How healthy is your heart?

People were considered to have optimal heart health if they met the following criteria: They did not have high blood pressure, high cholesterol or diabetes; they were not overweight, underweight or obese; they did not smoke; they did at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week; and they ate five or more servings of fruits and vegetables a day.

Few Americans Have 'Healthy' Hearts
MyHealthNewsDaily

Patient's fatal heart attack turns doctor to Paleo diet

As I drove home I could not get one thing out of my mind.  This gentleman had been to my office to see me just the week before, and I was very encouraging to him about how things were going.  He was in his early 60’s, and suffered from high blood pressure, diabetes, high cholesterol, and obstructive sleep apnea.  The thing is, they were all VERY WELL CONTROLLED! His blood pressure was perfect, his diabetes numbers mirrored that of a non-diabetic patient, and his cholesterol was well below the goals set by multiple cardiovascular studies.  In addition, his cardiologist had convinced him that his meat based diet was the culprit of his seemingly uncontrollable heart disease, and he had adapted a strict vegan diet for well over a year.  In many parts of the country that’s not too hard to believe, but to a Cajun from the land of boudin and pork cracklins, this was quite the feat! So, I asked myself…how could this skinny, well controlled hypertensive, diabetic, vegan Cajun gentleman in his early 60’s have just died from his fourth heart attack?  Something was wrong!

PaleolithicMD

Conflicting results on salt intake and mortality

France, Vendée (85), île de noirmoutier, pure Salt. Pinpin 20:24, 19 September 2006 (UTC)By Dr. John

So, which is it, limit the salt or not? Several reports have appeared this week on the health effects of dietary salt. The one that seems to have caught the most attention was the study recently published in the American Journal of Hypertension. As reported by Scientific American on July 8, "a meta-analysis of seven studies involving a total of 6,250 subjects … found no strong evidence that cutting salt intake reduces the risk for heart attacks, strokes or death in people with normal or high blood pressure." This was viewed by many as absolving salt of any significant health impact. Indeed, the declarative title of the Scientific American article seemed to leave no doubt: It’s Time to End the War on Salt. However, medicine and science are rarely that easy.

On July 12, writing in the Forbes blog CARDIOBRIEF, Larry Husten reports on a study published in July 11 issue of the Archives of Internal Medicine which included twice as many subjects  - "12,267 adults participating in the 3rd National Health and Nutrition Examination Survey." This study found that the sodium-potassium ratio was the important factor and that “a high sodium intake, especially when combined with a low potassium intake, is associated with an increased risk of cardiovascular disease (CVD) and mortality.” Husten's post includes the AMA press release which concludes:

In summary, our findings indicate that higher sodium-potassium ratio is associated with significantly increased risk of CVD and all-cause mortality in the general US population,” write the authors. “Public health recommendations should emphasize simultaneous reduction in sodium intake and increase in potassium intake."

There is good news for modern Paleolithic nutrition which refrains from processed foods and includes plenty of fruits and vegetables:

The authors point out that salt is frequently added to processed foods, thereby increasing the sodium-potassium ratio, while fruits, vegetables and dairy products tend to have a lower ratio.

So, there you have it. Time for more studies or just eat your fruits and vegetables?!