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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Overcoming Gravity – by Steven Low
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The author, a professional gymnast and coach with a background in the sciences, knows his stuff here. This is what it says on the tin: it’s rigorously systematic. It’s also the most science-based calisthenics book this reviewer has read to date.
If you just wanted to know how to do some exercises, then this book would be very much overkill, but if you want to be able to go from no knowledge to expert knowledge, then the nearly 600 pages of this weighty tome will do that for you.
This is a textbook, it’s a “the bible of…” style book, it’s the one that if you’re serious, will engage you thoroughly and enable you to craft the calisthenics-forged body you want, head to toe.
As if it weren’t already overdelivering, it also has plenty of information on injury avoidance (or injury/condition management if you have some existing injury or chronic condition), and building routines in a dynamic fashion that avoids becoming a grind, because it’s going from strength to strength while cycling through different body parts.
Bottom line: if you’d like to get serious about calisthenics, then this is the book for you.
Click here to check out Overcoming Gravity, and do just that!
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Give Your Adrenal Glands A Chance
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The Hats Of Wrath
Your adrenal glands are two little hat-shaped glands that sit on top of your kidneys (like your kidneys are wearing them as hats, in fact).
They produce adrenaline, as you might have guessed, and also cortisol and aldosterone, which you might or might not have known, as well as some miscellaneous corticosteroids that are beyond the scope of today’s article.
Fun fact! For a long time, doctors thought adrenal glands were much larger than they usually are, because of learning anatomy from corpses that were dissected, but invariably the corpses were those of poor people, especially criminals, whose adrenal glands were almost always overworked and swollen.
You don’t want yours to be like that.
What goes wrong
Assuming you don’t have a rare disorder like Addison’s disease (in which the adrenal glands don’t produce enough of the hormones they’re supposed to), your adrenal glands will usually not have trouble producing enough adrenaline et al.
However, as we learned from the Victorian vagabonds, they can also have no problems producing too much—much like any organ that gets overworked, however, this has consequences.
Hopefully you’re not living a life of stressful crime on the streets, but maybe you have other reasons your adrenal glands are working overtime, such as any source of chronic stress, bad sleep (can’t recharge without this downtime), overuse of stimulants (including caffeine and/or nicotine), and, counterintuitively, alcohol. All these things can tax the adrenal glands considerably.
When this happens, in the extreme we can get Cushing’s syndrome, characterized by the symptoms: hypertension, cortisol-based fat distribution i.e. especially face and abdomen, weakness, fragile easily irritable skin, hair loss and/or hirsutism, paradoxically, and of course general fatigue.
In the non-extreme, we get all the same symptoms just to a lower level, and experience what the medical profession is begging us not to call “Adrenal Fatigue Syndrome” because that’s not an official diagnosis, whereas if it gets a name then they’ll be expected to treat it.
What keeps things going right
Obviously, the opposite of the above, for a start. Which means:
Manage chronic stress; see: How To Manage Chronic Stress
Get good sleep; see: Why You Probably Need More Sleep
Go easy on the caffeine; see: Caffeine Mythbusting
Skip the nicotine; see: Nicotine Benefits (That We Don’t Recommend)!
Avoid alcohol; see: How To Reduce Or Quit Alcohol
There are specific vitamins and minerals that support adrenal health too; they are: vitamins B5, B6, B12, C, & D, and also magnesium and zinc.
Good dietary sources of the above include green leafy things, cruciferous vegetables*, nuts and seeds, avocados, olive oil, and if you eat fish, then also fatty fish.
In contrast, it is good to cut down (or avoid entirely) red meat and unfermented dairy.
*Unsure how to get cruciferous vegetables in more often? Try today’s featured recipe, superfood broccoli pesto
Want to know more?
A large part of adrenal health is about keeping cortisol levels down generally (except: for most of us, we can have a little hormesis, as a treat), so for the rest of that you might like to read:
Lower Your Cortisol! (Here’s Why & How)
Take care!
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Why You Don’t Need 8 Glasses Of Water Per Day
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The idea that you need to drink eight glasses of water daily is a myth. For most people most of the time, this practice will not make your skin brighter, improve mental clarity, or boost energy levels. All that will happen as a result of drinking beyond your thirst, is that you’ll pee more.
A self-regulating system
Our kidneys regulate hydration by monitoring blood volume and salt levels. When blood becomes slightly saltier or its volume drops, such as through sweating, the kidneys absorb more water into the bloodstream. If needed, the body triggers thirst signals to encourage fluid intake.
In most cases, you can rely on your body’s natural thirst cues to manage hydration. Thirst is a reliable indicator of when you need to drink water, making constant monitoring of water intake unnecessary for most people.
There are some exceptions, though! Some people, such as those with kidney stones, especially older adults, or those with specific medical considerations and resultant advice from your doctor, may need to pay closer attention to their water intake.
Nor does hydration have to be a matter of “drinking water”: many foods and drinks, such as fruit, coffee, soups, etc, contribute to your daily water intake and (because the body processes it more slowly) are often more hydrating than plain water (which can just pass straight through if you take more than a certain amount at once). If you listen to your body’s thirst signals, there’s no need to rigidly count eight glasses of water each day.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Hydration Mythbusting ← this also covers why urine color is not as good a guide as your thirst
Take care!
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An Elegant Defense – by Matt Richtel
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In a way, Richtel got the best and worst of the publication date lottery. This book, which he’d obviously been working on for however long, was published in March 2020. Yes, that March 2020. So, it obviously got a huge boost in sales that launced it to bestseller status, and/but it doesn’t actually discuss COVID at all.
What it does discuss, is—as one might expect—the immune system. Or really, the immune systems, plural, several systems working alongside each other. How we got to have such, how our immune functions work, where all the various immune cells come from and what part they play. What pathogens can do to fight and/or confuse (or even co-opt) our immune response, and what modern medicine can do to counteract the pathogens’ anti-countermeasure countermeasures. And how it can still go wrong.
The “Four Lives” promised in the subtitle are stories, and Richtel explains the immune system through specific people’s specific battles. In particular, a friend of his who had quite a remarkable battle against cancer, which was of course terrible for him, but illustrative for us.
The style of the book is very readably journalistic. The author is a Pulitzer-winning NYT journalist, and not normally a science writer. Here at 10almonds, “we like big bibliographies and we cannot lie”, and we didn’t get to enjoy that in this case. The book contained no bibliography (nor appropriate inline citations, nor equivalent footnotes). Maybe a future addition will include this.
Bottom line: there’s a lot of “science for the lay reader” here. While the lack of references is a big oversight, the book does give a very good overview of what both sides (immune response and pathogenic invasion) bring to the battle of your body.
Click here to check out Elegant Defense, and demystify immunology!
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The Bare-Bones Truth About Osteoporosis
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In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
The Bare-bones Truth About Osteoporosis
In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.
This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.
We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.
Let’s get to the myths and facts:
Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”
The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.
Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!
About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.
On the topic of that glass of milk…
- Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
- People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
- Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
- Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.
See also: An update on magnesium and bone health
Next most common myth: “bone health is all about calcium”
We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:
Read more: The effects of potassium on bone health
While we’re on the topic…
People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:
We Are Such Stuff As Fish Are Made Of
Want to really maximize your bone health?
You might want to check out this well-sourced LiveStrong article:
Bone Health: Best and Worst Foods
(Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)
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Jamaican Coconut Rice
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This is a great dish that can be enjoyed hot or cold, as a main or as a side. It has carbs, proteins, healthy fats, fiber, as well as an array of healthy phytochemicals. Not to mention, a great taste!
You will need
- 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same) (traditional recipe calls for pudding rice, but we’re going with the healthier option here)
- 2 cans (each 12 z / 400g) coconut milk
- 2 cups (or 2 cans, of which the drained weight is comparable to a cup each) cooked black beans. If you cook them yourself, this is better, as you will be able to cook them more al dente than you can get from a can, and this firmness is desirable. But canned is fine if that’s what’s available.
- 1 large red onion, finely chopped
- ½ cup low-sodium vegetable stock (ideally you made this yourself from vegetable offcuts you saved in the freezer for this purpose, but failing that, low-sodium stock cubes can be bought at any large supermarket)
- 2 serrano chilis, finely chopped
- 1 Scotch bonnet chili, without doing anything to it
- 1 tbsp black pepper, coarse ground
- 1 tbsp chia seeds
- 1 tbsp coconut oil
- Garnish: parsley, chopped
Note: we have erred on the side of low-heat when it comes to the chilis. If you know that you and (if applicable) everyone else eating would enjoy more heat, add more heat. If not, let extra heat be added at the table via your hot sauce of choice. Sounds heretical, but it ensures everyone gets the right amount! It’s easy to add heat than to take it out, after all.
However: if you do end up with too much heat in this or any other dish, adding acid will usually help to neutralize that. In the case of this dish, we’d recommend lime juice as a complementary flavor.
Method
(we suggest you read everything at least once before doing anything)
1) In a big sauté pan, add the coconut oil, melt it if not already melted, and add the chopped onion and the chopped chilis, at a temperature sufficient to sizzle. Keep them all moving. Once the coconut oil is absorbed into the onion (this will happen before the onion is fully cooked), add the vegetable stock, followed by the coconut milk; mix it all gently to create a smooth consistency.
2) Add the rice, chia seeds, and black pepper; mix it all gently but thoroughly; turn the temperature to a simmer, and add the Scotch bonnet chili, without cutting it at all.
3) Cover and keep on low for about 20–30 minutes until the rice is looking done. Check on it periodically to make sure it’s not running out of liquid, but resist the urge to stir it; it shouldn’t be burning but paradoxically, once you start stirring you can’t stop or it will definitely burn.
4) Take out the Scotch bonnet chili, and discard*. Add the black beans.
*its job was to add flavor without adding the high-level heat of that particular chili. If you’re a regular heat-fiend, feel free to experiment with using sliced Scotch bonnet chilis instead of serrano chilis; just be aware that there’s a big difference in heat. Only do this if you really like heat. Using it the way we described in the main recipe is what’s traditional in the Caribbean, by the way.
5) Now you can (and in fact must) stir, to mix in the black beans and bring them back to temperature within the dish. Be aware that once you start stirring, you need to keep stirring until you’re ready to take it off the heat.
6) Serve, adding the parsley garnish.
(this example went light on the beans; our recipe includes more for a heartier dish)
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Should You Go Light Or Heavy On Carbs?
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Burn! How To Boost Your Metabolism
- Capsaicin For Weight Loss And Against Inflammation
Take care!
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