Both found originally found small but significant blood pressure effects from sodium reduction.

The observational follow-up study began about 10 years after the first & 5 years of the 2nd study ended & lasted for about 4 years. Patients were sent questionnaires or reached by telephone to determine all cardiovascular events occurring after the end of the trials. Additional questionnaires were sent to responders every 2 years.

The primary outcome measure of cardiovascular disease included myocardial infarction, stroke, coronary artery bypass graft, percutaneous transluminal coronary angioplasty & death with a cardiovascular cause.

Among the 2,415 total participants with follow-up outcome information obtained (77%), the findings were:

• A 25% reduction in risk of cardiovascular disease among sodium reduction groups vs controls after adjustment for clinic site, demographics & randomization to weight-loss intervention (relative risk 0.75, 95% confidence interval 0.57 to 0.99, P=0.04).
• A 30% reduction in risk of cardiovascular disease with sodium reduction after additional adjustment for baseline weight & sodium excretion (RR 0.70, 95% CI 0.53 to 0.94, P=0.02).
• Attenuation of the effect of sodium reduction with further adjustment for weight change during the trials (RR 0.74, 95% CI 0.55 to 1.01, P=0.06).
• A similar but nonsignificant benefit of salt reduction excluding revascularization events (RR 0.72, 0.50 to 1.03, P=0.07).

"That's about what one might expect from a moderate dose of a statin," Dr. Cutler said.

Mortality showed an effect in the same direction, though the study wasn't powered to show a difference in mortality, particularly in this group of patients at relatively low risk of death, Dr. Cutler said.

In a full intent-to-treat analysis of 3,126 participants with mortality data, the sodium intervention groups had 20% lower mortality risk (35 vs 42 deaths, RR 0.80, 95% CI 0.51 to 1.26, P=0.34).

Cardiovascular disease-related mortality was likewise lower with sodium reduction (10 vs 15 deaths, RR 0.62, 95% CI 0.28 to 1.40, P=0.25).

Responses on the final questionnaire of the follow-up study also suggested that the original sodium-reduction interventions were effective long-term. Patients who reported a cardiovascular disease diagnosis were excluded from this analysis to reduce bias.

For the intervention group compared with controls, these results were:

• Significantly more reported liking low-sodium or unsalted foods (71% vs 64%, P=0.003).
• Significantly more reported usually or always using low sodium products (47% vs 29%, P<0.001).
• Significantly more reported reading food labels for sodium content (66% vs 44%, P<0.001).
• Significantly more reported keeping track of their daily sodium intake at least sometimes (28% vs 20%, P<0.001).

"Despite its relatively small size as a trial of clinical outcomes, it provides some of the strongest objective evidence to date that lowering sodium intake, even among those without hypertension, reduces the risk of future cardiovascular disease," the researchers concluded.

While the Trial of Hypertension Prevention interventions were fairly intense - individual & weekly group counseling sessions for the first 3 months & less frequently thereafter - to achieve a 25% to 35% reduction in dietary salt, even greater reductions are now being recommended.

The American Heart Association recommends a daily salt intake below 2,300 mg for most people & the American Public Health Association has called for a 50% reduction in sodium in processed & restaurant foods.

Many patients would require help from a dietitian to achieve these goals, but an even greater effect than seen in the trial could be expected, Dr. Cutler said.

source 

Can Salt Make You Fat?

I confess: I'm a saltaholic. I even salt my bread! Whether you're watching "American Idol" at home on your couch or the latest action flick at the multiplex, it's easy to snack on salty, crunchy nibbles straight through the credits.

In fact, the average person's salt intake has increased 55% in the past 20 years! Here's a little trick that may help you avoid gobbling an entire tub of popcorn in a blink: Go easy on the salt, or skip it altogether.

Just say no to that sodium urge. Why? Turns out that salting your popcorn may lead you to eat more of the fluffy stuff. Snackers in one study were given bowls of popcorn with either no salt, 1/2 teaspoon salt or one entire teaspoon of salt. And guess which ones consumed the most? That's right, the group that had the saltiest serving.

Plus, all that salty food can also make you thirsty, which researchers say could have you reaching for sugary sodas & juices.

It's no coincidence that consumption of carbonated drinks has also soared by 135% in the past 20 years, adding about 278 calories a day to our intake.

Translation: That's like hitting the vending machine for an extra candy bar daily! If you're trying to lose weight, or just keep the pounds off, opt for the unsalted versions of treats such as popcorn, nuts & crackers - & sip water instead of cola.

source: Yahoo Health

No More Bad Scale Days
By Carol Krucoff

Forget the notion of an "ideal weight." Don't follow a restrictive diet that considers some foods "good" & others "bad." Because all too often, these traditional approaches to battling the bulge fail.

"Americans spend more than $33 billion per year on weight control products & services," says the American Dietetic Association (ADA), "yet these efforts seem to have no effect on slowing the increasing prevalence of obesity."

1 in 3 adults & 1 in 4 children in the United States are obese & obesity-related medical conditions are the 2nd leading cause of death in America, after smoking-related illness.

That's why the nation's largest group of nutrition professionals is now advising people to stop focusing on weight loss alone.

Instead, they recommend working toward "weight management," which they define as "achieving the best weight possible in the context of overall health."

Hung Up On The Numbers

"Too many people get hung up on reaching a number on a height / weight chart that for them, genetically & physiologically, may be unattainable," says ADA spokeswoman Josephine Connolly, a nutritionist at the State University of New York at Stony Brook.

Inability to achieve these unrealistic goals can be physically & psychologically damaging, she says, since discouraged people often abandon healthy habits & consider themselves "failures."

That's why the ADA has "redefined success," Connolly says, "by encouraging people to focus on behaviors they can control rather than on weight loss, which they may not be able to directly control."

These behaviors, which ADA recommends for all weight management programs, include:

• Gradual change to a more healthful eating style with (proportional) increased intake of whole grains, fruits & veggies
• A nonrestrictive approach to eating based on eating when hungry & stopping when full.
• Gradual increase to at least 30 minutes of enjoyable physical activity each day.

In addition, Connolly says, "we're encouraging the notion of a healthy weight, which someone can achieve & maintain, as opposed to a cosmetic weight or ideal weight on a standardized chart."

Each person's healthy weight is determined individually, she says, based on his or her weight history & current medical condition including blood pressure, cholesterol profile & glucose tolerance.

Even modest weight losses, such as dropping 10 to 16 pounds, can dramatically improve these health parameters, Connolly notes:

Take it slow!

Rather than "racing to a goal weight for one day, then gaining the weight back," Connolly says, "it's better to lose a modest amount, then maintain it for 3 to 6 months before you try to lose any more. It's a great confidence builder. Plus, some research indicates this can help your body adjust its metabolic rate."

ADA also stresses the importance of daily physical activity - at least 30 minutes of moderate physical activity per day.

"Exercise is the single most powerful tool for weight control," says ADA spokeswoman Kathleen Zelman, a registered dietitian in Atlanta.

"We're encouraging people to pick an activity they enjoy, like gardening or walking, because we know that if people consider exercise a chore, it's not going to happen."

Pleasure Principle

This "pleasure principle" also applies to food choices.

"All foods can fit," she says. "What you love, you can have in moderation. But we also want to teach people to love healthy foods like broccoli, with lemon instead of butter & plenty of fresh fruits, vegetables & whole grains."

The basic message is "an attitude change," sums up ADA spokeswoman Leslie Bonci, a nutritionist at the University of Pittsburgh Medical Center.

"We're taking a more positive & realistic approach that encourages people to adopt healthy eating & exercises practices they can sustain & enjoy for their lifetime," says Bonci.

"And we're recognizing that how you feel & how much energy you have can be just as important a measure of success as a number on a scale."

from: foodfit.com!