Are you eating enough?
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How salt can save you from heart failure
Heart failure occurs when the heart muscle does not have enough energy to deliver nutrients around the body.
At the same time, heart failure researchers have noticed alterations in how the body handles fluid.
People with heart failure become bloated because their cells swell with excess fluid.
For a long time, doctors believed that this water retention was a side effect of heart failure.
But there is reason to believe that this swelling is actually a cause of the problems in the heart itself.
And researchers have investigated the role of sodium on water retention and heart failure.
The main source of sodium in the diet is salt — which is 50% sodium
The researchers found that the common advice to strictly and extremely limit salt intake may in fact contribute to heart failure progression.
The human research was carried out at the Department of Internal Medicine at the University of Palermo in Italy. Findings were published in Cardiology.
Water retention, an outward sign of heart failure, is now suspected as playing a role in the development of the disease.
“A growing body of evidence suggests that fluid accumulation plays a key role in the pathophysiology of heart failure.”
Researchers believe that inflammation and hormones produced in the brain cause cells to soak up too much fluid.
This fluid causes swelling in the face and extremities — but it also interferes with the pumping power of the heart.
“Inflammatory and neural hormonal activation contribute strongly to the progression of the disease.”
There are a number of things which affect how well we retain or lose water.
Probably the most well-known is sodium.
This study examined the effect of different amounts of sodium on water retention and heart failure.
“We evaluated the long-term effects of two different sodium diets on inflammatory neuro-hormones, hydration and clinical outcomes in heart failure patients.”
The study recruited 105 men and 68 women who had been hospitalized for advanced heart failure.
When they were released from the hospital, the participants were randomly split into two different groups.
One group was put on a low-salt diet (1.8g/day) along with their standard medication.
The other group was put on a higher salt diet (2.8g/day) with the exact same medication.
The researchers followed all of the participants for a year.
BNP (brain natriuretic peptide) is a marker of heart failure and other cardiovascular problems.
High levels of BMP tell doctors just how advanced heart failure is in the patient.
BNP levels were lower in people who ate more sodium.
Other markers of heart failure progression were also decreased in people in the higher sodium group.
“BNP, aldosterone, plasma renin activity and inflammatory proteins were significantly reduced in the higher sodium group.”
Natural, anti-inflammatory proteins were increased and the people who consumed more sodium too.
All markers of hydration and heart failure progression were improved in people who consumed more sodium over the year-long experiment.
“That very low-sodium diet activated neurohormones and cytokines associated with heart failure and worsening body hydration. Moderate sodium restriction maintained weight and improved outcomes in the long-term.”
All of the indicators from this study show that extreme sodium or salt restriction lead to poorer outcomes for heart failure patients.
This may be because extreme salt restriction causes water retention — impeding heart function.
“Our results appear to suggest a surprising efficacy of a new strategy to improve the chronic diuretic response by increasing sodium intake and limiting fluid intake.”
This beneficial approach is exactly the opposite of what is recommended by many heart failure “experts.”
“This counterintuitive approach underlines the need for a better understanding of factors that regulate sodium and water handling in chronic congestive heart failure.”
It used to be very common for healthcare professionals to advocate for very low-salt diets.
But time and time again the research has shown that these low-salt diets can do more harm than good.
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