulcer, also known as Bairnsdale ulcer, is a skin infection caused by the bacterium Mycobacterium ulcerans.
It starts off like a small mosquito bite and over many months, slowly develops into an ulcer, with extensive destruction of the underlying tissue.
While often painless initially, the infection can become very serious. If left untreated, the ulcer can continue to enlarge. This is where it gets its “flesh-eating” name.
Thankfully, it’s treatable. A six to eight week course of specific antibiotics is an effective treatment, sometimes supported with surgery to remove the infected tissue.
Where can you catch it?
The World Health Organization considers Buruli ulcer a neglected tropical skin disease. Cases have been reported across 33 countries, primarily in west and central Africa.
However, since the early 2000s, Buruli ulcer has also been increasingly recorded in coastal Victoria, including suburbs around Melbourne and Geelong.
Scientists have long known Australian native possums were partly responsible for its spread, and suspected mosquitoes also played a role in the increase in cases. New research confirms this.
Our efforts to ‘beat Buruli’
Confirming the role of insects in outbreaks of an infectious disease is achieved by building up corroborating, independent evidence.
In this new research, published in Nature Microbiology, the team (including co-authors Tim Stinear, Stacey Lynch and Peter Mee) conducted extensive surveys across a 350 km² area of Victoria.
We collected mosquitoes and analysed the specimens to determine whether they were carrying the pathogen, and links to infected possums and people. It was like contact tracing for mosquitoes.
Aedes notoscriptus was the mosquito identified as carrying the bacteria that caused Buruli ulcer.
Cameron Webb (NSW Health Pathology)Molecular testing of the mosquito specimens showed that of the two most abundant mosquito species, only Aedes notoscriptus (a widespread species commonly known as the Australian backyard mosquito) was positive for Mycobacterium ulcerans.
We then used genomic tests to show the bacteria found on these mosquitoes matched the bacteria in possum poo and humans with Buruli ulcer.
We further analysed mosquito specimens that contained blood to show Aedes notoscriptus was feeding on both possums and humans.
To then link everything together, geospatial analysis revealed the areas where human Buruli ulcer cases occur overlap with areas where both mosquitoes and possums that harbour Mycobacterium ulcerans are active.
Stop its spread by stopping mozzies breeding
The mosquito in this study primarily responsible for the bacteria’s spread is Aedes notoscriptus, a mosquito that lays its eggs around water in containers in backyard habitats.
Controlling “backyard” mosquitoes is a critical part of reducing the risk of many global mosquito-borne disease, especially dengue and now Buruli ulcer.
You can reduce places where water collects after rainfall, such as potted plant saucers, blocked gutters and drains, unscreened rainwater tanks, and a wide range of plastic buckets and other containers. These should all be either emptied at least weekly or, better yet, thrown away or placed under cover.
Mosquitoes can lay eggs in a wide range of water-filled items in the backyard.
Cameron Webb (NSW Health Pathology)There is a role for insecticides too. While residual insecticides applied to surfaces around the house and garden will reduce mosquito populations, they can also impact other, beneficial, insects. Judicious use of such sprays is recommended. But there are ecological safe insecticides that can be applied to water-filled containers (such as ornamental ponds, fountains, stormwater pits and so on).
Recent research also indicates new mosquito-control approaches that use mosquitoes themselves to spread insecticides may soon be available.
How to protect yourself from bites
The first line of defence will remain personal protection measures against mosquito bites.
Covering up with loose fitted long sleeved shirts, long pants, and covered shoes will provide physical protection from mosquitoes.
Applying topical insect repellent to all exposed areas of skin has been proven to provide safe and effective protection from mosquito bites. Repellents should include diethytolumide (DEET), picaridin or oil of lemon eucalyptus.
While the rise in Buruli ulcer is a significant health concern, so too are many other mosquito-borne diseases. The steps to avoid mosquito bites and exposure to Mycobacteriam ulcerans will also protect against viruses such as Ross River, Barmah Forest, Japanese encephalitis, and Murray Valley encephalitis.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney; Peter Mee, Adjunct Associate Lecturer, School of Applied Systems Biology, La Trobe University; Stacey Lynch, Team Leader- Mammalian infection disease research, CSIRO, and Tim Stinear, Professor of Microbiology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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