Replacing table salt with substitute reduces rates of stroke, heart attack, death, study finds
Here were go again: The old certainty that salt (NaCl) is bad for you. All the evidence that we simply excrete any excess is simply ignored.
The study below was mainly of elderly existing stroke victims and even there the effects were only of borderline significance. There are no lessons in it for people in general
The study, which was led by researchers from Sydney's George Institute for Global Health, has been published in the New England Journal of Medicine.
"I think this study has something for everyone, and I mean literally everyone, in the world," George Institute executive director and study co-author Bruce Neal told ABC RN's Health Report.
"Almost everyone in the world eats salt, and almost everyone in the world eats more salt than they should.
"If salt was switched for salt substitute worldwide, there would be several million premature deaths prevented every year."
So what's the problem with salt?
The recommended amount of salt for adults is about one teaspoon a day — equivalent to 2,000 milligrams of sodium.
High salt intake is linked to raised blood pressure, kidney damage, strokes and heart attacks.
It may even raise the risk of Alzheimer's disease and autoimmune diseases such as multiple sclerosis and rheumatoid arthritis, by increasing tissue damage through oxidative stress and inflammation.
The director of the Baker Heart and Diabetes Institute, Tom Marwick, says there is "no doubt" that consuming too much salt is associated with cardiovascular disease.
"We know that salt is a major driver of disease," he said.
"Getting community salt intake down has been an ongoing issue for decades."
Shouldering part of our salt intake is something Professor Neal terms "discretionary salt" — salt added for seasoning when you're cooking and eating, or when you're preserving foods.
The salt substitute he and colleagues developed comprised 75 per cent sodium chloride — so 75 per cent regular salt — and 25 per cent potassium chloride.
"It's the sodium that's the bad bit in salt," Professor Neal said.
"So the particular combination, the 25/75 mix, we chose in large part because we knew it gave a blood pressure lowering effect, but we also knew it tasted very similar to regular salt."
What happened when salt was switched
Between April 2014 and January 2015, 21,000 adults from 600 rural villages in five provinces across China were recruited for the study.
Participants all had a history of stroke, or poorly controlled blood pressure.
"We went to rural China, because it's relatively easy to replace the salt in a rural Chinese diet," Professor Neal said.
"We gave half of the people a salt substitute [and] the others continued to use 100 per cent sodium chloride, so just regular salt."
Study recruits were followed for five years. Strokes, heart attacks and deaths in each of the two groups were recorded and compared.
"We wanted to try and answer the question once and for all: if we reduce the amount of [table] salt that people ate, could we reduce clinical events?" Professor Neal said.
For those using the salt substitute, researchers found their stroke risk was reduced by 14 per cent; total cardiovascular events — that's strokes and heart attacks combined — reduced by 13 per cent; and premature death by 12 per cent.
The salt substitute group also ended up with lower blood pressure than the table salt group, Professor Neal added.
"It's not that far off what you get with a drug, and the effects [on reducing cardiovascular events and death] are perhaps not that far off what you get with the drug as well."
Professor Marwick said while the research was "a very significant achievement", it was conducted among a high-risk group.
"Stroke is a particular problem in China, but nonetheless, [the researchers] have shown a benefit," he said.
"The relative risk reduction of stroke was 14 per cent, and the absolute reduction was five per thousand – it's not nothing, but it's not huge.
"But what they have shown is that a relatively small reduction of salt intake does have an impact."
Are salt substitutes safe?
Salt substitutes may not be suitable for everyone due to the use of potassium.
Professor Neal said that high levels of potassium in your blood, known as hyperkalemia, could make you prone to cardiac arrhythmias and sudden death, particularly in people with chronic kidney disease.
As a result, people with serious kidney diseases were excluded from the trial, as were people using medicines that already raised their potassium.
"We saw no evidence of any increased risk of events caused by hyperkalemia. And we saw no evidence of any increased risk of sudden death either," Professor Neal said.
And while salt substitutes are a "pretty cheap" change to make, they are still more expensive than salt — about $2.20 per kilogram in China, compared to $1.48 per kilogram.
Professor Neal said he was concerned this price difference might put people off using salt substitutes.
"I think we're going to need to consider subsidising the cost of salt substitutes to the cost of regular salt in lower income settings if we're going to get the benefits," he said.
Professor Marwick said salt substitution was "a significant step, but not the only solution to a community-wide problem with salt".
"We can look at changing food intake, rather than substitution alone," he said.
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Withdrawal of planned guidance on chronic fatigue syndrome upsets patients
I once contracted this but thanks to my good immune system, I recovered after a month
It was years in the making, involving thousands of scientists, medics, patients and campaigners all with a vested interest in the first landmark guidance on ME of its kind for 14 years.
After much wrangling, the contentious document about myalgic encephalomyelitis (also known as chronic fatigue syndrome) had finally been seen by all stakeholders – but it was not to be.
Earlier this month, hours before publication, the National Institute for Health and Care Excellence (Nice) withdrew the planned guidance and pressed pause on changes that could have affected up to a quarter of a million sufferers and those who treat them, saying: “It has become apparent that a number of professional groups are unwilling to support the guidelines.”
The move has not only left patients distraught but has worsened the already sharp discord within the scientific community over approaches to the poorly understood condition.
On the surface, the delay appeared to pit vulnerable patients – who for decades have suffered prejudice, disbelief and stigma surrounding their illness – against what critics consider to be bad doctors and faulty science.
But a closer look at the controversy points to distinct differences of opinion about the nature of evidence underpinning contested behavioural approaches to ME, and how it has been assimilated and interpreted.
ME is thought to affect up to 250,000 people in the UK. Characterised by debilitating pain and fatigue, it hits one in four sufferers so severely that they are housebound. A constellation of other symptoms, from gastrointestinal issues to nervous-system disorders and sleep problems, can accompany the fatigue.
But what causes the disease remains unclear and consequently no specific treatment exists, although graded exercise therapy (Get) and cognitive behavioural therapy (CBT) have been used in an attempt to manage symptoms.
Nice last issued recommendations on ME in 2007. The new final guidance, seen by the Guardian and broadly in line with a draft published last November, would have abandoned the recommendation to use Get, which involves incremental increases in physical activity to gradually build up tolerance. It also advised that CBT, a talking therapy commonly used to treat anxiety and depression, is not curative for ME.
Charities and patient groups fighting for greater recognition of ME as a medical illness rather than a psychological problem had welcomed these changes. But a number of professional medical groups did not.
At the heart of the dispute is the Pace trial, which evaluated the effectiveness of interventions for ME, including Get and CBT. The results, published in 2011, suggested that both approaches were moderately beneficial for some ME patients, based on patient reports.
Critics, however, say the trial, the biggest of a range of similar studies, was riddled with shortcomings. Trial design concerns included the symptom criteria used to recruit patients in the trial, which critics say was too broad and could have led to people with milder disorders being included.
Another cited drawback is the lack of objective measures to measure outcomes – an activity tracker should have been used to cement subjective measures such as patient reports, said Jonathan Edwards, emeritus professor of connective tissue medicine at University College London and an expert witness for Nice.
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If We Soak the Rich, Will Everyone Get Wet?
President Joe Biden describes his $3.5 trillion spending scheme as a way to improve the economy and "build back better."
The intention is a good one, but at its core, this plan isn't so much about growing people's wealth as it is redistributing it. The goal is to make the economy not more prosperous but more equitable -- fairer.
The multi-trillion dollar spending plan offers lower-income and even middle-income people truckloads of free things: health care, dental care, food, pre-K, child care, rental assistance, student loan forgiveness and free community college. And we know that Americans love freebies.
But nothing the government doles out, including the proverbial "free lunch," is ever really "free." So to pay for the giveaways, the rich will pay more taxes under the Biden plan -- a lot more. Tax rates would rise to 50% or more, and death taxes would increase by a record amount. As one liberal commentator recently put it, "It's time to divide the spoils of the American economy."
But our tax code already is highly progressive, and far more than most people have been told.
If you believe the media, you would think there are country clubs full of millionaires and billionaires who pay little or no taxes. Some invest a lot of money in tax accountants and tax avoidance, but that isn't because tax rates are not high enough. If someone has a zero tax liability, raising the tax rate to 50% still means paying 50% of zero, which is zero. Tax avoidance happens because Congress has affixed so many special interest loopholes onto the tax code, like barnacles on the hull of a ship.
But as a group, the top 1% carry a surprisingly hefty portion of the income tax burden on their backs, much more so than in the past. For example, in the 1970s and 1980s, the top 1% in income paid a little less than 20% of all federal income taxes. Amazingly, back then, tax rates were a lot higher than now.
Today, according to IRS data collected by the Urban-Brookings Tax Policy Center, the top 1% pay roughly 40% of income taxes. The Tax Foundation has found that this is close to a record share of taxes paid by the rich, and far higher than in most other nations. Even in the more socialist European nations, the rich don't pay that large a share.
Here's another way to think about it. The wealthiest 1% now pay more in federal income taxes than the bottom 90%. But as rich as Warren Buffett, Oprah Winfrey, Jay-Z and Bill Gates are, they don't make anywhere near the combined income of the tens of millions of people with incomes below $100,000 a year.
The Biden plan seeks to force the top 1% to pay almost half of all income taxes. But, even if that were possible, is that a good thing for a democracy? Is it good that one out of 100 people bear the burden of half of all the taxes? These are highly successful people for sure, and most are small-business owners and investors. Still, since when in America do we have an explicit policy of punishing success?
The other troubling trend in federal tax policy is that since the coronavirus hit, the share of people who pay no taxes at all has skyrocketed. The Tax Policy Center shows that six of 10 households paid no federal income taxes during pandemic-stricken 2020. That's right. Zero.
Suppose the Biden plan, which dramatically expands tax credits for children and offers other loopholes, is passed. In that case, this percentage could rise to two-thirds of households avoiding income taxes altogether.
It is a dangerous trend. Do we really want nearly 200 million people receiving free government services but not paying any income tax to support the government? If the government becomes essentially free for most people, then these citizens will tend to vote continuously for more free goods and services. It is an outcome for which our forefathers issued warnings. They worried that if voters come to believe they can vote for spending policies that line their own pockets and make other people pay, our democracy will perish.
The temptation to plunder the wealth of the rich legally is called "the tyranny of the majority." It is why every worker and voter should have skin in the game in how our government spends money. One way to ensure this is to have a tax system that requires everyone to contribute, even if it is only a few hundred dollars of taxes a year.
A simple flat tax rate of 19% without all the loopholes would force almost everyone to pay some tax each year. Moreover, it would preclude the millionaire and billionaire crowd from sheltering the bulk of their income in loopholes and exotic deductions.
The Democrats love to talk about how "we are all in this together," and they are right. This is why we must not tolerate an income tax system with more than half of the public paying nothing. If only the rich pay the taxes, then a common lesson of history is that there are fewer and fewer rich people to soak over time.
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The Prince of Prussia's Nazi problem
Perched on a mountain top overlooking the Swabian Alps, Hohenzollern Castle, with its picturesque towers, seems like something out of a fairytale. It is a relic from a bygone era. When the proud owner is at home, his flag waves defiantly in the wind, but it bears the colours of a kingdom that no longer exists: the black-and-white of Prussia.
Georg Friedrich, Prince of Prussia, is the current head of the House of Hohenzollern. It is strange to look at the smiling businessman in the tailored suits and think of him as a Kaiser. But the 45-year-old father of four would be exactly that had the German monarchy not fallen.
His dynasty can trace its roots back to the 11th century. They became the first, last and only royal family to rule over a unified German nation state, but were forced to relinquish their power after the last German Kaiser, Wilhelm II, was held responsible for the calamity of the first world war. Germans have since found it difficult to find a place for the Hohenzollerns in the national narrative.
While Georg Friedrich has always maintained that he has no ambition to carve out a political role for himself, he has been keen to restore his family’s estate, much of which was confiscated in the wake of the second world war. According to the prince, this affects around 10,000 pieces of art as well as usage rights for palaces. In total, the disputed property amounts to hundreds of millions of euros.
Since reunification in 1990, the German state has generally been sympathetic towards those whose property was nationalised or seized after the second world war. While this happened in West Germany too, in the East land redistribution became an official policy. The former ‘elites’ were seen as fair game as they were unanimously regarded as Nazi sympathisers. Property above 100 hectares was confiscated and redistributed, which affected the Hohenzollerns particularly badly as their power base lay in the north east of Germany.
After the fall of the Berlin Wall, Georg Friedrich’s grandfather, Louis Ferdinand, began proceedings to claim the Hohenzollern estate back — but he quickly ran into problems. The first was public outrage. Many German commentators saw the prince’s efforts as sheer greed, especially as many of the objects were on public display and most of the palaces used as museums.
A separate (if related) issue is a legal hurdle designed to prevent families from claiming compensation for property that was confiscated because their ancestors had been been ‘substantially involved in furthering the Nazi system’. The key figure here is Georg Friedrich’s great grandfather, son of the Kaiser: Crown Prince Wilhelm. He publicly declared his support for the Nazis and Adolf Hitler in the early 1930s. But whether this amounted to ‘substantial’ support — whether this had a direct effect on the takeover — remains the question to be decided.
Crown Prince Wilhelm was a complex character. He could be charming and funny, loved parties and was a successful competitive showjumper. A particular passion of his was football long before it became a popular spectator sport. He sponsored his own cup in 1908, the first of its kind and still ongoing as the Länderpokal today. But he took his role as heir to the throne seriously. Wilhelm was a loyal son to his father Kaiser Wilhelm II and commanded troops at the Battle of Verdun, both in the full expectation that he would be Kaiser one day. But he was also the darkest character in the Hohenzollern family — a Nazi sympathiser who pledged his support to Adolf Hitler vociferously both before and after the latter became chancellor of Germany in 1933.
The nature of Wilhelm’s exact role in Hitler’s rise to power is more than family history to his great-grandson Georg Friedrich. It has a bearing on the dynasty’s presence and future, morally and financially. He has therefore commissioned the renowned historian Lothar Machtan, professor of modern history at the University of Bremen, to look into the matter — aided by a five-figure sum and full access to the family archives. Machtan’s findings have now been published in a comprehensive biography, The Crown Prince and the Nazis: The Hohenzollern’s Blind Spot.
In an interview with the Weltnewspaper last week, both men, historian and prince, showed themselves to be pleased with the results of the research. Machtan has concluded that there is no denying that ‘there was a phase during which one can speak of a collaboration with the rising Nazis’. But he is also certain that ‘the Hohenzollerns were not involved in the transition of power in the winter of 1932/1933, neither directly nor indirectly’. He characterised Wilhelm as a misguided and ‘erratic’ man who was dispensable in the eyes of the Nazis. The ‘terrible proclamations of loyalty’ he offered Hitler were neither demanded nor particularly useful to the future dictator, Machtan argues.
What the German courts will make of this new analysis remains to be seen. The Prince of Prussia is also still engaged in direct negotiations with cultural organisations in the hope that he might reach compromise solutions outside the courtroom.
But the wounds in German collective memory are still deep, as evidenced by the heated tone of the public debate. The Hohenzollerns have been called a ‘family clan which has haunted central Europe for over 1,000 years with its wars, nepotism and catastrophes’ by one commentator; others have called the claims ‘an insult to the republic’, ‘greedy’ and even an ‘erosion of democracy itself’. Georg Friedrich is clearly trying to rationalise the debate by employing the services of a respected expert in the field but he is fighting an uphill battle.
It is unlikely that press appearances, no matter how sleek and professionally conducted, will allay the collective historical anxiety that still holds sway in many areas of German public life. Even the professional research of a well-respected historian is unlikely to make a difference. Whether Crown Prince Wilhelm helped the Nazis to power or not may be the legal question. But the moral question for many Germans is still whether the Hohenzollerns deserve the return of their riches.
https://www.spectator.com.au/2021/08/the-prince-of-prussias-nazi-problem/
****************************************My other blogs. Main ones below:
http://dissectleft.blogspot.com (DISSECTING LEFTISM)
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)
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Kristina Pimenova, once said to be the most beautiful girl in the world. Note blue eyes and blonde hair
Bliss: What every woman wants: to feel safe and secure in the arms of her man. Robert Irwin and Rorie Buckey. See 
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