Vol. 110 September 15, 2014 Recent Updates From Around the World

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“Some believe in eating anything, while the weak only eat vegetables.
Those who eat must not despise those who abstain,
and those who abstain must not pass judgement on those who eat.”
Romans 14:2-3

This biblical citation has nothing to do with this week’s contents, but I was so surprised to hear it read in a church service,  and I want to preserve it to use in my defense when my children try to push lima beans, brussels sprouts, and quinoa on to my plate. Plus, I don’t think that it should be only the fundamentalists who quote the bible out of context to support their biases.

My favorite grace, of course, is the Robert Burns grace reproduced here in English (absent the Scottish dialect which really makes it poetic):

Some have meat and cannot eat,
And some would eat, but want it:
But we have meat, and we can eat,
And so let the Lord be “thanket”.

High Dose Flu Vaccine, Hype or Truth?

A study of 32,000 people over 65 years of age during 2011-13 showed that the “high dose” flu vaccine in that age group provided more protection than the standard dose. 1.9% (301) of the standard dose vaccinees got the flu while “only” 1.4% (228) of the high dose vaccinees did. Both vaccines had the same percentage of adverse side effects (9%).

The study’s conclusion was that high dose vaccine is 24% more efficacious, but to me these small numbers hardly justify the high-energy, hyped-up TV ads telling me to “Ask your doctor for the high dose flu vaccine!” AND the authors also remind us that any flu vaccine works best if it matches this year’s flu viruses. That is not always the case. Each year’s flu vaccine is developed from last year’s virus.

Bottom line: get a flu shot, any flu shot.

Too Much Salt Does Kill People, But Not So Much in the U.S.

In a huge, multi-year study funded by the Bill and Melinda Gates Foundation daily salt consumption was determined for 74% of the world’s adult population! The data taken from previously published surveys, 24-hr urine collection reports, and dietary intake studies was fed into a computer (Bill Gates, of course, but the authors added a disclaimer that the “funder had no role in this study or report”). The computer kicked out an average daily salt consumption by age, sex, and year for 187 countries.

The average worldwide salt consumption was about 4 grams per day, twice the amount recommended by the World Health Organization (2 grams per day). 181 of the 187 nations exceeded the WHO recommendation. The computer model went on to estimate that 2 out of 5 premature deaths (under 70 yo.) were attributed to salt consumption above 2 grams a day. The Institute of Medicine has stated that there is little evidence that reducing salt consumption below 2.3 grams a day reduces cardiovascular events. There is even some evidence that a low salt intake (under 1.5 grams a day) can increase your cardiovascular risk!

The good news, for us, is that the  U.S. and Canada have one of the lowest salt consumption rates, but still over the 2 grams threshold. The highest salt consumption associated mortality rates were in Central Asia, Central, and Eastern Europe,  Only Australia and New Zealand had lower CV mortality rates attributed to salt consumption than the U.S. and Canada (again, they beat us!).

Bottom line: If you’re worried about your future cardiovascular events try a 2 gram a day salt diet for a few days. Then very slowly, add a little bit more  salt each day until the food tastes good again.

From the “Duh Department”

Norwegians who have large, complex, or multiple non-cancerous polyps removed from their intestine by colonoscopy have a slightly higher death rate from colon cancer within 10 years than those people with small, single “low-risk” non-cancerous polyps. (3)

People in low income countries have lower risk factors for cardiovascular deaths, but have much higher death rates from heart attacks than middle- and high-income countries (Also true for “deaths from any cause”).(4)

References:
1. NEJM August 14, 2014 vol. 137, no. 7, pg. 635
2. Ibid; pg. 624 and 677 Editorial
3. NEJM August 28, 2014 vol. 371, no. 9, pg.799 and 860 Editorial
4. Ibid; pg. 818

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