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New U.S. Diet Guidelines: No more than 1.5 gm of sodium/day, get off your "SoFAS" - Solid Fats and Added Sugars
Decrease in salt consumption
The main recommendation is a decrease in salt consumption. New recommendation is below 1,500 mg/day for at-risk populations. At-risk populations include African-Americans, people with high blood pressure or kidney disease, and people over 51. Americans not at risk can consumer up to 2,300 mg of salt per day (for now, until the next update of the guidelines - commentary of the blog author). Kristin Kirkpatrick: I think the 1,500 mg/day recommendation should apply to the entire population for many reasons. There is strong scientific evidence that limiting salt can help prevent heart attacks and stroke. The problem with the current recommendations is that nearly everyone will enter the at-risk population at some point in their lives. In order to decrease your risk for a number of chronic diseases, it is advisable to consume as little salt as possible.
How to cut salt?
77% of sodium consumption in the US is obtained through processed foods.
Limit any food that can sit on your shelf for two years and still taste great when prepared. Try to only consume foods that will eventually rot if not eaten in 10 days or so.
Learn how to cook! Take a cooking class or experiment at home. Use spices, herbs for flavor instead of salt.
Investigate your eating-out choices beforehand. A typical restaurant meal averages 3,500 mg/salt.
Don't purchase canned soup - make your own! Most canned soup is very high in sodium.
Sea salt has more minerals and is less processed, but it contains the same level of sodium (or more) as iodized salt.
Get off your "SoFAS" - decrease Solid Fats and Added Sugars
Another recommendation is to replace solid fats with fats that are liquid at room temperature.
Read your labels and keep any foods with partially hydrogenated oils out of your shopping cart. Partially hydrogenated oils are linked to increased "bad" LDL cholesterol and decreased good "HDL" cholesterol
Focus more on consuming plant-based foods than animal-based foods to decrease saturated fat intake.
Don't forget that any kind of fat - good or bad - has, on average, 100 calories per teaspoon.
Good fats include avocado, seeds and nuts, olive and canola oil. Keep good fats to 20-25% of total caloric intake per day.
Vary protein sources in the diet - add seafood
Another recommendation is to vary protein sources in the diet.
It is recommended people consume 8-12 oz. of seafood per week. That's about 2 servings. Aim for seafood choices that provide omega-3 fatty acids like wild salmon, sardines, halibut, and trout. Pregnant women want to avoid higher mercury fishes like shark, swordfish, and king mackerel.
Eat a variety of fruits and vegetables
Another recommendation is to eat a variety of fruits and vegetables. Make sure to include dark green, red and orange vegetables in your diet. Kale, peppers and beets are good examples.
Food fact: The darker the color of the vegetable, the higher the antioxidant content.
Aim to consume five handfuls of fruit per day. When possible, keep the skins on for extra fiber.
Consume half of grains as whole grains
Another recommendation encourages Americans to consume half of their grains as whole grains. It is better to consume all of your grains as whole grains, however. Consume breads that contain 100% whole grain or whole wheat. Read the labels! Switch white rice to brown rice.
Check your pasta! The only ingredient should be 100% whole wheat. If "whole" or 100% isn't in front of "wheat", put it back. Pasta doesn't need to be wheat-based. You could also consume brown rice pasta. Brown rice pasta is gluten-free.
Practice healthy eating EVERY day
Most importantly, practice healthy eating patterns every day.
Eat together as a family, and turn off the TV and smartphone during meals. Distracted eating causes you to eat 40% more. Stay within your individual caloric needs. With all these recommendations, portion control is still key.
References:
Dietary Guidelines for Americans. USDA.
Primary takeaway from the new U.S. diet guidelines: Enjoy your food, but eat less. NYTimes.
Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook.
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Myriads of Indecency: Ruling Against Patenting Cancer Genes Makes Scientific, Legal and Ethical Sense
Just a quick browsing of the Myriad Genetics website tells you that this company embodies just about everything bioethics researchers have been warning for in connection to the commercialisation of genetic testing since the late 1980's. The University of Utah Research Foundation that held the claimed patent together with Myriad - and that may be assumed to have been cashing in handsomely as a passive partner - should be held equally, if not more, accountable for this attempt to undercut sound business law, decent health care ethical standards, scientific progress and, not least, the health of those people belonging to families burdened by hereditary cancer, whose access to the preventive opportunities offered through genetic testing, and forthcoming advances of medical research, has been undercut. But back to the poverty of Myriad Genetics.
To take just one example of this moral morass, Myriad offers predictive genetic testing for hereditary melanoma - a disease for which the actual risk figure is never given at the Myriad website. Clicking this product, you are immediately told that "Changes in the p16 gene increase cancer risk, making a melanoma diagnosis up to 50 times more likely by age 50", which of course tells you absolutely nothing about what risk of melanoma you actually run before the age of 50 if you have the indicated genetic mutation, but for most people convey the impression that a mutation makes your risk of contracting melanoma before 50 an even game. Clicking further on to the page supposed to give you an in-depth background to hereditary melanoma, you're exposed to the following explanation. Take a minute or so to read it!
Having that horrible mutation must make for a helluva risk, doesn't it? Actually: no! Even considering that the people involved in Myriad are presumably not proper clinical doctors (if they were, AMA would have revoked their licenses by now, right? - I'm being charitable to the US medical profession here), but a bunch of lab rats and business executives, this is as close to actual fraud you can get without actually committing it in the strict legal sense. Remember that nice graph you just saw? Its Y-axis measures not the actual risk of contracting melanoma, but - again! - the change in risk compared to what risk of contracting melanoma you would run were you a random member of the general population. But the impression of the picture is not that - the impression is - once again - that if you carry the mutation you run a 50/50 risk. This message is cleverly conveyed by the sinister manner in which the general population risk figure is illustrated in the graph. That green staple to the right of the tall blue one seems to reach up to the 1 of the Y-axis, right? It's 1% - right? Or something close to 1%? Actually, no! Have a closer look at the graph:
It is <1% - i.e. "less than 1%", i.e. the risk is not given. It could be 0.99%, it could be 0.0000000000000000000001% For all we know based on the information provided, the 50% increased risk may thus equal a 0.0000000000000000000002% risk. Who knows? Obviously not Myriad Genetics - or can they really be consciously hiding highly relevant facts from potential customers??
Just to get some perspective, hereditary melanoma is what geneticists refer to as a multi-factorial disease, i.e. it occurs as a result of the interaction between several genetic mutations and the environment. The p16 test offered by Myriad targets just one among many different genes where a mutation may increase the risk for melanoma. This is actually conveyed by this admirably pedagogic (right!) explanation of what a test result mean. Scroll down and read the message about the "uncertain variant", there you have it! But just above, Myriad boosts about the "comprehensive" (and presumably ridiculously expensive) variant of the test, described thus: "Think of a comprehensive analysis as reading an entire encyclopedia, line by line, to look for a single misspelled word" (italics added by me). Again, as close to fraud as you might dare to wander. The "entire encyclopedia" must be read the entire human genome, including all the other genes that may increase the risk of melanoma - right?? Actually, no! It's the same p16 gene, i.e. it's more or less the same test, just properly done so that all known melanoma predisposing mutations of this particular gene are included. So, suppose you test negative in a "comprehensive" test - this is compatible with you carrying any of the other known genetic mutations of other genes that increase the risk of melanoma - what Myriad so handsomely describe as "no increased cancer risk" when explaining what a test result means. Did anyone mention fraud or deceitful behaviour? - I certainly did not, but it would be interesting indeed to have melanoma or cancer patient organisations trying out that concept in US civil courts (in which case, the University of Utah Research Foundation must, of course, be included in the lawsuit)!
Hopefully, the ruling against patenting actual genes or naturally occurring genetic mutations will undercut the sour-tasting business of Myriad Genetics and other similar companies. For one thing, as a legal precedent, it has the potential of putting a stop to attempts of making ethically well-motivated and responsibly handled predictive genetic testing offered by national health services - for instance for colon-, breast- and ovarian cancer - unnecessary expensive and thus accessible for more people at risk. From a moral point of view, it is thus most welcome. From a legal point of view as well, since what judge Robert Sweet argues in the ruling, "...the claimed isolated DNA is not markedly different from native DNA as it exists in nature, it constitutes unpatentable subject matter" has been obvious to anyone from the outset interested in applying actual patent law, rather than laying the foundation for a new branch of business. If Myriad has a unique procedure to detect DNA, they may patent that, of course, but do they? It remains to be seen, but my guess is that they use the same state of the art science and technology as does any molecular genetic research lab, and that they knew very well that their only chance to make a buck was attempting the patenting of DNA trick.
The only defense offered by Myriad's and the UURF's lawyer was that patenting genes promotes "innovation" and therefore promotes health. False. In fact, the patent claims on BRCA-1 and BRCA-2 has made medical research based on these genes that may lead to deeper understanding of the mechanisms of these forms of cancer, and thus to newer and better treatments, slower and/or more expensive. Patents have the potential of furthering innovation only when all of the basic scientific work has been done (until then, the scientific principle of openness, free sharing, access and use of information is far superior), and in the case of human genetics, identifying genes connected to disease-groups is just the first letter of the first name of that long process. When Myriad says "innovation" they mean business and so does - shame on them - the UURF.
[Cross-posted from Christian Munthe's Philosophical Comment blog. Christian and research fellow Daniela Cutas have agreed to guest blog in the coming months]
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People who brush their teeth less than twice a day have a 70% increased risk of heart disease
Participants were 12,000 men and women, mean age 50. Oral hygiene was assessed from self reported frequency of toothbrushing. There were a total of 555 cardiovascular disease events over an average of 8 years of follow-up, of which 170 were fatal.
Participants who reported poor oral hygiene (never/rarely brushed their teeth) had an increased risk of a cardiovascular disease event (hazard ratio 1.7).
They also had increased concentrations of both C reactive protein and fibrinogen.
Poor oral hygiene is associated with higher levels of risk of cardiovascular disease and low grade inflammation, though the causal nature of the association is yet to be determined.
References:
Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey. BMJ 2010;340:c2451.
Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook.
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