This salt alternative could help reduce blood pressure. So why are so few people using it?
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One in three Australian adults has high blood pressure (hypertension). Excess salt (sodium) increases the risk of high blood pressure so everyone with hypertension is advised to reduce salt in their diet.
But despite decades of strong recommendations we have failed to get Australians to cut their intake. It’s hard for people to change the way they cook, season their food differently, pick low-salt foods off the supermarket shelves and accept a less salty taste.
Now there is a simple and effective solution: potassium-enriched salt. It can be used just like regular salt and most people don’t notice any important difference in taste.
Switching to potassium-enriched salt is feasible in a way that cutting salt intake is not. Our new research concludes clinical guidelines for hypertension should give patients clear recommendations to switch.
What is potassium-enriched salt?
Potassium-enriched salts replace some of the sodium chloride that makes up regular salt with potassium chloride. They’re also called low-sodium salt, potassium salt, heart salt, mineral salt, or sodium-reduced salt.
Potassium chloride looks the same as sodium chloride and tastes very similar.
Potassium-enriched salt works to lower blood pressure not only because it reduces sodium intake but also because it increases potassium intake. Insufficient potassium, which mostly comes from fruit and vegetables, is another big cause of high blood pressure.
What is the evidence?
We have strong evidence from a randomised trial of 20,995 people that switching to potassium-enriched salt lowers blood pressure and reduces the risks of stroke, heart attacks and early death. The participants had a history of stroke or were 60 years of age or older and had high blood pressure.
An overview of 21 other studies suggests much of the world’s population could benefit from potassium-enriched salt.
The World Health Organisation’s 2023 global report on hypertension highlighted potassium-enriched salt as an “affordable strategy” to reduce blood pressure and prevent cardiovascular events such as strokes.
What should clinical guidelines say?
We teamed up with researchers from the United States, Australia, Japan, South Africa and India to review 32 clinical guidelines for managing high blood pressure across the world. Our findings are published today in the American Heart Association’s journal, Hypertension.
We found current guidelines don’t give clear and consistent advice on using potassium-enriched salt.
While many guidelines recommend increasing dietary potassium intake, and all refer to reducing sodium intake, only two guidelines – the Chinese and European – recommend using potassium-enriched salt.
To help guidelines reflect the latest evidence, we suggested specific wording which could be adopted in Australia and around the world:
Why do so few people use it?
Most people are unaware of how much salt they eat or the health issues it can cause. Few people know a simple switch to potassium-enriched salt can help lower blood pressure and reduce the risk of a stroke and heart disease.
Limited availability is another challenge. Several Australian retailers stock potassium-enriched salt but there is usually only one brand available, and it is often on the bottom shelf or in a special food aisle.
Potassium-enriched salts also cost more than regular salt, though it’s still low cost compared to most other foods, and not as expensive as many fancy salts now available.
Jimmy Dean/Unsplash
A 2021 review found potassium-enriched salts were marketed in only 47 countries and those were mostly high-income countries. Prices ranged from the same as regular salt to almost 15 times greater.
Even though generally more expensive, potassium-enriched salt has the potential to be highly cost effective for disease prevention.
Preventing harm
A frequently raised concern about using potassium-enriched salt is the risk of high blood potassium levels (hyperkalemia) in the approximately 2% of the population with serious kidney disease.
People with serious kidney disease are already advised to avoid regular salt and to avoid foods high in potassium.
No harm from potassium-enriched salt has been recorded in any trial done to date, but all studies were done in a clinical setting with specific guidance for people with kidney disease.
Our current priority is to get people being managed for hypertension to use potassium-enriched salt because health-care providers can advise against its use in people at risk of hyperkalemia.
In some countries, potassium-enriched salt is recommended to the entire community because the potential benefits are so large. A modelling study showed almost half a million strokes and heart attacks would be averted every year in China if the population switched to potassium-enriched salt.
What will happen next?
In 2022, the health minister launched the National Hypertension Taskforce, which aims to improve blood pressure control rates from 32% to 70% by 2030 in Australia.
Potassium-enriched salt can play a key role in achieving this. We are working with the taskforce to update Australian hypertension management guidelines, and to promote the new guidelines to health professionals.
In parallel, we need potassium-enriched salt to be more accessible. We are engaging stakeholders to increase the availability of these products nationwide.
The world has already changed its salt supply once: from regular salt to iodised salt. Iodisation efforts began in the 1920s and took the best part of 100 years to achieve traction. Salt iodisation is a key public health achievement of the last century preventing goitre (a condition where your thyroid gland grows larger) and enhancing educational outcomes for millions of the poorest children in the world, as iodine is essential for normal growth and brain development.
The next switch to iodised and potassium-enriched salt offers at least the same potential for global health gains. But we need to make it happen in a fraction of the time.
Xiaoyue Xu (Luna), Scientia Lecturer, UNSW Sydney; Alta Schutte, SHARP Professor of Cardiovascular Medicine, UNSW Sydney, and Bruce Neal, Executive Director, George Institute Australia, George Institute for Global Health
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What’s the difference between shyness and social anxiety?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.
However, feeling shy, or having a shy personality, is not the same as experiencing social anxiety (short for “social anxiety disorder”).
Here are some of the similarities and differences, and what the distinction means.
pathdoc/Shutterstock How are they similar?
It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.
For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.
People who are shy or socially anxious may respond with “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “fawn” (by trying to appease or placate others).
A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.
For example, both shy children and adults with social anxiety have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.
People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.
How are they different?
Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.
For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.
To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.
Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.
People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.
Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.
Not all shy children go on to develop social anxiety. 249 Anurak/Shutterstock However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.
The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.
The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.
The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.
Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or refuse to speak in certain situations.
If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and parental support, patience and guidance, children can be taught strategies to overcome social anxiety.
Why does the distinction matter?
Social anxiety disorder is a mental health condition that persists for people who do not receive adequate support or treatment.
Without treatment, it can lead to difficulties in education and at work, and in developing meaningful relationships.
Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.
A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.
Different people have different support needs. However, clinical practice guidelines recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with exposure therapy (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective in-person, online and in brief treatments.
Treatment is available online as well as in-person. ImYanis/Shutterstock For more support or further reading
Online resources about social anxiety include:
- This Way Up’s online program for managing excessive shyness and fear of social situations
- Beyond Blue’s resources on social anxiety
- a guide to looking after yourself if you have social anxiety, from the Western Australian health department
- social anxiety online program for children and teens from the University of Queensland
- inroads, a self-guided online program for young adults who drink alcohol to manage their anxiety.
We thank the Black Dog Institute Lived Experience Advisory Network members for providing feedback and input for this article and our research.
Kayla Steele, Postdoctoral research fellow and clinical psychologist, UNSW Sydney and Jill Newby, Professor, NHMRC Emerging Leader & Clinical Psychologist, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Complex PTSD – by Pete Walker
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We’ve written before about Complex PTSD, but there’s a lot more to be said than we can fit into an article or two.
Pete Walker, a licensed marriage and family therapist, does an excellent job and pulls no punches, starting from the book’s dedication and carrying the hard-hitting seriousness all the way through to the Appendices.
To this end, it absolutely may not be an easy book to read at times (emotionally speaking), especially if you have C-PTSD. On the other hand, you may also find it a very validating 300-odd pages of “Yes, he is telling my life story in words, now this makes sense!”
That said, it’s mostly not an anecdotes-based book and nor is it just a feelsy ride; it’s also a textbook and a how-to manual. It’s a textbook of how and why things come about the way they do, and a manual of how to effectively manage C-PTSD, and find peace. There’s no silver bullet here, but there is a very comprehensive guide, and chapters full of tools to use (and no, not the same CBT things you’ve probably read a hundred times, this is C-PTSD-specific stuff).
Bottom line: this is the C-PTSD book; if you buy only one book on the topic, make it this one.
Click here to check out Complex PTSD: From Surviving To Thriving, and indeed thrive!
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‘I can’t quite shut it off’: Prevalence of insomnia a growing concern for women
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Tasha Werner, 43, gets up at 3:30 a.m. twice a week for her part-time job at a fitness centre in Calgary. After a five-hour shift, she is back home by 9 a.m. to homeschool her two children, aged 9 and 12. The hardest part of her position – stay-at-home mom, homeschool teacher and part-time worker – is the downtime “lost from my life,” says Werner.A study by Howard M. Kravitz, a psychiatrist in Chicago, showed that up to 60 per cent of women experience sleep disorders due to hormonal changes linked to menopause. But there is an increasing prevalence of insomnia symptoms in women that may be attributed, in part, to societal changes.
“We live in a world that didn’t exist a generation ago. Now everyone is trying to figure it out,” says Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona.
While women are no longer expected to stay at home, many who are employed outside the home also have the primary responsibility for family matters. And women aged 40 to 60 commonly fall within the “sandwich generation,” caring for both children and parents.
As women juggle their responsibilities, these duties can take a toll, both emotionally and practically.
Both Werner and her husband were raised in traditional homes; their mothers stayed at home to oversee childcare, cooking, grocery shopping and household duties. Initially, Werner and her husband followed a similar path, mirroring their parents’ lives as homemakers. “I think we just fell into what we were used to,” says Werner.
However, a notable shift in their family dynamics occurred once she started working outside the home.
Her children’s physical needs and illnesses have had major consequences on her sleep. If one of the children is sick with the flu, that’s “a week of not a lot of sleep during the night,” she says, “because that’s my job.” Many nights, she finds herself waking up between 1 a.m. and 3 a.m., worrying about how the kids are doing academically or behaviourally.
“We face a specific set of anxieties and a different set of pressures than men,” says Emma Kobil, who has been a therapist in Denver, Colo., for 15 years and is now an insomnia coach. There is so much pressure to be everything as a woman – to be an amazing homemaker and worker while maintaining a hot-rocking body and having a cool personality, to “be the cool mom but also the CEO, to follow your dreams and be the boss b****,” says Kobil.
And there’s an appeal to that concept. Daughters grow up viewing their moms as superwomen juggling responsibilities. But what isn’t always obvious are the challenges women face while managing their lives and the health issues they may encounter.
A study revealed that women are 41 per cent more at risk of insomnia than men.
A thorough study revealed that women are 41 per cent more at risk of insomnia than men. Beyond menopausal hormonal shifts, societal pressures, maternal concerns and the challenge of balancing multiple roles contribute to women’s increased susceptibility to insomnia.
Cyndi Aarrestad, 57, lives on a farm in Saskatchewan with her husband, Denis. Now an empty nester, Aarrestad fills her time working on the farm, keeping house, volunteering at her church and managing her small woodworking business. And she struggles with sleep.
Despite implementing some remedies, including stretching, drinking calming teas and rubbing her feet before bed, Aarrestad says achieving restful sleep has remained elusive for the past decade.
Two primary factors contribute to her sleep challenges — her inability to quiet her mind and hormonal hot flashes due to menopause. Faced with family and outside commitments, Aarrestad finds it challenging to escape night time’s mental chatter. “It’s a mom thing for me … I can’t quite shut it off.” Even as her children transitioned to young adulthood and moved out, the worries persisted, highlighting the lasting concerns moms have about their kids’ jobs, relationships and overall well-being.
Therapist Kobil says that every woman she’s ever worked with experiences this pressure to do everything, to be perfect. These women feel like they’re not measuring up. They’re encouraged to take on other people’s burdens; to be the confidante and the saviour in many ways; to sacrifice themselves. Sleep disruptions simply reflect the consequences of this pressure.
“They’re trying to fit 20 hours in a 24-hour day, and it doesn’t work,” says Grandner, the sleep specialist.
Grandner says that consistently sleeping six hours or less as an adult makes one 55 per cent more likely to become obese, 20 per cent more likely to develop high blood pressure, and 30 per cent more likely to develop Type 2 diabetes if you didn’t have it already. This lack of sleep makes you more likely to catch the flu. It makes vaccines less effective, and it increases your likelihood of developing depression and anxiety.
When is the time to change? Yesterday. Grandner warns that the sleep sacrifices made at a young age impact health later. But it’s never too late to make changes, he says, and “you do the best with what you’ve got.”
Kobil suggests a practical approach for women struggling with sleep. She emphasizes understanding that sleeplessness isn’t a threat and encourages a shift in mindset about being awake. Instead of fighting sleeplessness, she advises treating oneself kindly, recognizing the difficulty.
Kobil recommends creating a simple playbook with comforting activities for awake moments during the night. Just as you would comfort a child who’s afraid, she suggests being gentle with yourself, gradually changing the perception of wakefulness into a positive experience.
This article is republished from HealthyDebate under a Creative Commons license. Read the original article.
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This Naked Mind – by Annie Grace
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We’ve all read about the many, many, dangers of drinking. We’ve also probably all read about how to make the change to not drinking. Put things out of sight, tell your friends, have this rule, have this excuse (for not drinking) ready to give to people who challenge you, consider a support group, and so on.
What Annie Grace offers in this #1 bestseller is different:
A blend of mostly psychology and sociology, to examine the “liminal thinking” stages that funnel us to drink in the first place… and where that leads, and how to clamber back out of the pitcher plant we weren’t necessarily aware we were sliding into.
While she kicks off citing Jung, from a psychological perspective more of this book is CBTish, as it pertains a lot to examining the process of:
- belief—held and defended, based on the…
- conclusion—drawn, often irrationally, from the…
- experience—that we had upon acting on an…
- observation—often mistaking an illusion for the underlying…
- reality
…and how we can and often do go wrong at each step, and how little of the previous steps we can perceive at any given time.
What does this mean for managing/treating alcoholism or a tendency towards alchoholism?
It means interrupting those processes in a careful, surgically precise fashion, so that suddenly… The thing has no more power over us.
Whether you or a loved one struggle with a tendency to addiction (any addiction, actually, the advice goes the same), or are just curious about the wider factors at hand in the epidemiology of addiction, this book is for you.
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Relieve GERD and Acid Reflux with Stretches and Exercises
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Looking for relief from GERD or acid reflux? Today we’re featuring an amazing video by Dr. Jo, packed with stretches and exercises designed to ease those symptoms.
Here’s a quick rundown, in case you don’t have time to watch the whole video.
If you’re not familiar with GERD, you can find our simple explanation of GERD here. Or, if you’re on the other end of the spectrum and want to do a deeper dive on the topic, we reviewed a great book on the topic).
1. Mobilize Your SEM Muscle
The sternocleidomastoid (SEM) muscle, if tight, can aggravate acid reflux. Dr. Jo shows how to gently mobilize this muscle by turning your head while holding the SEM in place. It’s simple but effective.
2. Portrait Pose Stretch
Stretch out that SEM with the Portrait Pose. Place your hand on your collarbone, turn your head away, side bend, and look up. Hold for 30 seconds. You’ll feel the tension melting away.
3. Seated Cat-Cow Motion
Open up your stomach area with this easy exercise. Sit down, roll your body forward, arch your back (Cow), then curl your spine and tuck your chin (Cat). Alternate for 30 seconds and feel the difference.
4. Quadruped Cat-Cow with Breathing
Similar to the seated cat-cow, the quadruped cat-cow focuses on flexing the lower spine whilst on all fours. Bonus tip: focus on deep belly breathing during the exercise. This helps improve digestion and ease reflux symptoms.
5. Exaggerated Pelvic Tilt
Lie on your back and tilt your pelvis back and forth. This loosens up the abdominal area and helps everything flow better.
6. Trunk Rotation
Lie down, bend your knees, and rotate them to one side. Hold for 30 seconds, then switch sides. It’s a great way to relax and stretch your abdominal muscles.
We know this is a quick overview (sorry if it seems rushed!), but if you have a few more minutes on your hand you can watch the whole video below.
Feel better soon! And if you have any favorite tips or videos to share, email us at 10almonds.
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“The Longevity Vitamin” (That’s Not A Vitamin)
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The Magic of Mushrooms
“The Longevity Vitamin that’s not a vitamin” is a great tagline for what’s actually an antioxidant amino acid nutraceutical, but in this case, we’re not the ones spearheading its PR, but rather, the Journal of Nutritional Science:
Is ergothioneine a “longevity vitamin” limited in the American diet?
It can be found in all foods, to some extent, but usually in much tinier amounts than would be useful. The reason for this is that it’s synthesized by a variety of microbes (mostly fungi and actinobacteria), and enters the food chain via vegetables that are grown in soil that contain such (which is basically all soil, unless you were to go out of your way to sterilize it, or something really unusually happened).
About those fungi? That includes common popular edible fungi, where it is found quite generously. An 85g (3oz) portion of (most) mushrooms contains about 5mg of ergothioneine, the consumption of which is associated with a 16% reduced all-cause mortality:
However… Most Americans don’t eat that many mushrooms, and those polled averaged 1.1mg/day ergothioneine (in contrast with, for example, Italians’ 4.6mg/day average).
Antioxidant properties
While its antioxidant properties aren’t the most exciting quality, they are worth a mention, on account of their potency:
The biology of ergothioneine, an antioxidant nutraceutical
This is also part of its potential bid to get classified as a vitamin, because…
❝Decreased blood and/or plasma levels of ergothioneine have been observed in some diseases, suggesting that a deficiency could be relevant to the disease onset or progression❞
Source: Ergothioneine: a diet-derived antioxidant with therapeutic potential
Healthy aging
Building on from the above, ergothioneine has been specifically identified as being associated with healthy aging and the prevention of cardiometabolic diseases:
❝An increasing body of evidence suggests ergothioneine may be an important dietary nutrient for the prevention of a variety of inflammatory and cardiometabolic diseases and ergothioneine has alternately been suggested as a vitamin, “longevity vitamin”, and nutraceutical❞
~ Dr. Bernadette Moore et al., citing more references every few words there
Source: Ergothioneine: an underrecognised dietary micronutrient required for healthy ageing?
Good for the heart = good for the brain
As a general rule of thumb, “what’s good for the heart is good for the brain” is almost always true, and it appears to be so in this case, too:
❝Ergothioneine crosses the blood–brain barrier and has been reported to have beneficial effects in the brain. In this study, we discuss the cytoprotective and neuroprotective properties of ergotheioneine, which may be harnessed for combating neurodegeneration and decline during aging.❞
Source: Ergothioneine: A Stress Vitamin with Antiaging, Vascular, and Neuroprotective Roles?
Want to get some?
You can just eat a portion of mushrooms per day! But if you don’t fancy that, it is available as a supplement in convenient 1/day capsule form too.
We don’t sell it, but for your convenience, here is an example product on Amazon
Enjoy!
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