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0:00 Peripheral Arterial Disease
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Holiday fitness hacks
The festive season usually means diets and workouts are out the window, but to assuage your guilt, try these tips to moderate the eating and get a little exercise in.
Chewingum g can actually help reduce food cravings and appetite, so pop some in after you’ve eaten enough at the party.
— AFP
ONCE again, Christmas is here.
Your diet and workout may go out the window today, but never mind; it’s a day to find some merriment to light up your heart.
Even if you’re not celebrating Christmas, everyone can savour the holiday and hope that present troubles will pass.
As Malaysians, no doubt the first thing we want to do is get together and feast today – and this activity will probably continue until 2023 rings in.
Excessive eating is one of the main reasons for the additional weight gain, but it is also due to lack of physical activity and exercise.
After bingeing on good food and drinks, we feel guilty and sign up for gym memberships – a new year, a new start.
That’s what we’d like to believe anyway! But, instead of going downhill speedily, why not put your brakes on and glide steadily down the slope for a softer landing?
Try these useful tips to stay fit this holiday season.
Eat before heading out
There will be plenty of parties, dinners, lunches and gatherings, even if they are small ones.
So, eat something before leaving home so that you won’t be tempted to overeat there.
Some people prefer to skip their meals for the day to enjoy the festive spreads later, but that only means you will be enticed to eat more and thwart your digestion.
Foregoing meals actually leads to faster weight gain.
If you have a lot of invitations, eat smaller meals and chew food well.
Remember, the slower you eat, the faster you’ll feel full.
Fill up on salads and veggies
Chances are, if you are at a big party, there will be a variety of dishes to choose from.
Fill up at least half your plate with salads (minimise the dressing) and veggies (potatoes don’t count) as these choices contain very few calories and sugar.
Also, sit further away from the food, especially desserts, so that you have to get up and walk to get second or third helpings. Every little walking step counts!
It also helps prevent you from continuing to pick at a certain food just because it is in front of you.
Load up on water
Drink a lot of water to satiate your appetite and keep hydrated.
It will also prevent a possible hangover if you go overboard with the alcohol.
A dry mouth and a nagging headache are classic symptoms of dehydration.
As a rule of thumb, experts recommend drinking one full glass of water for every alcoholic beverage that you consume.
Bear in mind to drink moderately, and if you’re driving, definitely stick to non-alcoholic beverages.
If you do have one too many alcoholic beverages, have a glass of warm water with lemon or a green tea the next morning.
This will help to activate your system and begin any detoxification process needed.
Also, just prior to going out, have something like some yoghurt and a banana – the protein contained in them slows down stomach digestion, and the potassium will assist in balancing out any salty foods that might exacerbate dehydration.
Many Christmas treats and snacks are full of salt or sugar, which tends to throw your metabolism completely out of balance (including when it come to alcohol), so nibble instead of gobble.
Chew gum after meals
If you chew gum after tucking into your meal, that minty fresh taste and the action of chewing will help you avoid going back for more helpings, even if you’re still hungry.
A few small studies have shown that chewing gum can help reduce cravings and appetite, as well as shave calories.
Research conducted by the University of Rhode Island, United States, found that people who chewed gum every day consumed 68 fewer calories and did not bingeeat later.
Plus, gum chewers actually burned about 5% more calories than non-gum chewers.
Go ahead, chew gum when you have the urge to snack and right after your meals to prevent mindless munching.
However, note that chewing gum can also lead to swallowing air, which can cause bloating, so if you are prone to getting “wind” in your tummy, ignore this tip.
Get out of the house
Fret not if you don’t receive any invitations this year as many are struggling to make ends meet.
Allocate time for family and perhaps plan some outdoor activities that do not involve costs.
Maybe a hike in the forest, a picnic in the park, a frolic in the playground or a walk about town – if the weather permits.
All these will help burn calories while keeping the children entertained.
Squeeze in some strength training
Staying active and maintaining a semblance of an exercise routine may seem like an impossible task with a calendar full of holiday parties and family obligations. But it can be done.
Plan to exercise in the morning before starting your day, when there are minimal distractions.
To maintain the muscle mass that you’ve worked so hard to build, perform your strength-training exercises as you can burn just as many calories as a cardiovascular workout in a shorter span of time.
No weights?
No problem, just use your own bodyweight – 20 minutes daily or every other day is enough during this period.
Here are some examples of exercises you can do:
> One-minute jumping jacks and/or marching on the spot with knees high (to warm up).
> Twenty parallel squats.
> Twenty walking lunges.
> A one-minute plank.
> Ten push-ups.
> Twenty bicycle crunches.
> Twenty tricep dips.
> Twenty duck squats (with legs separated and feet turned out).
Opting for meat dishes at the parties and buffets might even mean you will gain some extra muscle – definitely much better than gaining some extra fat!
So, stay healthy, indulge a little bit, keep your face masks on in crowded areas, and as Ella Fitzgerald would sing, Have yourself a merry little Christmas.
See you next year!
RevMathi urugappan is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com. my. The information contained in this column is for general educational purposes only. neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
The Star Malaysia 25 Dec 2022REVATHI MURUGAPPAN starhealth@thestar.com.my
Tips for men who want to build muscle effectively and gain lean muscle mass
In order to grow your muscles, you must apply enough stress for them to become fatigued. — 123rf.com
For most males, hitting the gym is a way to get healthy, look good and feel more confident.
To get the most out of a workout session, a good understanding of health and nutrition can help maximise results.
However, if you were to ask most men what it takes to build muscle, they’d probably say that you just need to eat protein, protein and more protein.
Sure, protein is important.
After all, your muscles are made of protein, and your body requires adequate protein in the diet in order to have the building blocks it needs to build muscle mass.
But protein alone won’t do.
You also need to pay attention to the rest of your diet and exercise routine.
To help men start off on the right track, here are some tips on how to build muscle effectively.
Strike the right balance
A lot of people who are trying to bulk up are also trying to lose body fat at the same time.But sometimes, the approaches they use to meet those goals are at odds with each other.
They’ll take in plenty of protein, which, when coupled with a strength training routine, should lead to more lean mass.
But they may also cut their total calories back too far in an effort to get “shredded.”
That can be a problem.
If you cut your calories too much, some of the protein that you eat is going to be burned for fuel rather than being used to support muscle development.
So, to effectively build muscle mass, you want to ensure that you have enough calories to support your activity and the right balance of nutrients.
Don’t shy away from healthy fats, as they are a vital structural component of every cell membrane, including muscle cells. — Photos: Herbalife Nutrition
Fuel up with carbohydrates
Many bodybuilders see carbohydrates as the enemy, and that can be a mistake.Yes, highly refined carbohydrates and snacks hardly do the body good.
But the right carbohydrates help to fuel activity, including working muscles.Good sources can be found in whole grains, beans, fruits and vegetables.
Without adequate carbohydrates to fuel your exercise, some of the protein you’re eating might get burned for fuel.
So, to avoid “burning the candle at both ends,” make sure to include enough high-quality carbs in your diet.
Get some healthy fats
Dietary fat is sometimes underappreciated by some athletes. Like carbohydrates, fats may have an undeserved bad reputation.
Small amounts of the right kinds of fats are very important.
That’s because certain fatty acids, the building blocks of dietary fats, are essential as the body can’t make them.
Fatty acids are a vital structural component of every cell membrane, including muscle cells.
The body relies on fat to fuel moderate intensity, longer-term exercise.
That’s just the type of exercise that might be coupled with a strength training regimen to build mass and lose body fat.
Good sources of fatty acids include nuts. seeds, fatty fish, olive oil and avocado.
Protein intake and timing are key
Protein is crucial for muscle development, but instead of simply focusing on the amount of protein you take in, you should also pay attention to the timing of your intake.
The process of muscle protein synthesis (MPS) is stimulated by strength training activity, but it’s also stimulated when you eat protein.
This is one reason why those looking to bulk up should aim to spread their protein intake evenly over meals and snacks throughout the day.
MPS is greater under these conditions than it is under a more typical pattern in which little protein is consumed in the morning, a bit more at lunch, and then a large amount at dinner.
And, a bedtime snack containing about 25g of protein can help to stimulate MPS during the night.
Both plant-based and animal- based protein sources provide the necessary building blocks for MPS, but different proteins are digested and absorbed at different rates, so taking in a variety of protein sources could allow a prolonged release of amino acids into the system.For example, dairy products contain two proteins: whey and casein.
Whey is considered a “fast-acting” protein, while casein takes longer for the body to process.
It’s the reason why many athletes turn to dairy proteins since they provide a sustained release of amino acids over a longer period of time.However, animal proteins aren’t necessary in order to build muscle.
With careful planning and attention to total intake, even vegetarians and vegans can consume enough protein to support muscle development.
A fruit and milk/soy smoothie or yoghurt is a good recovery food option after a strength training session.
Best diet tips
> How to spread your protein intake, and how often should you eat?Ideally, you’ll want to time your eating so that it works with your workout, but also aim for three regular meals and a couple of snacks – making sure that they are balanced with both carbohydrates and protein.
That way, you can provide your body with the fuel it needs from the carbohydrate, as well as a steady supply of protein to stimulate MPS.
> What to eat before a workout?
You want to start your workout well-hydrated and well-fuelled.
For fluids, drink about two cups of water two to three hours beforehand, then have another cup about 15-20 minutes before.
The length of time between the time you eat your meal and the time you work out will dictate the type of meal you have:
If you have a few hours to digest, then a balanced breakfast that might include foods like eggs, yoghurt, whole-grain toast or cereals, milk/soy milk, and fruit would be appropriate.
If you’ll be eating fairly close to the time you work out, then something like a protein shake will take less time to digest.
Just be sure your shake includes not just protein but a source of carbohydrates, too.
So, in addition to a protein powder and/or milk or milk alternatives, include foods such as fruits and vegetables (such as carrots or sweet potato); you can even toss in some rolled oats.
> What to eat after a workout?
After you exercise, your muscles need some healthy carbohydrates and about 10-20g of high-quality protein to help them repair and recover.
A tub of yoghurt, a turkey or nut butter sandwich, a smoothie made with fruit and milk or soy milk, or a bowl of cereal and fruit are all good recovery foods after a session of strength training.
> What are good snacks in between meals?
Snacks should include the same healthy balance of protein and carbohydrates.
Some snack bars have a good balance of protein and carbohydrates and are convenient to carry with you.
Other quick snacks include a hard-boiled egg with whole grain crackers, yoghurt with fruit, or raw vegetables and hummus.
> How to gain muscle without putting on fat?In order to build muscle, your body does require additional nutrients and calories, but that doesn’t give you licence to eat as much as you want.
If you take in more calories than you burn – whether from unhealthy, fatty, sugary foods or from a healthy well-balanced diet – those calories will get stored as body fat.Choosing lean proteins, such as fish, poultry, low-fat dairy products, beans and tempeh, will help ensure that your body gets the protein it needs without excess calories.Similarly, choose healthy carbohydrates – fruits, vegetables, whole grains – over sugars and refined starches, so you can reap the benefits without the extra calories.
Left: Muscle growth happens with rest, so give yourself a day off to recover from your workout session. — dpa
Designing a plan
You need more than just protein in your diet to get the nutrients you need to build muscle.
The same applies to your exercise routine – doing the right workouts will help you reach this goal faster and more effectively.
Sports performance and fitness specialist, Denise Cervantes, shares her favourite tips for strength training.
Strength training, also known as resistance training, is the main form of exercise you want to focus on to build muscle.These exercises include weightlifting or bodyweight training (without weights) to improve your strength and strength endurance.
When you are training to increase strength or gain muscle, there are two things you need to make sure you are doing in your training to initiate the physiological change for hypertrophy (muscle growth in size).First, you need to make sure you are creating mechanical tension, meaning you are using a heavy enough weight to challenge the muscle through a full range of motion.Secondly, your training must also cause metabolic stress.
You will know you have done so when your muscle becomes fatigued, because it has used all of its stored energy to fuel its contractions to complete the repetitions.
This is a good thing!
These stresses you apply to the muscle will cause damage to the muscle fibres, causing “micro-tears,” which then send signals for the cells to regrow stronger and bigger.
And remember, growth happens with rest, so make sure to follow a well-designed programme that gives you a day to rest the muscle you just worked so it has a chance to recover and grow.
To see continual improvements from strength training, you should gradually increase the weight and number of repetitions.
Pretty soon, you’ll be a lot stronger physically and attracting a lot of attention!
Susan Bowerman is senior director, Worldwide Nutrition Education and Training, Herbalife Nutrition. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Eggs aren’t just filled with cholesterol. They have other important vitamins like vitamin A, which is good for the eyes, the immune system and the skin.
COOKED, fried, poached: All tasty ways to cook yourself an egg for breakfast. And yet, eggs don’t have the best reputation when it comes to health.
They’re often considered something of a cholesterol bomb, to be eaten in moderation.But experts say that’s only partially true. One egg does contain a fair amount of cholesterol – some 400mg on average.
However, not all of that stays in the body. Two-thirds of cholesterol in the bloodstream is actually produced by the body.
Still, nutritionists recommend keeping an eye on how many eggs you eat.
The suggested intake is up to three eggs per week. That includes eggs found in other foods such as bread, cake, pasta, sauces or mayonnaise.
Anyone who has high cholesterol levels or cardiovascular disorders should preferably stick to eating a maximum of three eggs a week.
Healthy and fit individuals can get away with eating one to two eggs per day assuming that they do plenty of exercises and balance it with lots of fruit and vegetables.Eggs aren’t just filled with cholesterol. They have other important vitamins like vitamin A, which is good for the eyes, the immune system and the skin.
Added to that is the protein-heavy egg white depended on by many athletes.
Eggs also contain lecithin, which is good for the nervous system. That’s what makes them a good bet for the elderly.
Not to mention that egg-based dishes can be easier to chew than other protein-rich foods.
Whether young or old, the question of whether eggs are healthy for you also depends on how they are prepared.
A fried egg cooked in fat and served with bacon will, of course, drive up cholesterol levels in your blood.
One more piece of advice: Make sure eggs are cooked through.
That allows you to kill off salmonella or other possible diseases. If you want to use eggs raw, make sure they’re fresh.— dpa
Functional foods do more than just provide energy and nutrients; they also promote optimal health and help reduce the risk of lifestyle-related chronic diseases.
EVERYONE needs to eat – some more than others.
There are so many food choices that picking something healthy may not always be on our mind.
“Let’s say you don’t have a nutritional background – it can be daunting to navigate what’s good and what’s not good.
“With this pandemic, I have noticed from friends, family and colleagues that the majority of us have become more health conscious.
“Covid-19 has put a different perspective on our health and we’re definitely putting more thought into what we eat.
“Functional foods and ingredients are becoming popular,” says Goh Peen Ern, dietitian and Beneo Asia Pacific’s manager of nutrition communication.
Functional foods are ingredients that offer health benefits that extend beyond their nutritional value (i.e. calories and nutrients).
The simplest examples include whole foods such as nuts, seeds, grains, fruits and vegetables. Foods that have been fortified, enriched or enhanced with nutrients, phytochemicals or botanicals, as well as dietary supplements, also fall within the realm of functional foods.
The concept was believed to have originated in Japan in the 1980s when Japanese government agencies started approving foods with proven benefits in an effort to better the health of its general population.
Advances in technology have helped to identify which ingredients would enhance the nutritional value of foods.
Nutritional ingredients are generally perceived as safe, and this assumption of safety has often been used for branding purposes.
Because consumers are aware of nutritional benefits and consider food safety important, food and beverage producers are positioning their products to reflect the health advantages that their ingredients offer.
Carbs: Good or bad?
While functional ingredients can help promote better health, there are still certain factors about us that are not modifiable, e.g. genetics, family history and age.
Goh says: “The good news is that nutrition is one of the most powerful tools that can modify and improve our health.
“In Asian cultures, food is also used as medicine.”
Healthier eating for all
Many think Carbohydrate as bad, but we should not forget that they are essential for brain functions such as thinking. memory and learning, among others.
She gives carbohydrates as an example: “Carbohydrates have been getting a lot of bad rap and people think it is the source of all ailments, but remember that the human body and brain’s main source of energy is from carbohydrates that have been broken down into glucose.
“All health bodies promote eating carbohydrates, which should comprise around 50% of our caloric intake.”
Just like fats, the quality of carbohydrates differs and not all are created the same.
With the number of diabetics in the country and region, choosing the right type of carbohydrate is important in achieving long-term metabolic health.
Fast-release carbohydrates, or high glycaemic index (GI) foods, release glucose into the bloodstream rapidly, causing a spike in blood sugar levels.
These include breads, cereals, sugars, fruits and some starchy vegetables.
A constant high blood glucose level will cause damage to organs such as the eyes, heart and kidneys.
However, fast-release carbohydrates are extremely beneficial when eaten after exercising, as the rapid rise in blood sugar is critical for restoring glycogen – i.e. the sugars stored for energy – in the muscles and liver.
Slow-release, or low GI, carbohydrates foods provide a slower and more sustained release of energy.
These include most vegetables, whole grains, seeds, nuts, beans, peas and legumes.
If you choose foods with slow-release carbohydrates for your meals throughout the day, you’ll have energy for an extended period of time.
Asian body type
Sugar is not necessarily the culprit leading to diabetes.
“About 60% of diabetics live in Asia.
“We have a higher risk of type 2 diabetes compared to Caucasians due to our genetic makeup.
“Asians appear to have a distinct ‘thin-outside-fat-inside’ (TOFI) characteristic phenotype.
“We wear small or medium size clothes, but inside we are ‘fatty’.
“If we do a body scan, our belly fat is much higher compared to Caucasians with the same body mass index (BMI),” says Goh.
Even if our BMI is lower than our Caucasian counterparts, we actually have a higher risk of developing diabetes.
She adds: “Abdominal fat is the worst kind to have as high levels of it is associated with increased inflammation – if the fat is on your arms, it is fine.
“So, Asian waistlines are actually bigger.
“We can’t change that, but we can change our diets by eating slow-release carbohydrates to reduce the risk of getting diabetes.
“Instead of going on a rollercoaster ride, let the blood sugar climb up the hill gently.”
Goh used to work as a dietitian in a hospital, but realised she was only helping the sick.
So, to prevent a larger group of people from getting sick and filling up hospital beds, she moved on to the food industry.
“The food industry is like an ecosystem consisting of companies that manufacture the end product and companies that produce the ingredients.
“If you look at the finished product sold in supermarkets and read the ingredient list that says sugar, it doesn’t mean the manufacturer has its own sugar plantation.
“They may be sourcing it from elsewhere and adding it to the product,” she explains.
Sugar substitute
Extracted from the sugar beet plant, isomaltulose ia a low GI ingredient composed of glucose and fructose, which can be used as sugar substitute
A good slow-release alternative sweetener is isomaltulose, which is extracted from the sugar beet plant that is grown in the Palatinate region in Germany.
Goh says: “This is a functional ingredient that is a fully-digestible, slow-release carbohydrate, which comes in powder form and has been used to replace the sugar in food and beverage products.”
Isomaltulose is fully, yet slowly, digested and absorbed, resulting in a lower blood glucose rise and less insulin release in the body when consumed.
“Unlike high-intensity sweeteners such as saccharine, isomaltulose has half the sweetness of table sugar.
“If I’m using a lot of brain work or playing sports, I need carbohydrates, and drinks containing isomaltulose are an excellent choice.
“Food manufacturers can use this as an ingredient in their products,” she says.
This low GI ingredient is already the number one sugar substitute in hard-boiled candies worldwide.
It can also be used as a bulk sweetener in confectionery, baked goods, cereals, dairy products, sports nutrition products and special nutrition products and so on.
Goh cites the example of canned herbal tea – people want it to be both tasty and healthy, meaning that they don’t want sugar in it.
However, when the manufacturer takes out the sugar, the tea will become unpalatable.
“The manufacturer has to put back something to get a better-tasting tea, so they can put in isomaltulose, which tastes really nice and is not as sweet.
“Many people also don’t check the sugar content and think if the product is not so sweet, it is healthier!” says Goh.
Another functional ingredient with plenty of benefits is chicory root fibre (a prebiotic), which comes from the chicory plant.
Prebiotics are non-digestible dietary fibres that promote the growth of beneficial microorganisms in the intestine.
Unlike probiotics, prebiotics are non-living organisms and aid the intestinal bacteria to flourish.
Chicory root fibre is derived from the chicory plant, which belongs to the dandelion family (and looks like radish), and is primarily composed of inulin.
Inulin is extracted from chicory root through a gentle hot water diffusion process, similar to the process used to extract sugar from beets.
The first step consists of obtaining a liquid concentrate from the chicory root.
This juice will then be refined into fibre in liquid or powder form.
Goh explains: “Back then, companies making cereal and nut bars used sugar syrup to bind the bar together, but now, some manufacturers have started using the liquid version to bind the ingredients so that the product is healthier.
“The chicory root fibre has plenty of healthy benefits and has been linked to improved blood sugar control and digestive health as it selectively increases the good gut microbiome.
“With isomaltoluse, it is slowly broken down by the body, but chicory root fibre is considered a prebiotic, so it is not broken down in the body and doesn’t affect blood sugar.”
In food packaging, some manufacturers will list the item as “having prebiotics” or a “sustained energy product”.
“What you can do is look at the ingredient list to see if it contains any functional ingredients.
“Food companies will usually use generic names, e.g. oligofructose, fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), plant sterols, isomaltulose, beta glucan, etc.
“These functional ingredients are not just for diabetics, but for everyone to keep themselves healthy.
“And no, these ingredients are not sold to individuals, but to food manufacturing companies,” she says.
Prioritise food intake
To lead a healthy life, Goh ranks nutrition as top of the priority list, followed by exercise, adequate sleep and controlling stress.
She points out: “If you do the first three things right, then the fourth is not a problem.”
When it comes to the affordability factor, Goh says not all foods with functional ingredients are expensive.
“Maintaining good health is not expensive.
“If you cannot afford these foods, go for home brands, cook your meals with lots of onion and garlic, choose lean meats for protein, and eat your fruit and veggies, but make sure they are rainbow-coloured.”
There are those who think eating healthy once in a while is good enough.
“Health eating is a daily thing!” Goh emphasises.
“It’s not only reserved for special occasions.
“You should be eating healthy 80% of the time and the 20% remaining, you can indulge in junk food, fast food, chocolates, etc – why not?
“In the end, it boils down to habit.
“If you’re eating healthy, it’s very hard to undo.
“If your habit is not so healthy, put your mind to it and consciously eat healthy again and again – you can change your habits.
“Just do one thing consistently until it becomes a habit two or three months later, then work on another thing,” she advises.
More importantly, you have to eat to feel good.
She says: “You can try it yourself, eat junk food one day and healthy food the next, and observe the difference.
Benefits of salt substitutes
Dietary salt substitutes can help lower the risk of heart attacks, stroke and death in those with high blood pressure.
DIETARY salt substitutes lower the risk of heart attack, stroke and death from all causes and cardiovascular (heart) disease, finds a pooled data analysis of the available evidence.
Published online in the journal Heart, the beneficial effects of these substitutes are likely to apply to people all around the world, say the researchers.
Cardiovascular disease is the leading cause of death worldwide, and high blood pressure is a major risk for an early death.
A diet high in sodium and low in potassium is known to drive up blood pressure.
Around 1.28 billion people around the world have high blood pressure, although more than half of these are undiagnosed, say the researchers.
Salt substitutes, in which a proportion of sodium chloride (Nacl) is replaced with potassium chloride (KCL), are known to help lower blood pressure.
A recently published large study from China, called the Salt Substitute and Stroke Study (SSASS), found that salt substitutes cut the risk of heart attacks, stroke, and early death.
But it was unclear whether these benefits would apply to other parts of the world.
In a bid to shed light on this, the researchers trawled research databases looking for randomised clinical trials published up to the end of August 2021, which reported on the effects of a salt substitute on blood pressure, cardiovascular health and early death.
Blood pressure, which is measured in mmhg, is made up of two numbers: systolic, which is the higher number that indicates the force at which the heart pumps blood around the body, and diastolic, which is the lower number that indicates arterial pressure when the heart is filling with blood.
They pooled the results of 21 relevant international clinical trials involving nearly 30,000 people, carried out in Europe, the Western-pacific region, the Americas and South-east Asia.
The study periods lasted from one month to five years.
The proportion of sodium chloride in the salt substitutes varied from 33% to 75%; the proportion of potassium ranged from 25% to 65%.
The pooled data analysis showed that salt substitutes lowered blood pressure in all the participants.
The overall reduction in systolic blood pressure was 4.61mmhg and the overall reduction in diastolic blood pressure was 1.61mmhg.
Reductions in blood pressure seemed to be consistent, irrespective of geography, age, sex, history of high blood pressure, weight (body mass index or BMI), baseline blood pressure, and baseline levels of urinary sodium and potassium.
And each 10% lower proportion of sodium chloride in the salt substitute was associated with a 1.53mmhg greater fall in systolic blood pressure and a 0.95mmhg greater fall in diastolic blood pressure.
There was no evidence that higher dietary potassium was associated with any health harms.
A pooled data analysis of the results of five of these trials involving more than 24,000 participants showed that salt substitutes lowered the risks of early death from any cause by 11%, from cardiovascular disease by 13%, and the risks of heart attack or stroke by 11%.
The researchers acknowledge certain limitations to their findings, including that the studies in the pooled data analysis varied in design and that there were relatively few data for people who didn’t have high blood pressure.
But they nevertheless highlight that their findings echo those of the SSASS – the largest ever trial of a potassium-enriched salt substitute to date.
“Since blood pressure lowering is the mechanism by which salt substitutes confer their cardiovascular protection, the observed consistent blood pressure reductions make a strong case for generalisability of the cardiovascular protective effect observed in the SSASS, both outside of China and beyond,” they write.
“These findings are unlikely to reflect the play of chance and support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce dietary sodium intake, increase dietary potassium intake, lower blood pressure and prevent major cardiovascular events,” they conclude.
