Tag Archives: salt

Adding salt to your food raises risk of death – study

Adding extra salt to your food puts you at a higher risk of dying, regardless of the cause, a new academic study has found.

The study looked at any possible association between adding salt to one’s food and premature deaths, though it notably did not include salt used in cooking but rather extra salt added to food.

The findings of the study were published in the peer-reviewed academic periodical the European Heart Journal.

Don’t be so salty

Scientists have long debated the exact nature salt intake during eating has on one’s health. 

Recently, this debate was sparked again by studies indicating that sodium intake (itself linked with salt, also known as sodium chloride) is linked with a higher risk of death, but results have often been inconsistent on this in the past.

Part of the reason for this is due to low accuracy sodium measurements. This is because sodium intake tends to vary greatly on a day-to-day basis.

This, in turn, was because of how sodium intake was studied, either by dietary survey or a single day’s urine sample, neither of which are enough to properly measure it.

Not only that, but there is further confusion regarding the studying of sodium intake and potassium intake, based on existing methods. 

So how can we properly study sodium intake? Well, the answer seems to be salt added to food.

What scientists do know is that adding extra salt to food is very common, influences one’s preference for salty flavors and can contribute significantly to how much salt one consumes. 

Scientists have determined that adding extra salt to food accounts for 6%-20% of total salt intake in Western diets.

But table salt, which is the primary type of salt used, also has the benefit of being nearly entirely (97%-99%) sodium chloride. What this means is that it is far easier to determine sodium intake from this without getting confused with other dietary elements, like potassium.

But few studies have ever actually gone so far as to study adding salt to food and how it impacts mortality rates. Until now.

Salt 424 (521) (credit: Courtesy Ari Gortersman)

The study

To analyze this data, the scientists made use of data covering over 500,000 people via the UK biobank. 

These participants were given a touch-screen questionnaire and were asked if they add salt to food, not including salt for cooking, and could give one of five possible answers: Never/rarely, sometimes, usually, always and prefer not to answer, the latter of which were assigned to a missing value.

In addition, the participants also had to answer if they made any major diet changes in the past five years, with the possible answers being no, yes because of illness, yes because of other reasons and prefer not to answer.

The scientists also collected urine samples, from which sodium and potassium counts were measured.

Next, the question was how to tell if one’s risk of dying was increased. How can one tell life expectancy was impacted?

To do this, scientists had to review death certificates from the UK’s National Health Services. From here, it became a matter of determining at one point is a death considered premature.

By studying the dates of death as well as other related info, it was determined that dying before the age of 75 was considered premature.

But how does this relate to salt? 

Here to study the participants adding salt to their food, the scientists used a life table. This refers to a table used in statistics that shows the probability that someone of each age might die. 

These tables used in this study covered the ages of 45-100. 

To calculate survival odds, the researchers used three estimates: The UK Office for National Statistics data on sex- and age-specific mortality rates; the sex-specific hazard ratios of mortality in each group depending on how often they added salt to their food; and the sex-specific prevalence of each frequency of adding salt.

So a high frequency of adding salt would be estimated as the difference in life expectancy between each group and the reference data.

Results

When the data was all calculated, the scientists concluded that people who always added salt to their food had a 28% raised risk of death.

Take into account that currently, among those between the ages of 40 and 69 in the general population, around three in every 100 people will die prematurely. Now, adding data from people always adding salt to their food, that number will climb to four in every 100 people dying early in this age group.

At the age of 50, women who always added salt to their food essentially lost 1.5 years of life, while men who did so lost 2.28 years.

That being said, there may be ways to reduce risks, at least somewhat, by eating high amounts of fruits and vegetables, though the difference this could bring wasn’t deemed statistically significant.

“Even a modest reduction in sodium intake, by adding less or no salt to food at the table, is likely to result in substantial health benefits, especially when it is achieved in the general population.”

Prof. Lu Qi

The most significant outcome of this, according to lead researcher Prof. Lu Qi, of Tulane University School of Public Health and Tropical Medicine, New Orleans, is that it can help with changing dietary habits to improve health. Especially since even cutting back on salt intake just a bit can be beneficial.

“To my knowledge, our study is the first to assess the relation between adding salt to foods and premature death,” Qi said in a statement. 

“It provides novel evidence to support recommendations to modify eating behaviors for improving health. Even a modest reduction in sodium intake, by adding less or no salt to food at the table, is likely to result in substantial health benefits, especially when it is achieved in the general population.”

So next time you go eat dinner, maybe be sure to hold the salt.



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Adding salt to your food at the table is link

image: The risk of premature death from adding salt to food
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Credit: Please credit European Heart Journal

People who add extra salt to their food at the table are at higher risk of dying prematurely from any cause, according to a study of more than 500,000 people, published in the European Heart Journal [1] today (Monday).

 

Compared to those who never or rarely added salt, those who always added salt to their food had a 28% increased risk of dying prematurely. In the general population about three in every hundred people aged between 40 and 69 die prematurely. The increased risk from always adding salt to food seen in the current study suggests that one more person in every hundred may die prematurely in this age group.

 

In addition, the study found a lower life expectancy among people who always added salt compared to those who never, or rarely added salt. At the age of 50, 1.5 years and 2.28 years were knocked off the life expectancy of women and men, respectively, who always added salt to their food compared to those who never, or rarely, did.

 

The researchers, led by Professor Lu Qi, of Tulane University School of Public Health and Tropical Medicine, New Orleans, USA, say their findings have several public health implications.

 

“To my knowledge, our study is the first to assess the relation between adding salt to foods and premature death,” he said. “It provides novel evidence to support recommendations to modify eating behaviours for improving health. Even a modest reduction in sodium intake, by adding less or no salt to food at the table, is likely to result in substantial health benefits, especially when it is achieved in the general population.”

 

Assessing overall sodium intake is notoriously difficult as many foods, particularly pre-prepared and processed foods, have high levels of salt added before they even reach the table. Studies assessing salt intake by means of urine tests often only take one urine test and so do not necessarily reflect usual behaviour. In addition, foods that are high in salt are often accompanied by foods rich in potassium, such as fruit and vegetables, which is good for us [2]. Potassium is known to protect against the risk of heart diseases and metabolic diseases such as diabetes, whereas sodium increases the risk of conditions such as cancer, high blood pressure and stroke.

 

For these reasons, the researchers chose to look at whether or not people added salt to their foods at the table, independent of any salt added during cooking.

 

“Adding salt to foods at the table is a common eating behaviour that is directly related to an individual’s long-term preference for salty-tasting foods and habitual salt intake,” said Prof. Qi. “In the Western diet, adding salt at the table accounts for 6-20% of total salt intake and provides a unique way to evaluate the association between habitual sodium intake and the risk of death.”

 

The researchers analysed data from 501,379 people taking part in the UK Biobank study. When joining the study between 2006 and 2010, the participants were asked, via a touch-screen questionnaire, whether they added salt to their foods (i) never/rarely, (ii) sometimes, (iii) usually, (iv) always, or (v) prefer not to answer. Those who preferred not to answer were not included in the analysis. The researchers adjusted their analyses to take account of factors that could affect outcomes, such as age, sex, race, deprivation, body mass index (BMI), smoking, alcohol intake, physical activity, diet and medical conditions such as diabetes, cancer and heart and blood vessel diseases. They followed the participants for a median (average) of nine years. Premature death was defined as death before the age of 75 years.

 

As well as finding that always adding salt to foods was linked to a higher risk of premature death from all causes and a reduction in life expectancy, the researchers found that these risks tended to be reduced slightly in people who consumed the highest amounts of fruit and vegetables, although these results were not statistically significant.

 

“We were not surprised by this finding as fruits and vegetables are major sources of potassium, which has protective effects and is associated with a lower risk of premature death,” said Prof. Qi.

 

He added: “Because our study is the first to report a relation between adding salt to foods and mortality, further studies are needed to validate the findings before making recommendations.”

 

In an editorial to accompany the paper [3], Professor Annika Rosengren, a senior researcher and professor of medicine at the Sahlgrenska Academy, University of Gothenburg, Sweden, who was not involved with the research, writes that the net effect of a drastic reduction in salt intake for individuals remains controversial.

 

“Given the various indications that a very low intake of sodium may not be beneficial, or even harmful, it is important to distinguish between recommendations on an individual basis and actions on a population level,” she writes.

 

She concludes: “Classic epidemiology argues that a greater net benefit is achieved by the population-wide approach (achieving a small effect in many people) than from targeting high-risk individuals (a large effect but only achieved in a small number of people). The obvious and evidence-based strategy with respect to preventing cardiovascular disease in individuals is early detection and treatment of hypertension, including lifestyle modifications, while salt-reduction strategies at the societal level will lower population mean blood pressure levels, resulting in fewer people developing hypertension, needing treatment, and becoming sick. Not adding extra salt to food is unlikely to be harmful and could contribute to strategies to lower population blood pressure levels.”

 

A strength of Prof. Qi’s study is the large number of people included. It also has some limitations, which include: the possibility that adding salt to food is an indication of an unhealthy lifestyle and lower socio-economic status, although analyses attempted to adjust for this; there was no information on the quantity of salt added; adding salt may be related to total energy intake and intertwined with intake of other foods; participation in UK Biobank is voluntary and therefore the results are not representative of the general population, so further studies are needed to confirm the findings in other populations.

 

Prof. Qi and his colleagues will be carrying out further studies on the relation between adding salt to foods and various chronic diseases such as cardiovascular disease and diabetes. They also expect potential clinical trials to test the effects of a reduction in adding salt on health outcomes.

 

(ends)

 

[1] “Adding salt to foods and hazard of premature mortality”, by Hao Ma et al. European Heart Journal. doi:10.1093/eurheartj/ehac208

[2] An example of a typically salty food that also contains vegetables are tacos, which are often filled with beans and vegetables.

[3] “Salt – the sweet spot?”, by Annika Rosengren. European Heart Journal. doi:10.1093/eurheartj/ehac336


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Kamaru Usman to face Leon Edwards in Salt Lake City

The UFC’s No. 1 pound-for-pound fighter has his next opponent.

UFC welterweight champion Kamaru Usman will defend his title against Leon Edwards at UFC 278 on Aug. 20, the promotion announced Saturday. The event will take place at Vivint Arena in Salt Lake City, Utah.

The fight is a rematch, as Usman defeated Edwards by unanimous decision in 2015. Neither fighter has lost since.

Since winning the belt against Tyron Woodley in March 2019, Usman has defeated Colby Covington twice, Jorge Masvidal twice and Gilbert Burns. He remains undefeated in the UFC and holds a career record of 20-1.

Edwards had been on an eight-fight win streak since his loss to Usman, but went nearly two years without a fight between July 2019 and March 2021. The UFC went as far as removing Edwards from its rankings after failing to figure out his next fight, with his lay-off ultimately ending against Belal Mugmmad after a Khamzat Chimaev fight fell through due to COVID-19.

The Edwards-Muhammad ended as a no-contest due to an accidental eye poke by Edwards. The welterweight went on to defeat Nate Diaz in his most recent fight, setting up a title shot.

UFC welterweight champ Kamaru Usman has his next opponent. (Photo by Mike Stobe/Getty Images)

Edwards is the latest member of one of the UFC’s most deep divisions to get a title shot. Should he lose, the possibility of a Chimaev title shot looms large after the rising star’s win over Burns at UFC 273. Edwards is officially ranked as the UFC’s No. 2 contender, while Chimaev as No. 3 (Covington remains No. 1).

Other fights reported to be in the works for UFC 278 include Luke Rockhold versus Paulo Costa and Victor Altamirano versus Jake Hadley.

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Monkeypox in Utah: Probable cases identified in Salt Lake County

Monkeypox is believed to be in Utah.

Two adults in the same Salt Lake County household “are considered probable monkeypox cases,” the Salt Lake County Health Department announced Monday, based on preliminary testing. Confirmation that the rare disease has come to the state is expected from the Centers for Disease Control and Prevention on Tuesday.

“There is no risk to the general public due to these probable monkeypox cases,” the county health department’s executive director, Dr. Angela Dunn, told reporters, adding that the disease is “very rare” and “does not easily spread from human to human. We’re not talking about COVID here.”

She said this is “not a reason to panic,” especially given that only about 100 cases have been seen worldwide.

Utah is the only state so far with more than one monkeypox case. In Massachusetts, monkeypox has been confirmed in a man who traveled to Canada, while a man in New York City and another in Florida who also traveled internationally are waiting confirmation they have the disease.

All of the cases involve men, according to Jennifer McQuiston, deputy director of the CDC Division of High Consequence Pathogens and Pathology, who declined to share specifics of their travel during a virtual news conference later Monday.

Both of Utah’s infected individuals have agreed to remain at home in isolation until their rash is gone, Dunn said, and all the people who have been in close contact with them are expected to have been reached by the county or Utah Department of Health by the end of the day.

None have been asked to quarantine because none had a high-risk exposure to the disease, she said. Instead, they’ve been told to monitor themselves for symptoms over the next 21 days, Dunn said, since people with the disease are not contagious prior to symptoms appearing.

She said the infected individuals started showing symptoms after traveling to Europe earlier this month to an area with monkeypox cases, adding their illness is mild and they are expected to fully recover. The pair saw their health care provider on Friday, who “immediately told them to isolate and called public health,” Dunn said.

Within 24 hours, she said their illness was identified as an orthopox virus infection through testing by the state laboratory, part of a family of diseases that also includes smallpox, although further testing is needed by the CDC to confirm it is monkeypox.

The county health department did not release any additional information about the suspected cases, citing medical privacy laws.

This 1997 image provided by the Centers for Disease Control and Prevention during an investigation into an outbreak of monkeypox, which took place in the Democratic Republic of the Congo depicts the dorsal surfaces of the hands of a monkeypox case patient, who was displaying the appearance of the characteristic rash during its recuperative stage. As more cases of monkeypox are detected in Europe and North America in 2022, some scientists who have monitored numerous outbreaks in Africa say they are baffled by the unusual disease’s spread in developed countries.

Center for Disease Control and Prevention via AP

Belgium is the first nation to impose a quarantine for those with the disease, usually found only in Africa, but President Joe Biden said Monday he did not believe that would be necessary in the United States.

“I just don’t think it rises to the level of the kind of concern that existed with COVID-19, and the smallpox vaccine works for it,” Biden said at a news conference in Japan on Monday, The Washington Post reported. Sunday, the president told reporters that monkeypox is a “concern in that if it were to spread, it would be consequential.”

Monkeypox, spread primarily through direct contact with body fluids, including the pustules that accompany the disease, has been identified in at least a dozen countries by the World Health Organization. Besides Africa and the United States, several European nations have seen the disease as well as Australia and Canada.

The county health department said monkeypox symptoms include fever, headache, muscle aches, exhaustion and swollen lymph nodes, along with a rash that often starts on the face before spreading to other parts of the body and turning into fluid-filled bumps that eventually scab over and fall off.

The illness typically lasts two to four weeks, and Dunn said people usually recover without treatment.

She advised anyone who has traveled recently to places where monkeypox is spreading, or have come into contact with someone who has a rash “to be on the lookout for symptoms and contact their provider if they do have them.”

Besides person-to-person contact involving body fluids, like prolonged touching, kissing or sex, or being close to someone for several hours, Dunn said the disease can also be spread through contact with clothing, bed linens or other materials contaminated with the pustules.

She said the disease is “spreading particularly” in the gay community, especially in men, and the county “will work with our partners, especially ahead of Pride Week, to make sure everyone involved in those activities understand the risks and how to protect themselves.”

A CDC post on the disease states the federal agency is “tracking multiple clusters of monkeypox that have been reported in early to mid-May in several countries that don’t normally report monkeypox, including in Europe and North America.”

The cases “include people who self-identify as men who have sex with men. CDC is urging healthcare providers in the U.S. to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender or sexual orientation.”

The disease can be serious, killing about 10% of those infected in Africa, but Dunn said she expects the death rate to be “much, much lower” in the United States because of better access to health care. Someone with a weakened immune system could experience a more severe case of monkeypox, she said.

Utahns traveling internationally should review the CDC’s current recommendations for their destinations and take precautions including “frequent, thorough hand washing; avoiding contact with animals; and avoiding close contact with people who have symptoms of illness,” the county health department said.

Appointments can also be scheduled with the Salt Lake County Health Department Travel Clinic for more information by calling 385-468-4111, and more information about monkeypox is available on the CDC website, at CDC.gov/monkeypox.

The Utah Department of Health had no comment on the disease’s presence in the state.

“We are respecting the role Salt Lake County Health Department has as the lead agency on this response and will be referring comments to their agency at this time. We are working closely with their team on the response,” state health department spokeswoman Jenny Johnson said.

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So, Apparently Sony Demanded Changes to Salt and Sacrifice’s Price on Other Platforms

Oooft! The bad press keeps a-coming, and while we can kinda understand this one if we squint, Sony’s going to be guilty in the all-important court of public opinion. According to a report by TechRaptor, the price of indie Souls-like Salt and Sacrifice has significantly increased on the Epic Games Store in a number of different countries – and all because PlayStation was p*ssed that Ska Studios was selling it cheaper than on the PS Store.

From what we can infer, Sony has a deal with the game which has resulted in its console exclusive release. The catch is that Ska Studios set the price individually for each country on the Epic Games Store, which meant it was cheaper in some places than others. Co-owner Shane Lynch explained that his company “can’t actually control individual prices on Sony, so some of it had to go up or down” on Epic Games Store because of contractual obligations and a demand for parity.

For the UK, that’s good news – it’s actually gone down from £15.99 to £12.99. But for many other countries, like Brazil, the price has rocketed – we’re talking an increase from R$37.99 to R$104.90. That’s a 276 per cent jump! It’s a similar story in Turkey, where the title’s gone up from ₺33 to ₺153. This does make the price a bit more consistent across the various different countries, but obviously it doesn’t account for the differences in earnings et al.

As we said at the top of the article, we do understand how this has happened: Ska Studios has evidently signed a deal with Sony and it can’t be seen to be giving other platforms or storefronts a better deal as a result. However, we’d argue that the onus should be on PlayStation to offer better regional pricing flexibility on the PS Store – and, to be honest, in a period dominated by bad press, the company could do without the negative PR, couldn’t it?



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Salt and Sacrifice’s “obligation to price match” sees prices rocket in some countries

Players tempted by – but yet to purchase – Ska Studios’ Salt and Sacrifice may be in for a bit of a shock today, as the price for the Soulslike 2D action game has shot up in some territories on the PlayStation Store.

Forced to match the local prices on the Epic Games Stores across the world – regardless of each country’s own economy or the fact the game has already launched – Sony’s prices have absolutely rocketed for some, with places like Brazil seeing a price hike of 276 per cent (thanks, TechRaptor).

In the UK, players will actually see a saving – the price here has dropped from £16 to £13 – and in Canada, it’s jumped a little from $22CAD to $27CAD.


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In Brazil, though, the price has leapt from $38 to $105, and in India, it’s gone from ₹450 to ₹1331. It means that the game will cost around $20 for all across the world, regardless of local economies.

“Some prices on EGS were originally set much lower than Sony, and we’re obligated to match prices on all platforms”, developer Shane Lynch told the game’s community on its Discord server. “I can’t actually control individual country prices on Sony, so some of it had to go up or down. Sorry.”

Salt and Sacrifice, the follow-up to Ska Studios’ 2D Soulslike Salt and Sanctuary is out now on PC via the Epic Games Store and PS4 and PS5.

As Matt summarised for us at the time, Salt and Sacrifice reprises much that made the original so good, with side-scrolling exploratory platforming and measured combat. It promises to be more than a retread of past glories, however, offering players – this time in the role of a Marked Inquisitor – a range of new features to experiment with, including a refreshed choice of classes: Highblade, Paladin, Assassin, Cleric, Dualist, Fighter, Ranger, and Sage.

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Why more COVID-19 in Salt Lake County wastewater isn’t worrying officials

COVID-19 risk levels in the areas served by both the South Valley and Jordan Basin water reclamation facilities have moved up enough to make the state’s watch list, but a Salt Lake County Health Department official said that doesn’t mean another virus surge is coming.

“I don’t think we have a reason to think that transmission is going to explode like it did in January,” Kylie Sage, the county health department’s data and surveillance manager said, citing still low rates of emergency room visits for the virus and the availability of more vaccinations and treatments.

“People have more options for protection and so those three indicators together don’t necessarily spark immediate concern,” Sage said, even though the county, like the state, is now relying on a measure of the presence of COVID-19 in feces samples collected at sewage treatment plants to monitor outbreaks rather than case counts.

“Wastewater tells us what we might be able to expect, but it’s just one tool in the surveillance toolbox. And because of that, we shouldn’t necessarily react to every fluctuation in the data. We know that COVID is still spreading in our communities,” Sage said, so some ups and downs are likely.

COVID-19 cases are climbing in other parts of the country as so-called “stealth omicron” sweeps through the United States. According to theCenters for Disease Control and Prevention, the even more highly transmissible subvariant of omicron, which drove Utah’s case counts to record highs in January, now dominates this region.

But Salt Lake County’s wastewater surveillance levels are comparable to the same point last year, Sage said. Since then, children have become eligible for COVID-19 vaccinations and booster doses have become available, including a second booster dose for those 50 and older or who are immunocompromised.

Utah has just moved to a new “steady state” pandemic response announced earlier this yearby Gov. Spencer Cox. The governor said by March 31, the state would end most testing and treatment and begin dealing with COVID-19 more like the flu or other endemic disease that, while still deadly, isn’t a constant threat.

Under the new response, the Utah Department of Health has replaced daily reports on COVID-19 with a single update posted online Thursdays at coronavirus.utah.gov that includes data from the state’s twice-weekly analysis of wastewater samples gathered from 32 sites around the state.

While Thursday’s update showed increases in the virus at just six sites, a map on another state website, wastewatervirus.utah.gov, on Friday showed nine sites have higher levels of COVID-19 but still puts the South Valley facility in the unchanged category.

Sage said both South Valley and Jordan Basin don’t just have more COVID-19 being detected, but she said it’s enough that the state has now deemed them sites to watch. The state defines the level as “of potential concern, but not high enough to be considered elevated.”

Nathan LaCross, the state health department wastewater surveillance manager, said after the state’s weekly update came out Thursday, new data has moved sites in Moab and Park City to the highest risk level, elevated, and four sites — the two in Salt Lake County, one in Davis County and another in Hyrum — to the watch list.

He said even though the Moab and Park City systems have been determined to have elevated levels of COVID-19, no one there should be “incredibly alarmed, but they should be aware that there are strong indications we’re seeing more transmission in some areas and take appropriate measures,” such as social distancing.

There’s no such red flag in Salt Lake County yet, but Sage offered similar suggestions.

“My advice would be to stay diligent in the really simple ways that you can protect yourself — washing your hands, staying home if you’re sick, getting vaccinated if you’re not, or boosted if you’re eligible,” she said. “Really, just abiding by those hygiene practices we’ve all become so familiar with in the past two years.”

Most people don’t need to wear masks or social distance, Sage said, unless they are at high risk for severe illness from COVID-19 or regularly interact with someone who is. The COVID-19 vaccine still offers the best protection against hospitalization or death, said.

And COVID-19 isn’t the only virus on the upswing in Salt Lake County — so is the flu, Sage said.

“It’s still low but it is unusual that at this point in the year, flu activity is going up. Normally spring is the end of our flu season,” she said. Flu had all but disappeared during the first winter of the pandemic, but now many people are more relaxed about the hygiene habits they adopted against COVID-19.

“I think that’s the most likely cause” of the increase in the flu, she said, urging those who have not done so to get a flu shot. “More or less, everybody’s gone back to their quote-unquote normal lives and as we see more people and do more things, that just gives us more potential to spread different viruses.”

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Common Over-The-Counter Painkillers Can Be an Unexpected Source of Too Much Sodium

Dissolvable painkillers might bring rapid relief, but researchers are warning many of them also come with a hidden and hearty dose of salt.

For each half a gram of paracetamol, or acetaminophen, that comes in a dissolvable tablet, you may also swallow around 0.4 grams of sodium, one of the main components of salt.

 

Sodium is often added to drugs to help them disintegrate in water; this allows the body to absorb the medicine faster than by swallowing a pill. But if the maximum daily dose of dissolvable paracetamol is taken, a person can easily exceed the two grams of salt recommended in the diet per day.

Even for those without high blood pressure, a population-based study in the United Kingdom suggests all that extra sodium can take a toll on the body, especially the cardiovascular system.

The research sought to mimic a randomized controlled trial by comparing the health data of nearly 300,000 adults over the age of 60, some of whom had high blood pressure and some of whom didn’t, but all of whom were recently prescribed paracetamol by their physicians.

Compared to those patients who were prescribed painkillers without sodium, the authors found those who took daily paracetamol with sodium were slightly but significantly more at risk of heart attack, stroke, heart failure, and death a year later.

Without looking closer at individual patients, it’s not clear how high salt intake might be impacting these outcomes, but numerous studies have shown a connection between sodium levels and cardiovascular disease among those with high blood pressure.

 

What’s interesting about the findings of the current study, however, is that individuals with both high and normal blood pressure were at similar risk of heart issues when extra salt was added to their daily diets.

The actual risk only increased a percentage or so from those who take medication without sodium, but at a population level that’s still significant.

Further tests will be needed to determine if this added dose of sodium ultimately led to higher blood pressure, thus impacting the health of the heart. Previous studies looking at how sodium-steeped medicine impacts blood pressure have produced inconclusive results.

In the meantime, researchers are warning doctors and patients to be aware that some medication can exceed sodium intake recommendations.

“People should pay attention not only to salt intake in their food but also not overlook hidden salt intake from the medication in their cabinet,” says Chao Zeng from Xiangya Hospital, Central South University in China.

“Although the US Food and Drug Administration requires that all over-the-counter medications should label the sodium content, no warning has been issued about the potentially detrimental effect of sodium-containing paracetamol on the risks of hypertension, cardiovascular disease and death. Our results suggest re-visiting the safety profile of effervescent and soluble paracetamol.”

 

Thankfully, there are some forms of dissolvable paracetamol available that are made without sodium, or only small amounts of it. These are great alternatives for those looking for the rapid effects of effervescent medicine without the possible downsides of long-term use.

In light of the new findings, an editorial, published alongside the current study, urges providers to ensure common painkillers are not causing undue harm to unsuspecting consumers.

“There is an immediate need for protection of consumers against these risks,” write the authors of the editorial.

“The most plausible and effective strategy is likely to be the mandatory labeling of all medications containing significant quantities of sodium with a front-of-pack warning label. [..] Information programs that raise public and practitioner awareness of the hidden sodium in medications, and education about the need to avoid effervescent, dispersible, and soluble medicines in all but essential circumstances should also be considered.”

The study was published in the European Heart Journal (link not yet live at time of publication).

 

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Dissolvable paracetamol may be bad for your heart because of its hidden salt content

Dissolvable paracetamol tablets can be bad for your heart because of their ‘hidden’ salt content, a major study has warned.

Doctors are now urging millions who rely on soluble or effervescent versions of the painkiller to check their sodium content.

Sodium — one of the main components of salt — is commonly used in dissolvable medication, which kicks in faster than swallowed pills. 

But some formulations can contain one-and-a-half times an adult’s recommended sodium intake, if taken as the maximum daily dosage. This is the equivalent of nearly four McDonald’s Big Macs. 

A Chinese-led team of researchers analysed medical records of 300,000 Brits who were prescribed paracetamol (acetaminophen) on the NHS.

Results showed patients on the high sodium versions of the drug were up to 45 per cent more likely to suffer a heart attack, stroke or heart failure within a year.  They were also more likely to die in that period.

Lead author Professor Chao Zeng, from Central South University in Changsha said: ‘People should pay attention not only to salt intake in their food but also not overlook hidden salt intake from the medication in their cabinet.’

Professor Zeng also said health chiefs should consider adding health warnings to sodium-containing paracetamol to warn patients of the dangers. 

Patients and doctors have been urged to steer away from dissolvable paracetamol products that are high in sodium after a new study suggested using them could increase the risk of cardiovascular disease and death

HEART DISEASE RISK IN HIGH BLOOD PRESSURE PATIENTS: This chart shows the cumulative risk for patients with hypertension (high blood pressure) developing strokes, heart attacks or heart failure when taking dissolvable acetaminophen (called paracetamol in the UK) containing sodium vs a non-sodium version over a year

DEATH RISK IN HIGH BLOOD PRESSURE PATIENTS: This chart shows the cumulative risk of death for patients with high blood pressure when taking dissolvable paracetamol containing sodium vs a non-sodium alternative over a year

HEART DISEASE RISK IN PATIENTS WITHOUT HIGH BLOOD PRESSURE : A similar pattern for patients without high blood pressure was also observed in the study, with patients who took the sodium containing paracetamol also at a higher risk of strokes and heart attacks

DEATH RISK IN PATIENTS WITHOUT HIGH BLOOD PRESSURE: And this chart shows the cumulative risk of death for patients without high blood pressure when taking the sodium containing painkillers, demonstrating there was still a significant added risk to health

WHAT IS HIGH BLOOD PRESSURE? 

High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

More than one in four adults in the UK have high blood pressure, although many won’t realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher
  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • low blood pressure is considered to be 90/60mmHg or lower
  • A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:

  • heart disease
  • heart attacks
  • strokes
  • heart failure
  • peripheral arterial disease
  • aortic aneurysms
  • kidney disease
  • vascular dementia 

Source: NHS

Heart disease is one of Britain’s biggest killers, causing 160,000 deaths from  strokes heart attacks and heart failures every year — around one every three minutes.

In the US, heart disease alone kills 660,000 Americans a year, making up a quarter of all deaths.

As well as being overweight, consuming too much salt is one of the biggest causes of high blood pressure — which can lead to heart disease. 

The NHS recommends that adults consume only 2.4g of sodium per day, equivalent to 6g of salt, about one teaspoon.

Effervescent paracetamol, which works quicker in liquid form as it is absorbed more quickly by the digestive system than a standard tablet , can contain up 0.44g of sodium per pill.

If taken at the maximum recommended daily dose of two tablets four times a day, a person would consume 3.5g of sodium from the tablets alone.

However, other formulations of these painkillers exist that contain an extremely small amount of sodium or none at all.

Experts examined GP records of 150,000 patients with high blood pressure, known medically as hypertension.

Roughly 5,000 had been given sodium-containing paracetamol, while the rest had non-sodium containing paracetamol.

The academics, whose findings were published in the European Heart Journal, also analysed a similar-sized group of patients without hypertension. 

They also included approximately 5,000 patients who were given paracetamol that contained sodium.  

All of the participants were between the ages of 60 and 90 and had been prescribed the paracetamol between 2000 and 2017.

Patients with hypertension on the high sodium pills had a 5.6 per cent risk of a heart attack, stroke, or heart failure compared to 4.6 per cent in the non-sodium group.

Those taking higher sodium painkillers also had a higher risk of death, with 7.6 per cent dying in the year long monitoring period compared to 6.1 per cent in the other patient group. 

Patients who had five or more prescriptions of the high sodium medication during the study were 45 per cent more likely to have a stroke, heart attack or heart failure. Just one prescription boosted the risk by 26 per cent. 

Death risk by number of prescriptions dosage for the high sodium version increased by 177 per cent with one dosage and rocketed to 264 per cent for five or more.

The study also found the risk of cardiovascular disease among patients without high blood pressure when they took high sodium effervescent painkillers was 4.4 per cent, compared to 3.7 per cent in patients given an alternative.

How much paracetamol is safe to take?

The NHS recommends that that for the treatment of general aches and pains, as well as to reduce temperature that adults take a dose of 500mg of paracetamol, usually two tablets.

This does can be repeated up to four times a day, but people should wait four hours between each repetition.

Paracetamol medications for children can come in the form of both tablets or syrups.

Doses for children can vary from 2.5ml of syrup for babies between the age of three to six months, to 10ml for children between 10 to 12 years.  

For tablets it can vary between 250mg per dose, to an adult dose depending on the age of the child.   

Similar to adults, doses can be repeated up to four times a day but there should a four hour wait between doses.

And the risk of death among patients without hypertension one-year in to taking the pills was 7.3 per cent for those on the higher salt version compared to 5.9 per cent in lower sodium group. 

Similar patterns for number of prescriptions and corresponding increase of cardiovascular disease and death were also observed in this patient group. 

Professor Zeng said both medics and patients should consider moving away from prescribing or taking high sodium dissolvable paracetamol and opt for healthier alternatives.  

The study was observational, meaning while an association with the salt content was spotted, it could not be proven that sodium was to blame.

There were also other limitations, such as the salt content of the patients’ diet wasn’t recorded.

It means that some patients would have been at greater or lesser risk of developing cardiovascular disease and death than others.

Additionally, while GP prescription data for medication is considered reliable, there is an obvious caveat that some patients may not have followed their dosing correctly and this may have influenced the results.

But, it is not the first study to show popping paracetamol frequently can raise the risk of heart problems.  

Earlier this month University of Edinburgh scientists unveiled data showing just four days of taking paracetamol causes a clinically significant hike in blood pressure.

From this they calculated that regular paracetamol use — about 4g a day, or eight standard tablets — could increase the risk of heart disease or stroke by around 20 per cent. 

However, the researches have insisted taking the occasional paracetamol — known as acetaminophen in the US — to deal with a headache or fever is safe.

Responding to the latest study, Professor Tim Chico, an expert in of cardiovascular medicine, said while more research needed to be done in other patient groups to confirm the findings he would be considering the implications for his patients.   

‘This study makes me more cautious about prescribing sodium-containing paracetamol (or other sodium-containing medications) for long-term use,’ he said.

‘Unless there is a very good reason people can only swallow soluble forms of the medication, it is possible they might be safer using the non-sodium containing versions.’ 

Professor Sir Nilesh Samani, medical director at the British Heart Foundation said cutting down on salt consumption was a key way to reduce the risk of having a heart attack or stroke.

However, he added that taking the occasional sodium containing paracetamol should not worry people.

‘If you take paracetamol that contains sodium occasionally to manage an isolated headache or very short bouts of pain, these research findings should not cause unnecessary concern,’ he said. 

Dr Richard Francis, head of research at the Stroke Association added that patients who had been prescribed these forms of paracetamol should consider making changes to reduce salt consumption.

‘People who have been prescribed salty, soluble paracetamol should have its salt content made clearer to them, try to reduce the salt content in the food they eat, work with their doctor to manage their blood pressure and try to switch to a type of paracetamol without salt’ he said.

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Organic chemistry and salt deposits in Urvara impact crater

Rugged surface: Numerous large, striking craters are found on the surface of dwarf planet Ceres. Credit: MPS, based on data from the Dawn mission: NASA/JPL-Caltech/UCLA/MPS/DLR/IDA

The third-largest crater on the dwarf planet Ceres was geologically active at least once many millions of years after its formation. In a recent study published today in the journal Nature Communications, researchers from the Max Planck Institute for Solar System Research (MPS) in Göttingen, the University of Münster (WWU) and the National Institute of Science Education and Research (NISER) in Bhubaneswar, India present the most detailed study of Urvara crater to date. For the first time, they evaluated camera images from the last phase of NASA’s Dawn mission, which reveal geological structures only a few meters in size. The Dawn spacecraft entered orbit around the dwarf planet in 2015 and studied it up close for about three and a half years. Like Occator crater, Urvara crater may have been the scene of cryovolcanic activity, the researchers argue. The study supports the picture that a global saline ocean extended beneath Ceres’ crust, some of which may still be liquid today.

Numerous large craters cover the surface of dwarf planet Ceres, the largest body in the asteroid belt at about 960 kilometers in diameter. Probably the most striking of these craters is Occator located in the northern hemisphere. The bright spots in its interior, which were already clearly visible during Dawn’s approach phase, turned out to be saline remnants of a subsurface brine, which rose to the surface through cryovolcanic processes until recent geological times. In another large crater, called Ernutet, there is evidence of exposed organic compounds and thus very complex chemistry. In their latest publication, researchers led by the MPS now turn their attention to Urvara crater. Located in the southern hemisphere, it is Ceres’ third largest crater, with a diameter of 170 kilometers. The impact that formed it about 250 million years ago is thought to have revealed material from depths of up to 50 kilometers.

“The large impact structures on Ceres give us access to the deeper layers of the dwarf planet,” explains Andreas Nathues of the MPS, first author of the current study and Lead Investigator of Dawn’s camera team. “As it turns out, the current topography and mineralogical composition of some of Ceres’ large craters is the result of complex and long-lasting geological processes that have altered the dwarf planet’s surface,” he adds.

High-resolution imaging and spectroscopic data are needed to trace these processes as accurately as possible. The most precise observational data of Urvara crater were obtained during Dawn’s extended mission: after the primary mission, which was initially designed to last two years, expired, the remaining fuel was sufficient to fly more daring and highly elliptical orbits taking the spacecraft to within 35 kilometers of the surface. During this phase the two Dawn Framing Cameras, the mission’s scientific camera system, took images in which structures several meters in size can be identified. The camera system was developed and built under the leadership of the MPS and operated by the MPS during the mission.

Striking structure: Urvara crater measures approximately 170 kilometers in diameter. The multi-terraced crater walls enclose a variety of diverse geologic structures. The most prominent feature is the approximately 25-kilometer-long mountain range that extends not far from the crater’s center.   Credit: © MPS, based on data from the Dawn mission: NASA/JPL-Caltech/UCLA/MPS/DLR/IDA

The high-resolution images of Urvara crater reveal a geologically distinctly diverse landscape. Multiple terraced crater walls enclose the impact basin; the most prominent feature rising slightly away from the center of the crater is a mountain range about 25 kilometers long and 3 kilometers high. Its southern flank is the site of rugged cliffs, areas peppered with boulders—and occasional bright material reminiscent of the famous bright spots of Occator crater. Furthermore, the images show a deep central depression, areas with remarkably smooth surfaces, and some dotted with numerous smaller, rounded depressions.

“Our analysis reveals that different areas of the crater have very different ages,” says Nico Schmedemann of WWU’s Institute of Planetology. “The age difference is up to 100 million years. This suggests that processes were at work that lasted long after the crater was actually formed,” he adds. For studies of this type, researchers count the small craters that cover every surface of atmosphereless bodies. Because older surfaces have had more time to “accumulate” such impacts of smaller asteroids, they have more craters than younger ones. In addition, models of the strength of bombardment at different times play a role in determining the exact age.

According to these models, the most pristine areas in Urvara crater are about 250 million years old. This time marks the formation of the crater itself. Younger surfaces within the crater include extensive smooth, dark areas, as well as pits that were probably formed by gas escape in the subsurface.

Further clues to the crater’s turbulent past are provided by images taken using the camera system’s color filters. They allow to conclude which wavelength ranges of visible light certain surfaces reflect into space—and thus help infer their mineralogical composition. As it turns out, the bright material is salts. Data from Dawn’s VIR spectrometer, contributed to the mission by the Italian space agency ASI, also indicate that organic compounds have been deposited along with salts on a slope west of the central mountain range. Such a combination of salt deposits and organic compounds has not been observed before. The deposits of organic compounds also appear to be comparatively young.

White spots: A close look at the mountain range inside Urvara crater. Bright material that has been identified as salt deposits can be found on its southern flank. Credit: © MPS, based on data from the Dawn mission: NASA/JPL-Caltech/UCLA/MPS/DLR/IDA

“The origin and formation of organics on Ceres remain interesting open questions that have important implications for the overall geologic history of Ceres as well as potential links to astrobiology and habitability. The organics we believe to have found in Urvara basin in the Southern Hemisphere differ from the organic rich areas in Ernutet crater in the Northern Hemisphere and will help us to answer these questions”, says NISER-scientist Guneshwar Thangjam. “The team is working on these aspects using both FC and VIR spectral data”, he adds.

“Overall, the Urvara crater presents us with a decidedly complex picture that we do not yet fully understand and that leaves room for two interpretations,” Andreas Nathues summarizes the results. For example, the impact that formed Urvara crater could have transported salts from the interior of the dwarf planet to the surface. However, some evidence suggests that a salty brine was involved instead, rising up from the interior and initiating further processes. Whether the brine reached the surface or merely accumulated just below it is unclear.

Regardless of the exact interpretation, the current results reinforce the picture of the dwarf planet that the Dawn mission has drawn of Ceres in recent years: a geologically active body with saline layers extending beneath its crust at various depths. These may be related to an earlier subsurface ocean that also contained organic compounds. Despite Ceres’ vast distance from the Sun, thanks to the dissolved salts, this brine could still survive today in large liquid reservoirs at depths of about 40 kilometers.


Traces of Ceres’ icy crust found at occator crater


More information:
Andreas Nathues et al, Brine residues and organics in the Urvara basin on Ceres, Nature Communications (2022). DOI: 10.1038/s41467-022-28570-8
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Max Planck Society

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Dwarf planet Ceres: Organic chemistry and salt deposits in Urvara impact crater (2022, February 22)
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