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Welcome! My blog now contains over 200 articles and recipes. To help you find them more easily I’ve given the front page a bit of a refresh and created some attractive topic archive pages which you can access from the ‘By Topic’ menu in the black bar above or by clicking on the icons above. Have fun exploring!
LATEST ARTICLES
Aloe vera plants – why every home should have one (14/Mar/17) - Aloe vera is the number one treatment for first and second degree burns. Easy to grow - a must have plant for every home. Continue reading
Cardiologist attacks diet dogma at 2017 Symposium (3/Mar/17) - MUST WATCH - Cardiologist Dr Salim Yusuf presents findings from the PURE study which challenge fat, carb, meat, salt and 5-a-day dogma Continue reading
February News Round-Up (1/Mar/17) - Arsenic, asthma, bison, sleep, coeliac, mercury, chocolate, PPIs, BPA, mammoths - We join the dots - PLUS: Mummy Mouse and Baby Mouse special Continue reading
THINKING ALOUD: SHORT POSTS

IN THE NEWS
February News Round-Up - Arsenic, asthma, bison, sleep, coeliac, mercury, chocolate, PPIs, BPA, mammoths - We join the dots - PLUS: Mummy Mouse and Baby Mouse special Continue reading
2017 January News Round-Up - Had enough of experts? Judge their latest pontifications for yourself: chopping boards, statins, roast potatoes, high fat diets and metabolic syndrome, eggs and brain health. Continue reading
NUTRITION & HEALTH
Salt and cardio-vascular disease: Policy and Science clash (19/Mar/17) - Salt recommendations - way out of step with the science Continue reading
Salt vs sodium measurements (12/Mar/17) - Confusing sodium and salt measurements - it happens to the best of us. Continue reading
Cardiologist attacks diet dogma at 2017 Symposium (3/Mar/17) - MUST WATCH - Cardiologist Dr Salim Yusuf presents findings from the PURE study which challenge fat, carb, meat, salt and 5-a-day dogma Continue reading
MOST POPULAR POSTS
(22,350 views) (20,948 views) (4336 views)
EVOLUTION & DIET
The Waterside Ape on BBC Radio 4 - Listen Again: an excellent introduction into controversial theory that humans evolved in riverside / shoreline environments. Continue reading
GUEST POST from Miki Ben-Dor: “Big brains needed carbs” (???) - Miki Ben-Dor from Tel Aviv University brings his expertise of paleo-anthropology to bear on the question of whether cooked starches drove human evolution. Continue reading
Did cooked tubers drive human evolution? - Recent claims that starchy tubers drove human brain evolution are put under the microscope. Studies of the Hadza suggest otherwise. Continue reading
UNDERSTANDING GLUTEN
THE ENVIRONMENT AND FOOD PRODUCTION
Study: dairy, not plant based diets is the best way to feed the planet - New Zealand farm analysis finds that mixed dairy/cropping systems feed the greatest number of people. Protein considerations prove pivotal. Continue reading
Why home-grown food is up to ten times better than arable crops - Study shows that UK allotments and gardens are more productive and fertile than farmland. Continue reading
Safari in deepest Sussex – now you can experience the Knepp re-wilding project for yourself! - From glamping in a sepherd's hut to night safaris led by bat experts - Knepp estate now offers many ways to experience the UK's top re-wilding success story. Continue reading
Featured videos: the environmental argument for pasture raised meat
HERBAL MEDICINE
Aloe vera plants – why every home should have one - Aloe vera is the number one treatment for first and second degree burns. Easy to grow - a must have plant for every home. Continue reading
The three wise herbalists brought… Gold, Frankincense and Myrrh - Let's take a look at three herbs brought from the East, valued for their broad therapeutic use. Continue reading
A quick tour of my clinic - I have just finished giving my consulting room a make-over. May I show you around?. Continue reading
LATEST RECIPES
My Grain-Free Christmas Dinner - Our traditional Christmas dinner worked exceptionally well this year, and included roast turkey with all the trimmings. Continue reading
Grain-Free Christmas Pudding - It's the traditional pud gone paleo. Soaked fruit, almonds and honey make this rich Christmas bomb go with a bang. Continue reading
Keto Bounty Bars - Coconut filled chocolate sweet-meats that are suitable for ketogenic diets. Continue reading
Orange & almond cake - This delicious sponge is light, moist and very tasty, made with whole whizzed boiled oranges. Citrus pizzazz! Continue reading
Stuffed (Farmed) Sea Bass - A delicious baked dish using wholesome ingredients that bring out the best in this fish. Continue reading
More Recipes
Related post: Eating well needn’t cost a fortune
PHOTOTHERAPY: LIGHT AND HEALTH
Red light phototherapy (3/3): Hair regrowth, Pain reduction, Wound healing and Practical applications - In part 3 we look at NASAs original work on red light and pain reduction, recent discoveries about wound healing, and finish with a range of simple things you can do to benefit from red-light at home. Continue reading
Red light phototherapy (2/3): Brain, Muscles and Eyes - Red light stimulates mitochondrial function. We look at the accumulating evidence that phototherapy can improve brain function in Alzheimer's, schizophrenia and Parkinson's. Plus red light enhances muscle endurance and a has major role in eye health. Continue reading
Red light phototherapy (1/3): The Skin - Research is uncovering a huge range of beneficial effects of red light. In part 1 I look at the remarkable protective effects of red light on the skin. Continue reading
WEST SUSSEX HISTORY OF MEDICINE SOCIETY LECTURES
Afifah Is the official blogger for WSHoMSoc which meets in the Autumn at St Richard’s Hospital Chichester
WSHOMS Nov 5th 2016 - 1) How Graylingwell Hospital near Chichester West Sussex served war wounded during WW1 2) Why Malta was known as the 'Hospital Island' Continue reading
WSHOMS Dec 5th 2015 - (1) The incredible history of plastic and cosmetic surgery that was initially mastered in ancient India (2) Toulouse Lautrec and his Muse, Jane Avril Continue reading
FEATURED VIDEO FROM OUR SEMINAR
RECOMMENDED POSTS FROM THE ARCHIVE
Vitamin A from animal sources – more good news - Studies show vitamin A may prevent obesity, diabetes, and protect the heart - but Beta-carotene may counteract vitamin A health benefits. Continue reading
Is Low-Carb really Normo-Carb? - Looking at the effects of high and low-carb diets on glucose, insulin and free fatty acids suggests low carb diets are normal. Continue reading
New study vindicates Weston A Price - Scientists identify Price's 'Displacing Foods of Commerce' as ideal for inducing full-blown metabolic syndrome in rats. Continue reading
Calorie Counting vs Meal Timing - Why a high protein breakfast might work better than calorie counting. Continue reading
Keto Pancakes - One of our most popular recipes. Makes low-carb breakfasts a doddle. Continue reading

Recent Posts

Salt and cardio-vascular disease: Policy and Science clash

The recent video we posted of Dr SalimYusuf’s PURE study had a section on sodium intake, where he showed that the lowest risk of cardiovascular events, cardiovascular deaths and all-cause mortality was associated with an intake between 3000 and 6000 mg of sodium per day (equivalent to 7 to 15g salt per day). The current US average sodium intake is 3800 mg placing the general population nicely within this sweet spot, although towards the lower end.

Current US and UK dietary recommendations recommend an upper limit at 2300mg of sodium (6g of salt) whilst cardiovascular recommendations by bodies such as the American Heart Association aim to reduce sodium intake to 1500 mg per day (approx 3.75 g salt). If the PURE study is right (and it is not alone in questioning the current guidelines), then these aspirations would do more harm than good.

How did such discrepancy arise? The problem may be the use of surrogate markers. The thinking goes like this: Salt raises blood pressure. Raised blood pressure increases CVD risk, so salt increases CVD risk. This kind of thinking was evident in 2011 when the American Heart Association (AHA) called for salt targets to be reduced to 1500mg per day.At the time MedPage Today explained:

The evidence linking salt intake with blood pressure — and the major adverse outcomes of heart disease, stroke, and kidney disease — is “impressive,”…

That evidence includes more than 50 trials assessing the blood pressure effects of salt, as well as a meta-analysis showing that cutting salt intake by about 1,800 mg per day lowered blood pressure by 5 mm Hg systolic and 2.7 mm Hg diastolic.

This is a “critically important public health issue,” according to Appel and colleagues, and this AHA advisory must be considered “a call to action.”

On the basis of this ‘A leads to B leads to C, therefore A leads to C’ thinking initiatives were instigated all round the world to reduce public consumption of salt. A task force of concerned scientists even formed a lobby group to put pressure on food manufacturers, which successfully led to reductions in added salt in manufactured foods.

However, within a short time of the AHA call to action reports started coming in contradicting this advice.

Over this period it is clear that scientists were becoming more and more irritated with the dogmatic approach of the AHA and government bodies, and by the last article were publicly calling the AHA anti-scientific!

Despite all of the research questioning the validity of further salt reduction US and UK policy remains stubbornly wedded to the ‘less is best trajectory’. In their 2016 survey the UK government reported proudly that average sodium consumption fell from 3500mg in 2005 to 3200 mg in 2014.

Their report claimed “Too much salt in the diet can raise blood pressure which increases the risk of heart disease and stroke. A reduction in average salt intake from 8g to 6g per day is estimated to prevent over 8000 premature deaths each year and save the NHS over £570million annually.”

Yet contrary evidence from studies including PURE would suggest that this is not simply futile but probably harmful. You would think that with the swathe of research challenging the low salt dogma that public policy would be questioning the wisdom of further reductions. Not a bit of it. Dr Alison Tedstone, chief nutritionist at Public Health England, makes no bones about it:

Our analysis makes clear that there is a steady downward trend in salt consumption. While people are having less salt than 10 years ago, we are still eating a third more than we should.

Many manufacturers and retailers have significantly reduced the salt levels in everyday foods. However, more needs to be done, especially by restaurants, cafes and takeaways.

The intransigence of health policy makers leads researchers to exasperation and despair. As one writer put it:

…the ‘salt hypothesis’ is rather like a monster from a 1950s B movie. Every time you attack it with evidence it simply shrugs it off and grows even stronger. – Malcolm Kendrick

In an interview with MedPage today researchers who found that patients with heart failure who ate more salt did better than those who ate less made the following statement which we have published before, but is such a gem it deserves another outing:

“We have had no basis for any of our recommendations regarding sodium restriction during the past 50 years, although these recommendations have changed a great deal (for no good reason). After this report, we still have no basis for any of our recommendations regarding sodium restriction. We were ignorant before; we are not any smarter now. Did we really need this report to tell us that we lack evidence for our recommendations regarding dietary sodium in patients with heart failure?”
Milton Packer, Professor in the Division of Cardiology, UT Southwestern

Further reading:

  1. Aloe vera plants – why every home should have one 2 Replies
  2. Salt vs sodium measurements Leave a reply
  3. Cardiologist attacks diet dogma at 2017 Symposium 1 Reply
  4. February News Round-Up Leave a reply
  5. Kids eat sugar. But no one knows how much. Apparently. 2 Replies
  6. Whole grains? Not a health food say these researchers Leave a reply
  7. Fish n Chips a l’Afifah 2 Replies