American Heart Association Nutrition Committee Research Articles

Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association.

A 2009 American Heart Association scientific statement titled “Dietary Sugars Intake and Cardiovascular Health” (1) concluded that current intake of added sugars among Americans greatly exceeds discretionary calorie allowances based on the 2005 U.S. Dietary Guidelines (2). For this reason, the American Heart Association Nutrition Committee recommended population-wide reductions in added sugars intake. The present statement from the American Heart Association and the American Diabetes Association addresses the potential role of nonnutritive sweeteners (NNS) in helping Americans to adhere to this recommendation in the context of current usage and health perspectives. By definition, NNS, otherwise referred to as very low-calorie sweeteners, artificial sweeteners, noncaloric sweeteners, and intense sweeteners, have a higher intensity of sweetness per gram than caloric sweeteners such as sucrose, corn syrups, and fruit juice concentrates. As a caloric sweetener replacement, they are added in smaller quantities; hence, they provide no or few calories. In our current food supply, NNS are widely used in thousands of beverages and other food products such as diet soft drinks, yogurts, desserts, and gum. Food manufacturers often use a blend of NNS or use a blend of sugar and NNS to improve the flavor acceptability of NNS. In developing this scientific statement, the writing group reviewed issues pertaining to NNS in the context of data on consumer attitudes, consumption patterns, appetite, hunger and energy intake, body weight, and components of cardiometabolic syndrome. The objective was to review the literature to determine whether there were adequate data to provide guidance for the use of NNS. The focus of the statement is on the 6 NNS that are described in Table 1. Aspartame, acesulfame-K, neotame, saccharin, and sucralose are regulated as food additives by the U.S. Food and Drug Administration and therefore had to be approved as safe before being marketed. Regarding stevia, …

Nonnutritive Sweeteners: Current Use and Health Perspectives

A 2009 American Heart Association scientific statement titled “Dietary Sugars Intake and Cardiovascular Health”1 concluded that current intake of added sugars among Americans greatly exceeds discretionary calorie allowances based on the 2005 US Dietary Guidelines.2 For this reason, the American Heart Association Nutrition Committee recommended population-wide reductions in added sugars intake. The present statement from the American Heart Association and the American Diabetes Association addresses the potential role of nonnutritive sweeteners (NNS) in helping Americans to adhere to this recommendation in the context of current usage and health perspectives. By definition, NNS, otherwise referred to as very low-calorie sweeteners, artificial sweeteners, noncaloric sweeteners, and intense sweeteners, have a higher intensity of sweetness per gram than caloric sweeteners such as sucrose, corn syrups, and fruit juice concentrates. As a caloric sweetener replacement, they are added in smaller quantities; hence, they provide no or few calories. In our current food supply, NNS are widely used in thousands of beverages and other food products such as diet soft drinks, yogurts, desserts, and gum. Food manufacturers often use a blend of NNS or use a blend of sugar and NNS to improve the flavor acceptability of NNS. In developing this scientific statement, the writing group reviewed issues pertaining to NNS in the context of data on consumer attitudes, consumption patterns, appetite, hunger and energy intake, body weight, and components of cardiometabolic syndrome. The objective was to review the literature to determine whether there were adequate data to provide guidance for the use of NNS. The focus of the statement is on the 6 NNS that are described in Table 1. Aspartame, acesulfame-K, neotame, saccharin, and sucralose are regulated as food additives by the US Food and Drug Administration and therefore had to be approved as safe before being marketed. Regarding stevia, …

Consumption of Fructose and High Fructose Corn Syrup Increase Postprandial Triglycerides, LDL-Cholesterol, and Apolipoprotein-B in Young Men and Women

The American Heart Association Nutrition Committee recommends women and men consume no more than 100 and 150 kcal of added sugar per day, respectively, whereas the Dietary Guidelines for Americans, 2010, suggests a maximal added sugar intake of 25% or less of total energy. To address this discrepancy, we compared the effects of consuming glucose, fructose, or high-fructose corn syrup (HFCS) at 25% of energy requirements (E) on risk factors for cardiovascular disease. PARTICIPANTS, DESIGN AND SETTING, AND INTERVENTION: Forty-eight adults (aged 18-40 yr; body mass index 18-35 kg/m(2)) resided at the Clinical Research Center for 3.5 d of baseline testing while consuming energy-balanced diets containing 55% E complex carbohydrate. For 12 outpatient days, they consumed usual ad libitum diets along with three servings per day of glucose, fructose, or HFCS-sweetened beverages (n = 16/group), which provided 25% E requirements. Subjects then consumed energy-balanced diets containing 25% E sugar-sweetened beverages/30% E complex carbohydrate during 3.5 d of inpatient intervention testing. Twenty-four-hour triglyceride area under the curve, fasting plasma low-density lipoprotein (LDL), and apolipoprotein B (apoB) concentrations were measured. Twenty-four-hour triglyceride area under the curve was increased compared with baseline during consumption of fructose (+4.7 ± 1.2 mmol/liter × 24 h, P = 0.0032) and HFCS (+1.8 ± 1.4 mmol/liter × 24 h, P = 0.035) but not glucose (-1.9 ± 0.9 mmol/liter × 24 h, P = 0.14). Fasting LDL and apoB concentrations were increased during consumption of fructose (LDL: +0.29 ± 0.082 mmol/liter, P = 0.0023; apoB: +0.093 ± 0.022 g/liter, P = 0.0005) and HFCS (LDL: +0.42 ± 0.11 mmol/liter, P < 0.0001; apoB: +0.12 ± 0.031 g/liter, P < 0.0001) but not glucose (LDL: +0.012 ± 0.071 mmol/liter, P = 0.86; apoB: +0.0097 ± 0.019 g/liter, P = 0.90). Consumption of HFCS-sweetened beverages for 2 wk at 25% E increased risk factors for cardiovascular disease comparably with fructose and more than glucose in young adults.

Components of a cardioprotective diet: new insights.

The global burdens of cardiovascular diseases (CVD), type 2 diabetes mellitus (DM), and obesity are rising, producing enormous losses of life and disability-adjusted life-years in both developed and developing nations.1 Most of these burdens are preventable and are occurring at unnecessarily younger ages, largely owing to suboptimal lifestyle, which includes poor diet quality, excess caloric intake, physical inactivity, and smoking.2,–,5 Worldwide, striking differences in dietary habits and rates of chronic diseases exist. The identification and targeting of dietary factors with the greatest potential for reducing CVD, DM, and obesity are of major scientific and public health importance. The science of diet and chronic disease is relatively young, spanning perhaps only half a century.6 New advances offer substantial evidence from complementary research paradigms on cardiometabolic effects of specific dietary factors. Several recent evidence-based reviews conducted in conjunction with national and international policy-making efforts provide the context for the present report. The need to prioritize selected foods and overall dietary patterns rather than only individual nutrients, the relevance of carbohydrate and fat quality as well as quantity, the effects and policy implications of sodium consumption, the importance of energy balance, and the role of dietary supplements represent several key findings of interest. Evidence-based insights into successful individual and public health strategies for behavior change are also addressed. Overall, the present report is intended to provide a useful framework for health practitioners and policy makers to understand contemporary issues related to the effects of diet on CVD. Evidence for effects of dietary factors on cardiometabolic health was reviewed, often derived from recent comprehensive reviews performed for policy-making or similar activities, including those of the American Heart Association (AHA) 2020 Impact Goals Committee (D.M., L.J.A.),7 the AHA Nutrition Committee (D.M., L.J.A., L.V.H.),8,9 the …

Cardiovascular and Overall Mortality Risk in Relation to Alcohol Consumption in Patients With Cardiovascular Disease

Alcohol, in striking contrast to tobacco and illicit drugs, is linked to an extensively documented J-shaped dose-effect curve, with regular moderate consumption reducing cardiovascular and overall mortality,1 whereas excessive or binge drinking has the opposite effect.1,2 Data indicative of a lower risk of cardiovascular events among moderate drinkers in apparently healthy people are extensive and consistent, whereas the role of alcohol intake among patients with cardiovascular disease (CVD) is less clear.3 Among the factors that contribute to prevention in survivors of primary cardiovascular events, lifestyle and dietary habits play a major role. However, guidelines in this area are based either on studies of apparently healthy subjects or on a few studies of cardiovascular patients.4,5 In particular, recommendations about alcohol consumption in patients with previous CVD reflect experts’ consensus rather than circumstantial evidence.3,6 The US Food and Drug Administration warns that heart disease patients should stop drinking, and people who take aspirin regularly should not drink alcohol.7 However, in the American Heart Association/American College of Cardiology guidelines for secondary prevention,5 CVD patients are encouraged to maintain a lifestyle that includes drinking alcohol in moderation. The “Diet and Lifestyle Recommendations” scientific statement from the American Heart Association Nutrition Committee8 advises, “If you consume alcohol, do so in moderation (equivalent of no more than 1 drink in women or 2 drinks in men per day).” The latter statement is largely accepted within the scientific community, definitely when referring to healthy people, although some would advise people to abstain completely rather than encouraging them to drink small amounts regularly. It has in fact been suggested that the consumption of alcohol for certain health benefits should not be encouraged, because the harm would far outweigh the gain, especially among poor populations and in low-income countries, where the …

Nutritional Considerations in Kidney Disease: Core Curriculum 2010

Nutritional Considerations in Kidney Disease: Core Curriculum 2010

Scientific Opinion on the substantiation of health claims related to potassium and maintenance of normal muscular and neurological function (ID 320, 386) and maintenance of normal blood pressure (ID 321) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

Scientific Opinion on the substantiation of health claims related to potassium and maintenance of normal muscular and neurological function (ID 320, 386) and maintenance of normal blood pressure (ID 321) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

Effect of genistein therapy on plasma levels of asymmetric dimethylarginine in healthy postmenopausal women: a randomized, placebo-controlled study

The aim of this study was to investigate the effects of pure genistein therapy on asymmetric dimethylarginine in healthy postmenopausal women. Healthy postmenopausal women received pure genistein (n=21) or placebo (n=17) for 6 months, and no statistically significant effects on plasma asymmetric dimethylarginine levels were found with pure genistein treatment.

Lifestyle Management of Obesity: NHANES and Erectile Dysfunction— How to Motivate Change

Weight loss represents a significant goal for improving physical and psychological health. Management to obtain this goal must include gradual changes in both diet and physical activity, incorporating modifiable and reachable goals. Self-monitoring, goal setting, and stimulus control are the framework of any successful plan. Recently, lifestyle recommendations have been added to the Diet and Lifestyle Recommendations Revision put forth by the American Heart Association Nutrition Committee to lower risk of cardiovascular disease. The relationship of erectile dysfunction as a harbinger of occult vascular disease may serve as a motivator to prompt men to make changes in diet and lifestyle, as improvements in body mass index and physical activity are independently associated with improvements in sexual function, as documented by a recent randomized controlled trial.

Correction

HomeCirculationVol. 114, No. 23Correction Free AccessCorrectionPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessCorrectionPDF/EPUBCorrection Originally published5 Dec 2006https://doi.org/10.1161/CIRCULATIONAHA.106.180281Circulation. 2006;114:e629This article corrects the followingDiet and Lifestyle Recommendations Revision 2006In the article “Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee,” by Alice Lichtenstein et al, which published online before print on June 21, 2006, and appeared in the July 4, 2006, issue of Circulation (Circulation. 2006;114:82–96), the following relationships with industry should be added: Writing Group member William S. Harris reports ownership interest in OmegaMetrix, LLC, and has served as a consultant to and/or member of the advisory boards of Monsanto, Frito-Lay, Bayer Consumer Products, Cardiotabs, and TherRx Corporation.Table 6 (“Relationships With Industry—AHA Writing Group to Develop Diet and Lifestyle Recommendations”) has been updated in the current online version of the statement. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Glasser S, Lynch A, Devereux R, Hopkins P and Arnett D (2013) Hemodynamic and Echocardiographic Profiles in African American Compared With White Offspring of Hypertensive Parents: The HyperGEN Study, American Journal of Hypertension, 10.1093/ajh/hpt178, 27:1, (21-26), Online publication date: 1-Jan-2014. Related articlesDiet and Lifestyle Recommendations Revision 2006Alice H. Lichtenstein, et al. Circulation. 2006;114:82-96 December 5, 2006Vol 114, Issue 23 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.106.180281 Originally publishedDecember 5, 2006 PDF download Advertisement

Impact of Dietary Patterns and Interventions on Cardiovascular Health

Dietary recommendations are a key element in the management of cardiovascular disease. Evidence is mounting that certain dietary patterns can influence cardiovascular health by modifying risk factors such as obesity, dyslipidemia, and hypertension, as well as factors involved in systemic inflammation, insulin sensitivity, oxidative stress, endothelial function, thrombosis, and cardiac rhythm.1,2 In recent years, numerous dietary fads have emerged, in part as a response to the rising prevalence of obesity in the United States.3 In the present study, we review the various dietary portfolios that have emerged in the literature and the major studies that investigated their effectiveness in modifying cardiovascular risk. Currently, the typical American diet is estimated to derive 49% of its calories from carbohydrates, 34% from fat, and 12% to 16% from protein.4 Proposals to alter the proportions and/or types of macronutrients in this diet have been made for weight loss and cardiovascular health (Table 1).5–12 For weight management, for example, the strategy recommended by most medical groups entails the intake of a low-calorie, low-fat diet. The concept of fat restriction for weight management stems from traditional calorimetric measurements, which assign greater energy values to fat (&9 kcal/g) and less to carbohydrate and protein (&4 kcal/g). The low-calorie concept, on the other hand, is an intuitive technique to induce negative energy balance and has been adopted by some commercialized weight loss programs such as Weight Watchers International. View this table: TABLE 1. Various Dietary Patterns, Including Those Popularized Commercially and Those Investigated by Observational Studies and Clinical Trials One alternative proposed for weight loss is the low-carbohydrate diet. This was first described by William Banting13 in the 1860s and recently has received much attention in the form of the Atkins’, Stillman, Protein Power Lifeplan, and Zone diets. The Atkins’ diet begins with a weight-loss …

Soy Protein, Isoflavones, and Cardiovascular Health

This editorial summarizes the recent American Heart Association (AHA) Science Advisory on soy protein and isoflavones (phytoestrogens) published in the February 21, 2006, issue of Circulation .1 Soy protein and isoflavones have gained considerable attention for their potential role in improving risk factors for cardiovascular disease. This scientific advisory report assesses the more recent work published on soy protein and its component isoflavones. In 22 randomized trials, isolated soy protein with isoflavones compared with milk or other proteins decreased LDL cholesterol concentrations in most studies; the average effect was approximately 3%. This reduction is very small compared with the large amount of soy protein tested in these studies, averaging 50 g, approximately half the usual total daily protein intake. No significant effects were evident on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure. Among 19 studies of soy isoflavones, the average effect on LDL cholesterol and other lipid risk factors was nil. Soy protein or isoflavones have not been shown to lessen vasomotor symptoms of menopause, and results are mixed regarding slowing of postmenopausal bone loss. The efficacy and safety of soy isoflavones for preventing or treating cancer of the breast, endometrium, and prostate are not established; evidence from clinical trials is meager and cautionary as regards a possible adverse effect. For this reason, use of isoflavone supplements in food or pills is not recommended. Thus, earlier research indicating that soy protein compared with other proteins has clinically important favorable effects has not enjoyed confirmation. In contrast, many soy products should be beneficial to cardiovascular and overall health because of their high content of polyunsaturated fats, fiber, vitamins, and minerals and low content of saturated fat. In October 1999, the US Food and Drug Administration (FDA) approved labeling for foods containing soy protein as protective against coronary heart disease.2 …

Thematic review series: Patient-Oriented Research. Dietary fat, carbohydrate, and protein: effects on plasma lipoprotein patterns

In general, under isoweight conditions, different types of dietary protein or individual amino acids have little effect on lipoprotein patterns. Dietary carbohydrate tends to increase plasma triglyceride when it displaces fat, accompanied by a decrease in HDL cholesterol concentrations. Potential differential effects of types of carbohydrate are difficult to assess because of differences in rates of absorption and confounding of dietary fiber. Saturated fatty acids increase LDL and HDL cholesterol, whereas trans fatty acids increase LDL but not HDL cholesterol. Unsaturated fatty acids decrease LDL and HDL cholesterol, polyunsaturated more so than monounsaturated. There has been considerable interest in the potential benefit of major shifts in dietary macronutrients on weight loss and lipoprotein patterns. Short-term data favor substituting protein and fat for carbohydrate, whereas long-term data have failed to show a benefit for weight loss. During an active weight loss period low-carbohydrate diets more favorably affect triglyceride and HDL and less favorably affect LDL cholesterol concentrations. Additional efforts need to be focused on gaining a better understanding of the effect of dietary macronutrient profiles on established and emerging cardiovascular disease risk factors, mechanisms for changes observed and contributors to individual variability. Such data are needed to allow reassessment and, if necessary, modification of current recommendations.

High-Protein Weight Loss Diets and Purported Adverse Effects: Where is the Evidence?

Results of several recent studies show that high-protein, low-carbohydrate weight loss diets indeed have their benefits. However, agencies such as the American Heart Association (AHA) have some concerns about possible health risks. The purpose of this review is to evaluate the scientific validity of AHA Nutrition Committee's statement on dietary protein and weight reduction (St. Jeor ST et al. Circulation 2001;104:1869–1874), which states: "Individuals who follow these [high-protein] diets are risk for ... potential cardiac, renal, bone, and liver abnormalities overall. Simply stated, there is no scientific evidence whatsoever that high-protein intake has adverse effects on liver function. Relative to renal function, there are no data in the scientific literature demonstrating that healthy kidneys are damaged by the increased demands of protein consumed in quantities 2–3 times above the Recommended Dietary Allowance (RDA). In contrast with the earlier hypothesis that high-protein intake promotes osteoporosis, some epidemiological studies found a positive association between protein intake and bone mineral density. Further, recent studies studies suggest, at least in the short term, that RDA for protein (0.8 g/kg) does not support normal calcium homeostasis. Finally, a negative correlation has been shown between protein intake and systolic and diastolic blood pressures in several epidemiological surveys. In conclusion, there is little if any scientific evidence supporting above mentioned statement. Certainly, such public warnings should be based on a thorough analysis of the scientific literature, not unsubstantiated fears and misrepresentations. For individuals with normal renal function, the risks are minimal and must be balanced against the real and established risk of continued obesity.

A Statement of the American Heart Association Nutrition Committee on Dietary Protein and Weight Reduction: A Rigorous Rebuttal

Results of several recent studies show that high-protein, low-carbohydrate weight loss diets indeed have their benefits. However, there are always some concerns about high-protein diets. According to the American Heart Association (AHA) Nutrition Committee, highprotein diets may possess significant health risks. The purpose of this review is to evaluate the scientific validity of AHA Nutrition CommitteeA s statement on dietary protein and weight reduction (St. Jeor ST et al. Circulation 2001;104:1869-1874). Simply stated, there is little if any scientific evidence supporting above mentioned statement. Certainly, such public warnings should be based on a thorough analysis of the scientific literature, not unsubstantiated fears and misrepresentations. For individuals with normal renal function, the risks are minimal and must be balanced against the real and established risk of continued obesity.

A Statement of the American Heart Association Nutrition Committee on Dietary Protein and Weight Reduction: A Rigorous Rebuttal

Results of several recent studies show that high-protein, low-carbohydrate weight loss diets indeed have their benefits. However, there are always some concerns about high-protein diets. According to the American Heart Association (AHA) Nutrition Committee, highprotein diets may possess significant health risks. The purpose of this review is to evaluate the scientific validity of AHA Nutrition Committee´s statement on dietary protein and weight reduction (St. Jeor ST et al. Circulation 2001;104:1869–1874). Simply stated, there is little if any scientific evidence supporting above mentioned statement. Certainly, such public warnings should be based on a thorough analysis of the scientific literature, not unsubstantiated fears and misrepresentations. For individuals with normal renal function, the risks are minimal and must be balanced against the real and established risk of continued obesity.

AHA Science Advisory. Monounsaturated fatty acids and risk of cardiovascular disease. American Heart Association. Nutrition Committee.

This report summarizes our current understanding of how monounsaturated fatty acids (MUFAs) affect risk for cardiovascular disease (CVD). This is a topic that has attracted considerable scientific interest,1 2 3 in large part because of uncertainty regarding whether MUFA or carbohydrate should be substituted for saturated fatty acids (SFAs) and the desirable quantity of MUFA to include in the diet. MUFAs are distinguished from the other fatty acid classes on the basis of having only 1 double bond. In contrast, polyunsaturated fatty acids (PUFAs) have 2 or more double bonds, and SFAs have none. The position of the hydrogen atoms around the double bond determines the geometric configuration of the MUFA and hence whether it is a cis or trans isomer. In a cis MUFA, the hydrogen atoms are present on the same side of the double bond, whereas in the trans configuration, they are on opposite sides. The American Heart Association Nutrition Committee recently published a scientific statement regarding the relationship of trans MUFA to CVD risk,4 and the present statement, therefore, will be limited to a discussion of dietary cis MUFAs, of which oleic acid ( cis C18:1) comprises ≈92% of cis MUFAs. In the United States, average total MUFA intake is 13% to 14% of total energy intake, an amount that is comparable to (or slightly greater than) SFA intake. In contrast, PUFAs contribute less (ie, 7% of energy). The major emphasis of current dietary guidelines involves replacing SFAs with complex carbohydrates to achieve a total fat intake of ≤30% of calories. There is evidence suggesting that the substitution of MUFA instead of carbohydrate for SFA calories may favorably affect CVD risk.5 6 7 The American Heart Association dietary guidelines for healthy American adults recommend a diet that provides <10% of calories from SFA, up …

Very-Low-Fat Diets

To the Editor: I would like to respond to the recent Science Advisory from the American Heart Association Nutrition Committee on very low fat diets.1 The advisory ignored much of the published scientific data supporting the value of a very-low-fat diet (VLFD) for the prevention and control of coronary heart disease (CAD). No mention was made of the vast amount of epidemiological data supporting the value of a VLFD. Numerous publications from the recent China project document that a society of millions existing on a VLFD has 1/25th the incidence of heart disease we have in the United States. The statement cites 1 study by Ornish and 1 by myself from the Pritikin Center showing “impressive” results. The statement then goes on to criticize the VLFD studies for having a small number of subjects with limited follow-up. The writers ignored the previously published data on 4587 participants from the Pritikin program.2 They also ignored the follow-up data previously reported from the Pritikin program showing good long-term compliance and the avoidance of bypass surgery, as well as the control of diabetes and hypertension.3 4 They criticized the studies for not controlling for weight loss, which is a natural consequence of a VLFD. Because obesity is a major health problem in the United States, the American Heart Association should be supporting the VLFD, not criticizing it. The statement criticizes the VLFD for causing a rise in triglycerides. The writers fail to recognize that a low-fat diet does not cause triglycerides to rise if the fat is replaced by unrefined, complex carbohydrates, naturally high in fiber, as reviewed by Anderson et al.5 Ornish et al6 reported regression of CAD on a 10% fat-calorie diet in spite of a rise in triglycerides. The drop in HDL cholesterol on a …

Dietary electrolytes and blood pressure: a statement for healthcare professionals from the American Heart Association Nutrition Committee.

Blood pressure–associated risks ensue incrementally over a wide range of blood pressure levels, and even among nonhypertensive persons, blood pressure levels are predictive of morbidity and mortality from stroke, heart disease, and end-stage renal disease.1 2 3 On a population basis, it has been estimated that a reduction in diastolic blood pressure of 2 mm Hg would result in a 15% reduction in risk of stroke and transient ischemic attacks and a 6% reduction in risk of coronary heart disease.4 Between 1971 and 1991, national health examination surveys5 documented a downward trend in blood pressure levels and the prevalence of hypertension in the United States. Adoption of a healthier lifestyle may have contributed to this favorable trend. Not all subgroups have benefited equally, however, particularly African Americans. According to the Third National Health and Nutrition Examination Survey (NHANES III)6 (1988 to 1991), 24% of the US population was classified as having hypertension. Blood pressure level and hypertension prevalence increase with age: high-normal and high blood pressure continue to be major contributors to cardiovascular disease.7 The relationship between dietary electrolyte consumption and blood pressure is the focus of this brief review. Evidence for a positive association between sodium chloride (NaCl) intake and blood pressure is discussed. Increasing evidence also suggests that dietary patterns associated with low intakes of potassium, calcium, and possibly magnesium also contribute to higher levels of blood pressure. An understanding of these associations has important implications not only for the prevention and treatment of hypertension but also for developing population-based strategies to decrease cardiovascular disease risk by shifting the overall blood pressure distribution toward lower levels. A high NaCl intake convincingly contributes to elevated arterial pressure in a number of animal models of genetic and acquired hypertension. The chimpanzee is phylogenetically close to …

Unresolved issue: Do drinkers have less coronary heart disease?

The notion that a bit of imbibery is good for the heart is causing concern among physicians who fear that will give people a new rationalization for drinking. At the recent American Heart Association (AHA) meeting in Anaheim, Calif, William P. Castelli, MD, medical director of the Framingham Heart Study, reiterated material from his recent editorial inJAMA(242:2000, 1979): Can you tell people to take two drinks a day and stop? I can't see telling someone to start. That person could be prone to alcoholism, and you could end up destroying his family. Castelli echoed the concern of the AHA Nutrition Committee, which issued an advisory in October stating that it would be premature to recommend a change in anyone's drinking habits.... Furthermore, there is no doubt that the dangers of acute or chronic excessive alcohol intake far outweigh any theoretical beneficial effect on HDL [high-density lipoprotein] cholesterol.