Researchers from Boston University School of Medicine have identified a link between the G alpha i-2 sub-unit protein pathway in the brain and renal excretion of sodium. They found that changes in salt intake affected changes in G alpha i-2 sub-unit protein levels and were able to prove that the protein pathway plays an important role in calming the renal sympathetic nervous system and facilitating the elimination of salt through the kidneys. The discovery points to a promising new target for treating salt-sensitive hypertension.

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Researcher Finds Link Between Brain Signaling and Renal Function, Medical News Today, June 7, 2012

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The UN summit on non-communicable diseases taking place 17 days from now in New York may not be on every American’s radar, but it should be. The ambitious meeting aims to tackle the alarming rise of chronic diseases affecting the world’s population, particularly in developing nations – cancer, respiratory disease, cardiovascular disease, and diabetes. Everyone knows someone suffering from one of these diseases. Many argue that obesity should be included in this list, and it should be. Perhaps it deserves its own special high-level meeting. Chronic kidney disease should be listed, too, but if the world’s nations can manage to reduce the number of people developing high blood pressure and diabetes, they will prevent many cases of CKD.

This summit will be a start, but there is still a lot of work to be done. The proclamation outlining the details for preventing and controlling these diseases is still in draft form. And there have been no goals set for reducing the number of preventable deaths. Nations are at odds on the important issues of reducing tobacco and salt consumption. Norway’s proposal to set a salt reduction target of 5 grams per person per day worldwide by the year 2025 has been removed from the Outcome Document. This is disheartening. To get some perspective, the average American diet contains 12 to 14 grams of salt per day. Reducing salt to about a teaspoon a day would mean fewer strokes, fewer heart attacks, fewer deaths, fewer cases of hypertension, and by implication, fewer instances of chronic kidney disease. A recent study on salt published in the British Medical Journal showed that reducing salt intake by 3 grams per day in the U.S. “…would result in up to 120,000 fewer cases of coronary heart disease, up to 66,000 strokes and up to 99,000 heart attacks annually.” The NCD Alliance estimates that “…reducing global salt consumption by just 15% through mass-media campaigns and reformulation of processed foods and salt substitution could prevent an estimated 8.5 million deaths in just 10 years.”

The EU, Australia, Japan, the United States, and Canada currently oppose Norway’s salt target. The global group World Action on Salt and Health (WASH) recently issued a press release urging those nations to reconsider their position on salt reduction. News stories about the reasons behind the attempts to block reductions in salt, as well as sugar and fat have appeared in the Canadian press, but the media in the U.S. has yet to pick up on the story. It could be because Hurricane Irene and the unstable economy have dominated our recent news. However, one could argue that becoming a healthier nation in a healthier world would help our economy by saving money in the long run.

As this story evolves, we’ll keep you updated. Let’s hope the EU, Australia, Japan, the United States, and Canada reverse their position on salt. Stay tuned!

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Dear diary, it’s been too long! So much has happened since my last entry back in October and it’s a bit complicated to explain. Maintaining a healthy body can be a difficult balancing act. After a complete physical, including an artery scan and blood vessel flexibility test, my doctor found anomalies that pointed to elevated blood pressure – some thickening in the neck arteries and small blood vessels that tested “abnormal”. (Interestingly, I have since read a Science Daily article that explained that vegans and strict vegetarians are at risk for hardened arteries if they don’t get enough of the vitamins and nutrients that can prevent it, namely B12 and Omega 3′s.) My cholesterol levels weren’t an issue, but my vegetarian diet, which didn’t include eggs or milk, clearly needed improvement. I was very low in vitamins B12 and D. At that point, I was feeling pretty lousy from the lack of B12 – nervous, unfocused, plagued with painful and annoying sores on my tongue, constantly sick with colds and a wicked throat ailment that delayed one of my doctor visits. Before this, I was hardly ever sick. I was glad there was a reason and a solution for my ill health, and the vitamin D deficiency actually gave me hope. I had just read about a study linking low vitamin D to high blood pressure. I told my doctor cheerfully and he was full of genuine sympathy. “Maybe we’ll get lucky,” he said.

Because I’m fairly young and my blood pressure readings taken in the doctor’s office tend to hover in the pre-hypertension to stage 1 range, he was inclined to put me on medication to bring it down right away, but I didn’t want that. I convinced him to let me monitor myself morning and night and follow a regular exercise routine – a 2 mile walk a day at least 5 days a week. He knew the walking would be good for my heart, but he wasn’t sure it would help my blood pressure that much. Again, I had read about another study that showed that exercise can lower blood pressure in the short term as well as the long term. Plus exercise is a great stress reliever. Although I accept that my high blood pressure is at least partly hereditary, I know stress has something to do with it. After 2 weeks of walking, the doctor could see that my blood pressure numbers were dropping. He knew how determined I was, so he agreed to give me a few months to see what exercise, relaxation, and vitamin D could do.

So that’s what I’ve been up to – doctoring (and slowly paying off the doctor bill), taking my vitamins, exercising like crazy, working hard, and attempting to de-stress. There have been setbacks. The B12 didn’t kick in until I took a potent liquid version. And I lost a little too much body fat from walking, which left me exhausted and threw my hormones out of whack. I’m back in the swing now, eating sockeye salmon, drinking milk, eating eggs, and everything under the sun reputed to lower blood pressure – oranges, orange juice, blueberries, strawberries, walnuts, dark chocolate, green tea.

I have days when my blood pressure gets me down, when I don’t want to test myself. The beeping sound when the test begins makes me nervous and I hate it when the cuff squeezes my arm, sometimes so tight that it leaves a red mark. Even if I have 8 out of 10 good blood pressure readings, the perfectionist in me seizes on the higher ones (even when they aren’t that high at all).  I wonder what I did wrong.

Sometimes this whole health regimen overwhelms me. I’ve started practicing a relaxing breathing technique described by Dr. Andrew Weil. It seems to be helping, but I know I have more to do. In the last few months, I’ve read about so many activities that are said to lower blood pressure that I feel I need to make a list and create a schedule for myself to fit everything in – tai chi, yoga, meditation, singing, music therapy, tap dancing (I made this last one up myself; if I could dance in front of the TV watching Fred Astaire and Ginger Rogers, I’m convinced I’d tap the high blood pressure away.)

It’s nearly April 15. Last night I couldn’t help thinking about my taxes as the blood pressure cuff squeezed tighter and tighter. Needless to say, the reading was a little high. Maybe that “to do” list isn’t such a crazy idea after all.

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There are so many studies and stories about blood pressure in the news this week! Georgia Health Sciences University will be undertaking an interesting study to find out whether lower blood pressure reduces kidney disease progression in CKD patients age 55 and older. - Study Examines Whether Lower Blood Pressure Reduces Kidney Disease Progression

This is a very specific and intriguing example of blood pressure reduction due to singing. It may have to do with the calming effect of singing for this individual and perhaps it’s linked to the breathing required for singing. (The story that follows this one elaborates on the correlation between breathing and blood pressure.) - Singing Reduces Blood Pressure Prior to Total Knee Replacement Surgery

Here’s another study that points out the role music, singing, and joy can play in reducing stress and blood pressure. - Laughter, Music May Lower Blood Pressure Study Says

This study is encouraging because no matter how carefully you watch your sodium at home, sometimes you end up eating at a restaurant or party where you have less control over salt in your food. - Physical Activity Decreases Salt’s Effect on Blood Pressure

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DIARY OF A KIDNEY LOVER

It’s good to be back here writing again after these last three weeks on the DASH diet. They weren’t necessarily bad weeks, but I was definitely up and down – excited, elated, frustrated, blue. To recap from my blog of a few weeks ago, my blood pressure is sometimes on the high side, so I’m on a quest to protect my kidneys and lower my blood pressure naturally.  I’ve been watching my sodium for quite some time, but that alone doesn’t seem to do much for me.  The DASH diet (that stands for “Dietary Approaches to Stop Hypertension”) sounded like an intriguing solution. It’s based on a comprehensive scientific study and is proven to lower blood pressure within 14 days.  The DASH way of eating calls for a combination of whole foods – not vitamin supplements – that provide the right combination of potassium, magnesium, calcium and fiber to lower blood pressure.  For me, that meant 6 servings of grains a day (which I never got up to), 4 of veg, 4 of fruit, 2 of low-fat dairy, 1 of fats/oils and 1/4 of nuts, seeds and beans. The diet is basically a better, healthier version of my already vegetarian diet; and for those who eat meat, that’s definitely allowed. You don’t necessarily need to restrict sodium with this diet, but it works better if you do, so I kept the sodium to a minimum like I normally do.

Week 1 started out fine. I enjoyed shopping for organic kale and chard and things I hadn’t consumed in years like low fat milk and graham crackers. I quickly discovered that (1) the cereal I bought just didn’t agree with me – way too much fiber when combined with the other things I was eating – and (2) this diet calls for more food than I normally eat.  The latter was partly ok, since I’m often too busy to eat a midday snack and end up starving by dinner time.  I dialed down the quantities a bit; even then, there was no room for non-essential food. When I strayed a bit on the weekends (I usually eat out at least twice or have a sweet with coffee), I found I missed my fruits and vegetables. The variety of colors, shapes, textures, never mind the flavors – appealed to the artist in me. This was clearly my honeymoon period. I was so enamored with my asparagus, squash and carrot tacos that I took a picture of them for you.

Gorgeous Grilled Goodness

I was walking around my neighborhood every evening, feeling good about life. At the end of the first week, I took my blood pressure at the pharmacy (not as reliable as a trip to the doctor, of course) and my reading had gone down about 10 points from the week before.  The bottom number was still a little high, but not as high as the previous week. I felt great.

By week 2, I had the food nailed down. I snacked happily on Asian pear, peaches, carrots, but my workload increased and the days turned ridiculously hot. There wasn’t enough time to exercise and the few times I went out at the end of the day (in 100 plus temps) it got dark much faster than before. I didn’t think slacking off on the exercise would make that much of a difference, but it did. My next trip to the pharmacy about 2.5 weeks in, was completely disappointing. Granted, the circumstances weren’t ideal. I’m always nervous when I take my blood pressure. Two really nice seniors had set up a table right next to the machine (I have no idea what they were advocating) and I had to crawl into the seat to take my reading. I was having trouble figuring out where to put my arm in the machine while the helpful man by my side, straight out of American Gothic, was predicting a wonderfully low reading for me.  No such luck. I was about 20 points higher than the previous week.  My pulse was over 100. I was either unbelievably nervous or in serious trouble. I took another reading and got my usual high normal numbers. My pulse had slowed only slightly. I was really mad. It didn’t help having an elderly gentleman, however nice, telling me I “really need to take care of that.”

So I moped, I railed, I took a day away from work so I could think. I became nervous that my pulse was too high, that maybe I had a hyperactive thyroid, which runs in my family. In the middle of the night, I felt my pulse and it was always the same – a seemingly fast bump, bump, bump. I considered changing my Facebook status to “Michelle is a stressball.” I could see that I had approached this endeavor all wrong. I had not been disciplined enough about exercise. A friend I had not talked to in a long time said, “I think your body needs yoga.” So, I planned to do yoga the following night.  What the heck. I used to love yoga. (Then why did I stop?) The next day, I took more time for myself. I unearthed my camera and took photos in my mother’s garden. I found a cactus that made me very happy, and here it is.

Will a cactus help lower my blood pressure?

That night, yoga felt great, but I had trouble with the deep breathing. That was telling.  Stressballs don’t do much deep breathing.  It’s an important thing to relearn.

I continued to do things for myself.  I took the time to read a great article in the April Vogue (Yes, I am obviously way behind on my reading). It was about young Dutch model Kim Noorda’s struggle with food and weight.  On the borderline of an eating disorder, she had become adept at eating “a little less.” She spent so much time worrying about what she ate that she didn’t have time for anything else. The author, Sally Singer, encouraged her to enter a program to help her see that she could be more than a model who worried about every bite she ate.  She encouraged her to be “a little more.” I really liked that advice.  As much as I wanted balance in my life, I could see that I wasn’t getting there.  I was too focused on health and blood pressure and stress and it was stressing me out. In the past, balance meant the right amount of creativity vs. work.  But yoga has made me realize that I need time for breathing, too, and stillness and relaxation, meditation.  That has to be the way forward for me.

My doctor’s appointment is just about a week away. I’m going to keep on exercising, practicing yoga, eating good food, worrying less, spending time writing, drawing, taking photos. This time around, I’ll be sure to stop and smell the cactus and BREATHE.

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DIARY OF A KIDNEY LOVER

OK.  Time for a change.  After a very tasty Chinese dinner last week, I had one of the worst heart-burn episodes I have ever had (and I don’t even get heartburn).  I felt like I was going to die.  Thinking about it, I’m sure that yoga move my Mom told me to try didn’t help any.  There is a time and a place for yoga and this wasn’t it.

But here I am, alive and eager to turn over a new leaf, literally!  I am a vegetarian, so I wouldn’t say that I am really unhealthy, but I do need more balance in my diet, less stress, less sodium, less restaurant meals, more exercise – the usual healthy stuff.  And I should confess that I have had a few moderately high blood pressure readings at the doctor’s office.  I attributed these to “white-coat” hypertension – blood pressure that’s only high when you’re in the doctor’s office.  You can read more about that here. http://www.winnipegfreepress.com/life/ignoring-white-coat-pressure-dangerous-102324989.html.  Although I really like medicine and enjoy talking to doctors if we’re talking about kidneys, I don’t like talking to doctors if I’m the patient.  The possibility of pain, illness, the reminder of the high cost of my health insurance, not to mention the cost of the visit – no wonder my blood pressure is a little high! The whole doctoring experience makes me nervous.  But I shouldn’t dismiss my previous readings, given what I know about high blood pressure and kidney disease.  Kidney filtration is driven by our blood pressure and higher BP “slams” the kidneys, forcing them to work much harder. It can cause permanent scarring and damage.

I’ll be making my doctor’s appointment very soon (still need to work up to that, but it’s on the task list for Monday) and in the meantime, I’ll be making changes to my diet. The DASH diet (“Dietary Approaches to Stop Hypertension”) – a healthier way of eating that’s safe for nearly everyone – has caught my eye lately. I’ve seen news articles all over the web and even in the research project pages on the UKRO site.  Check out this USA Today article for more info http://www.usatoday.com/yourlife/food/diet-nutrition/2010-09-03-dash-heart_N.htm and this research project abstract if you’re feeling a bit more ambitious http://ukrocharity.org/research/john-mckay-fellowship-grant/yang-full-project-summary/. The first few paragraphs describing the connection between low blood pressure and an optimal diet of more potassium vs. sodium are particularly interesting to me.

I can’t wait to dig into the DASH book on my desk.  Once I’ve read the book (it’s quite short!), I’ll get out to the pharmacy for a few free blood pressure checks, and on to the farmer’s market for some leafy greens and other veggies, fruits, nuts.  Now that the weather’s fine, there’s nothing stopping me from adding daily walks to my kidney lover regimen. Then, it’s on to the doctor’s office.  I’ll let you know how it all goes.

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From Reuters
April 15, 2010
A new study shows that kidney stones are on the rise in children from South Carolina, most likely due to obesity, too much salt in the diet and not enough milk. It’s an alarming trend, but one that can hopefully be reversed with dietary measures, including drinking more water to stay hydrated.
Kidney Stones on the Rise in South Carolina Children

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From Medical News Today
November 2, 2009
In an 11 year study of 3000 women, researchers link diets high in sodium and soda to a decline in kidney function.
Study Shows Diets High In Sodium And Artificially Sweetened Soda Linked To Kidney Function Decline

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