Salt in Your Diet

February 11, 2017

Are you conscious about the amount of salt (aka sodium chloride) you eat? Are you certain the amount of salt you eat is appropriate for your body?

You may be surprised to find out you consume more salt than you think.

You may not use salt at all, and you still may be consuming too much of it if you eat a lot of prepared and processed foods. As a matter of fact, the sodium in most people’s diets in the United States comes from processed and prepared foods found in restaurants and grocery stores.

Now, the U. S. Food and Drug Administration (FDA) is trying to restrict the amount of sodium added to foods. A draft guidance for industry has been released by the FDA with the intent to have industries decrease the amount of sodium added to prepared and processed foods. The restriction concerns the amount of salt added to your foods before by the restaurants and manufacturers before you even get a chance to season them yourself.

The objective of the FDA is to have people decrease their daily salt intake to 2,300 milligrams (mg) a day, which is the equivalent to a teaspoon of salt. Right now, Americans consume about 50% more than what’s recommended for a daily allowance.

The Problem with Excess Sodium Consumption

The terms salt and sodium may be used as synonyms, but they are not identical substances. Salt is the crystal-like substance you sprinkle over your food and is 40% sodium and 60% chloride. Sodium is a mineral found in salt, but salt is the primary form that you consume sodium. Almost 95% of the sodium consumed–whether added by you or added by the manufacturer comes in salt form.

The body needs sodium to assist in doing its daily functions, and sodium can be found naturally in a lot of foods (including milk, beets and celery). Regardless of which form it’s in, sodium is also used to improve flavor, thicken foods and preserve foods.

The downside of sodium is the potential for it to cause high blood pressure, which is a precursor to heart disease and stroke. Therefore, a lot of deaths and sickness can be eliminated just by decreasing sodium intake.  

What Foods Are Typically High in Sodium?

Prepared and processed foods like soups, cheese, pizza, pasta dishes, snacks, sandwiches and salad dressings are rich in sodium.

You can’t assume a food has little sodium just because you can’t hardly taste any salt in it. That’s because most foods high in sodium won’t taste salty like pickles do. For example, pastries and sweet cereals are high in sodium but don’t taste salty. Also, some foods are low in sodium but may be consumed in quantities that make them a risky source of sodium (like a slice of bread).

Scientific evidence shows that taking an aspirin daily can help prevent a heart attack or stroke in some people, but not in everyone. It also can cause unwanted side effects.

According to Robert Temple, M.D., deputy director for clinical science at the Food and Drug Administration (FDA), one thing is certain: You should use daily aspirin therapy only after first talking to your health care professional, who can weigh the benefits and risks.

Who Can Benefit?

“Since the 1990s, clinical data have shown that in people who have experienced a heart attack, stroke or who have a disease of the blood vessels in the heart, a daily low dose of aspirin can help prevent a reoccurrence,” Temple says. (A dose ranges from the 80 milligrams (mg) in a low-dose tablet to the 325 mg in a regular strength tablet.) This use is known as “secondary prevention.”

However, after carefully examining scientific data from major studies, FDA has concluded that the data do not support the use of aspirin as a preventive medication by people who have not had a heart attack, stroke or cardiovascular problems, a use that is called “primary prevention.” In such people, the benefit has not been established but risks—such as dangerous bleeding into the brain or stomach—are still present.

Caution Needed With Other Blood Thinners

When you have a heart attack, it’s because one of the coronary arteries (which provide blood to the heart), has developed a clot that obstructs the flow of blood and oxygen to the heart. Aspirin works by interfering with your blood’s clotting action.

Care is needed when using aspirin with other blood thinners, such as warfarin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixiban (Eliquis).

What about people who have not had heart problems or a stroke but who, due to family history or showing other evidence of arterial disease are at increased risk? Is an aspirin a day a safe and effective strategy for them?

Again, Temple emphasizes, the clinical data do not show a benefit in such people.

He adds, however, that there are a number of ongoing, large-scale clinical studies continuing to investigate the use of aspirin in primary prevention of heart attack or stroke. FDA is monitoring these studies and will continue to examine the evidence as it emerges.

‘Real Cost’ of Tobacco

February 19, 2015

The Food and Drug Administration (FDA) has launched its first public health education campaign—”The Real Cost”—to prevent and reduce tobacco use among at-risk young people ages 12-17. Mitch Zeller, J.D., director of FDA’s Center for Tobacco Products (CTP), explains why the agency is undertaking this effort and how it will work.

Q: Why has FDA launched a youth tobacco prevention campaign? 

A: Tobacco use is the leading preventable cause of disease, disability, and death in the United States, responsible for more than 480,000 deaths each year. But the consequences of tobacco use are not limited to adults. Tobacco use is almost always initiated and established during adolescence. More than 3,200 young people under age 18 smoke their first cigarette every day in the United States—and another 700 become daily smokers. FDA sees a critical need for targeted efforts to keep young people from starting on this path. Reducing the number of teens who start smoking will diminish the harmful consequences that tobacco use has on the future health of our country. “The Real Cost” campaign ads will run nationwide beginning on February 11.

Q: Tell us more about the campaign and its target audience.

A: As FDA’s first campaign to prevent youth tobacco use, “The Real Cost” targets the 10 million young people ages 12-17 who are open to trying smoking or who have already smoked between one puff and 99 cigarettes in their lifetime. These youths share important characteristics that put them at risk for tobacco use. They are more likely to live chaotic, stressful lives due to factors such as socioeconomic conditions; be exposed to smoking by friends and family; and use tobacco as a coping mechanism or a way to exert control or independence. Additionally, many at-risk youths who experiment with cigarettes do not consider themselves smokers, do not believe they will become addicted, and are not particularly interested in the topic of tobacco use. We want to make these teens hyperconscious of the risk from every cigarette by highlighting consequences that young people are concerned about, such as loss of control due to addiction and health effects like tooth loss and skin damage.

Q: How is FDA going to implement the campaign?

A: We’ll use paid advertising to surround teens with the “The Real Cost” message. This includes advertising on TV, radio and the Internet, as well as in print publications, movie theaters and outdoor locations like bus shelters. We plan to reach more than 9 million youths with our messages as many as 60 times a year.

Q: How will FDA know if the campaign is working?

A: FDA is going to evaluate the campaign over time to see if it’s effective. We’re going to conduct a longitudinal study, meaning that we are going to try to follow the same 8,000 youths over a two-year period. We will assess key changes in their tobacco-related knowledge, attitudes, beliefs and behaviors over several years to measure the impact and effectiveness of the campaign. In-person, baseline data collection started in November 2013 in 75 media markets across the country. Ultimately, we want to see if exposure to the campaign is associated with a decrease in smoking among youth.

Q: Is this campaign funded by U.S. tax dollars?

A: No. User fees collected from the tobacco industry fund all FDA’s tobacco-related activities, including educating the public about the harms of tobacco use.

Q. Is this FDA’s only youth tobacco prevention campaign?

A: This initial FDA effort is the first of several distinct youth-focused campaigns being launched in the next two to three years. Other youth tobacco prevention campaigns will target additional audiences such as African American, Hispanic, Asian/Pacific Islander and American Indian/Alaskan Native youths, rural youths, and lesbian, gay, bisexual and transgender youths.

Q: How can I get involved?

A: FDA’s goal is to keep “The Real Cost” campaign authentic through a peer-to-peer approach. The campaign website and social channels are intended for teens. We recommend that adults use and share the materials on FDA’s resource page, including campaign information and customizable resources such as posters, postcards and campaign flyers. All materials are available for free download and many will soon be available for ordering through the campaign’s clearinghouse. Stakeholders who work with youth audiences can help extend the campaign by encouraging teens to share campaign messages with their peers, or by sharing our resources with other youth-focused organizations.

Reduce Sodium Intake!

March 1, 2013

Most Americans consume way too much sodium, with salt (sodium chloride) being the most common form. That can be a serious health hazard, because excess sodium consumption contributes to the development and escalation of high blood pressure, a leading cause of heart disease, kidney disease, and stroke.

Research shows that Americans consume on average about 3,300 milligrams (mg) of sodium every day. The 2010 Dietary Guidelines for Americans recommends a reduction of sodium intake to less than 2,300 mg daily.

And those age 51 and older, and people of any age who are African-American or have high blood pressure, diabetes or chronic kidney disease should further reduce sodium intake to 1,500 mg daily. This amount meets your essential need for sodium.  These populations comprise about half the U.S. population.

The Centers for Disease Control and Prevention (CDC) recently reported that children and adolescents consume about the same amount of sodium as adults and also risk developing high blood pressure. The researchers found that kids who consumed the most sodium faced double the risk of having high blood pressure, compared to those who took in less sodium. For overweight or obese children, the risk was more than triple.

“There has been a common misconception that sodium intake is just a concern for people with high blood pressure,” says Jessica Leighton, Ph.D., MPH, senior advisor for science in the Food and Drug Administration’s Office of Foods and Veterinary Medicine. “But it’s a health risk for all people, including children, as the CDC report shows.”

FDA is working on a number of fronts to help consumers manage their sodium intake.

Benzocaine Products

October 9, 2012

Benzocaine products—which are sold as gels, liquids, sprays and lozenges—are also widely used by adults.  Doctors and dentists often use sprays containing benzocaine to numb the mucous membranes of the mouth and throat during such procedures as transesophageal  echocardiograms, endoscopy, intubation, and feeding tube replacements.

Even though children are more at risk, it’s still a good idea to talk to your health care professional about using benzocaine, especially if you have heart disease; are a smoker; or have breathing problems such as asthma, bronchitis or emphysema. These conditions put you at greater risk for complications relating to methemoglobinemia, says Taylor.

FDA advises consumers to:

  • store any products containing benzocaine out of the reach of children.
  • use benzocaine gels and liquids sparingly and only when needed. Do not use them more than 4 times a day.
  • read the label to see if benzocaine is an active ingredient when buying OTC products. Labels on OTC products containing benzocaine are not currently required to carry warnings about the risk of methemoglobinemia.  If you have any concerns, talk to your health care professional before using them.

FDA is clarifying dosing recommendations and warnings for the antidepressant Celexa (citalopram hydrobromide). In August 2011, the agency issued a Drug Safety Communication stating that citalopram should no longer be used at doses greater than 40 milligrams (mg) per day because it could cause potentially dangerous abnormalities in the heart’s electrical activity. Use of citalopram is discouraged at any dose for people with certain medical conditions. However, because some patients may lack viable alternatives, the citalopram label (the package insert that comes with a prescription medicine) has been changed to describe precautions they should take when using it. The revised label also describes lower doses that should be taken by people over 60 years old.

Risk: Changes in the electrical activity of the heart—specifically, prolongation of the QT interval, a measure of the heart’s electrical activity— can lead to a risk of a potentially fatal abnormal heart rhythm called Torsades de Pointes. People at risk for developing QT prolongation include those with underlying heart conditions and those who tend to have low levels of potassium and magnesium in their blood.

Recommendations

  • Do not stop taking citalopram or change your dose without talking to your health care professional. Stopping citalopram suddenly can cause withdrawal effects.
  • If you are currently taking a citalopram dose greater than 40 mg per day, talk to your healthcare professional.
  • Seek immediate care if you experience an irregular heartbeat, shortness of breath, dizziness, or fainting while taking citalopram.
  • If you are taking citalopram, your health care professional may occasionally order an electrocardiogram (ECG, EKG) to monitor your heart rate and rhythm.
  • Your health care professional may also order tests to check levels of potassium and magnesium in your blood.
  • Read the Medication Guide for citalopram carefully and discuss any questions you have with your health care professional.
  • Health care professionals and patients are encouraged to report any side effects related to the use of these products to MedWatch.

Healthy Heart: Food Tips

December 22, 2010

Making healthy food choices is one of many lifestyle changes that can help reduce your risk for getting heart disease—the No. 1 killer in the United States. The Nutrition Facts found on most foods and health claims allowed on some foods can help you choose wisely.

To help ward off heart disease, choose foods with

  • less fat
  • less sodium (salt)
  • less cholesterol
  • fewer calories
  • more fiber

“Making better food choices for your health doesn’t mean you will need to exclude favorite foods,”

says Barbara Schneeman, Ph.D., director of the Food and Drug Administration’s (FDA’s) Office of Nutrition, Labeling and Dietary Supplements.

“You can use one of the most valuable tools people have—the food label—to make dietary trade-offs. For example, if you eat a food that is high in saturated fat, you can make other choices during the day that are low in saturated fat to keep your total daily intake in balance by using the part of the food label called Nutrition Facts.”

People concerned about their blood pressure who want to limit how much salt (sodium) they eat may be faced with five different types of tomato soup on the shelf, says Schneeman. You can compare the sodium content of each product by looking at Nutrition Facts to choose the one with the lowest sodium content.

Some food products carry health claims—statements that the product may help reduce the risk of developing a certain disease or condition. FDA authorizes some health claims based on “significant scientific agreement,” which means that the claim is supported by strong, scientific evidence based on studies in people and that the claim is unlikely to be reversed by new studies. Only foods that meet the criteria for a claim are allowed to carry the claim on their labels.

Here are claims related to heart disease that you may see on some foods:

  • While many factors affect heart disease, diets low in saturated fat and cholesterol may reduce the risk of this disease.
  • Diets low in sodium may reduce the risk of high blood pressure, a disease associated with many factors.
  • Soluble fiber from foods such as [name of food], as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.