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Who Gets High Blood Pressure from Salt?

Not everyone gets high blood pressure from taking in too much salt. The people who are most likely to get high blood pressure from taking in too much salt are those whose cells do not respond well to insulin (Hypertension, Jan 2013). People whose cells do not respond well to insulin are called "insulin resistant". On the other hand, those whose cells respond well to insulin are called "insulin sensitive". They can develop high blood pressure from not taking in enough salt.

SALT RESTRICTION ISN'T FOR EVERYONE. Thirty-five years ago, researchers first described people whose blood pressure and weight rise when they take in extra salt. They are called "salt sensitive". They gain weight because their kidneys cannot get rid of the extra salt. The extra weight is caused by retaining extra fluid. Eventually, taking too much salt can cause salt-sensitive people to suffer kidney damage as evidenced by leaking protein (albumin) into their urine. (Diabetes Res Clin Pract, April 1998;39 Suppl:S15-26). Those who do not develop high blood pressure when they take in large amounts of salt are called "salt insensitive".

DEFINITION OF INSULIN RESISTANCE: Most cases of high blood sugar in diabetics are caused by inability of cells to respond to insulin, not by lack of insulin. Before insulin can do its job of driving sugar from the bloodstream into cells, it must first attach to special hooks on the outer cell surface called insulin receptors. Anything that blocks insulin from attaching to its receptors on the surface of cells can cause high blood sugar levels and high blood pressure. People who respond normally to insulin usually do not get high blood pressure from taking in too much salt. Insulin receptors are blocked by eating red meat, eating animal saturated fat, lack of exercise, excess fat in fat cells, overweight, fat stored in the belly, not eating enough fruits and vegetables, and lack of vitamin D.

THIS STUDY: People who are salt sensitive and have high blood pressure are usually fatter, and have higher blood levels of creatinine, cholesterol, aldosterone, glucose and insulin (Hypertension, Jan 2013).
• Creatinine goes up when the kindeys are damaged.
• Aldosterone is secreted by the adrenal glands to cause the body to retain salt.
• Blood sugar goes up when insulin receptors are blocked.
• Insulin goes up when blood sugar levels rise.

SALT-SENSITIVE PEOPLE HAVE A HIGH RISE IN INSULIN WHEN THEY TAKE IN EXTRA SALT. Fasting blood sugar levels are usually normal and did not differ between salt sensitive and salt resistant people with high blood pressure regardless of how much salt they took in. However fasting blood levels of insulin increased in salt sensitive patients when they took in extra salt (Am J Hypertens, 1998 (Apr);11(4 Pt 1):397-402). . The extra salt causes high insulin levels which constrict arteries to raise blood pressure. People who have insulin resistance at low salt intake will have much more insulin resistance at a higher intake of salt. For them, a high salt intake increases blood pressure, insulin, and blood sugar.

HOW TO TELL IF YOU ARE INSULIN INSENSITIVE AND THEREFORE PROBABLY SHOULD RESTRICT SALT: People who are insulin insensitive usually have what is called metabolic syndrome. You have metabolic syndrome if you have any three of the following:
• storing fat primarily in your belly
• having small hips
• being overweight
• having blood triglycerides (>150)
• having blood HDL cholesterol (<40) • having a fatty liver • having a fasting blood sugar >100 (HbA1c> 5.7)
• having high insulin levels
• having high blood pressure

EVERYONE SHOULD CHECK HIS OR HER BLOOD PRESSURE: Get a blood pressure cuff. Take your blood pressure just before you go to bed. If your systolic blood pressure is above 120 much of the time, you have high blood pressure and should check with your doctor to see if you are salt sensitive and therefore, should restrict salt (and make other lifestyle changes).

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Fruits Lower, and Fruit Juices Raise, Cholesterol

A study from Denmark shows that apples lower blood levels of the bad LDL cholesterol by 6.7 percent, while apple juice raises the bad LDL cholesterol by 6.9 percent (Eur J Nutr., Feb, 2013). Neither apples nor their juices changed the good HDL cholesterol, triglycerides, weight, waist-to-hip ratio, blood pressure, inflammation (as measured by CRP blood test), composition of the gut bacteria, or markers of how the body processes sugar (insulin, IGF1 and IGFBP3).

The authors state that apples are rich in polyphenols and pectin, two cholesterol-lowering components. Clear juice has no pectin or other cell wall components. They conclude that fiber is necessary for the cholesterol-lowering effect of apples, and that clear apple juice (lacking fiber) should not be used in a cholesterol-lowering, diabetes-treating or weight-loss diet.

Many other studies show that eating fruit is associated with decreased risk for heart attacks, diabetes, overweight, and strokes, while fruit juices are associated with increased risk for these health problems.

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Helicobacter Helps to Prevent Diabetes!

Scientists at Virginia Tech have shown that infection with a bacteria called Helicobacter pylori helps to control obesity and diabetes (PLOS One, February 2013). Mice that have Helicobacter in their stomachs are far less likely to be obese or to develop diabetes. Fifty percent of the world's population have stomachs infected with Helicobacter pylori, the bacteria that causes stomach ulcers and stomach cancer.

HELICOBACTER MORE PREVALENT IN PRIMITIVE SOCIETIES: Up to 100 percent of people in primitive societies have Helicobacter growing in their stomachs. Infection is far more common in primitive societies that have polluted water and food and do not have sanitary control over their environments. Sterilizing food and water supplies and passing laws to limit food-causing infections helps to reduce the incidence of helicobacter.

HOW HELICOBACTER PREVENTS OBESITY AND DIABETES: H. pylori infection helps to control chronic inflammatory, allergic and autoimmune diseases. Mice that do not have Helicobacter pylori in their stomachs are far more likely to be obese and to develop diabetes. Mice infected with H. pylori respond to insulin far better than those who do not have that bacteria. More than 90 percent of human diabetics have too much insulin. Their disease is caused by their inability to respond to insulin. Presumably, H. pylori in the stomach damages the inner linings of the stomach and intestines and interferes with the absorption of food. Reducing the intake of calories helps to prevent diabetes.

This could explain why H. Pylori has infected human stomachs for more than 116,000 years. H. Pylori helps to prolong the lives of those infected by helping to prevent obesity and diabetes.

WHY YOU SHOULD NOT TAKE ANTIBIOTICS EVERY TIME YOU GET A SORE THROAT: You have more bacteria in your intestines than you have cells in your body. You have good bacteria that help your body function normally and bad bacteria that can make you sick and kill you. When you take any antibiotic, you always kill off beneficial bacteria as well as harmful ones. This allows many harmful bacteria to replace them to cause diseases such as obesity, allergies, inflammatory bowel disease, and asthma. H. pylori may be beneficial to people who have no intestinal or stomach symptoms.

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Exercise Prevents and Treats Prostate Cancer

Among a group of 164 white men having prostate biopsies to look for cancer, those who exercised regularly were less likely to have prostate cancer and less likely to have the high- grade type of prostate cancer that can kill (Cancer, published online Feb 11, 2013). Among 143 African Americans, exercise was not associated with decreased prostate cancer risk, or with risk of high-grade disease.

EXERCISE CAUSES BLOOD FACTORS THAT INHIBIT PROSTATE CANCER: Twelve years ago, researchers at UCLA showed that men who exercised and ate a low-fat, high-fiber diet had factors in their bloodstream that markedly reduced the growth of LNCaP prostate cancer cells in a test tube (The Journal of Urology. Sept, 2001;166(3):1185-1189). The blood of obese, non-exercising men promoted the growth of these cancer cells. After eleven days of exercising and eating a low fat, high-fiber diet, their blood inhibited the growth of these prostate cancer cells. The blood of long-term exercisers reduced growth of prostate cancer cells even more.

A REVIEW OF STUDIES ON EXERCISE AND PROSTATE CANCER: Between 1976 and 2002, 27 studies appeared in medical journals on the association between exercise and prostate cancer (Sports Medicine, 2004;34(6):363-369). Sixteen showed an association between exercise and decreased prostate cancer risk. The average risk reduction ranged from 10-30 percent. Exercise lowers certain hormones, prevents obesity, enhances immune function and reduces oxidative stress; all of these help to protect against cancer.

INTENSE EXERCISE REDUCES PROSTATE CANCER EVEN MORE: Researchers from the Health Professional Follow-Up Study followed 2,705 males with prostate cancer over a period of 18 years (Journal of Clinical Oncology, January 4, 2011). They found that regular exercise improves survival from prostate cancer. Those who walked at least 90 minutes per week briskly were 46 percent less likely to die from any cause compared to men who walked less than 90 minutes per week at a slow pace.

Those who exercised more intensely were far less likely to die from prostate cancer. They defined intense exercise as at least three hours of intensive exercise each week. Prostate cancer patients who exercised intensely had a 61 percent lower chance of dying from prostate cancer compared to those who only did one hour or less of easy exercise per week.

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This week's medical history:
Vera Caslavska: Marriage of Two Great Olympic Athletes

For a complete list of my medical history biographies go to Histories and Mysteries

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Recipe of the Week:

Oatmeal Bars

You'll find lots of recipes and helpful tips in The Good Food Book
- it's FREE

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February 17th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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