Johns Hopkins Health Alert – Potassium and Sodium

Reprinted from the original email.

Potassium and Sodium:
Achieving the Proper Balance

 Potassium is an important nutrient everyone needs, but if you have heart disease or are at risk for it, potassium takes on particular importance. Getting plenty of potassium from food is a wise move for most people. Others, however, may need to limit potassium in their diets, including those who are taking certain blood pressure or heart medications or have kidney disease.

Why potassium is important. Potassium is an electrolyte with many essential jobs: It helps conduct nerve impulses and muscle contractions, regulates the flow of fluids and nutrients into and out of body cells, and helps keep your blood pressure in check. Essentially, the level of potassium in your blood can make the difference between normal and abnormal activity in your heart and blood vessels.

Potassium does not act in a vacuum, though. It interacts with other electrolytes, including sodium. It’s long been known that sodium raises blood pressure, while potassium lowers it. But it’s becoming clearer that getting the right balance between sodium and potassium in the diet may be key to your heart health.

How much potassium do you need? In general, adults should get at least 4,700 mg of potassium daily, while limiting themselves to 1,500 mg of sodium. But most Americans are not meeting either goal.

Why is this? The main culprit is too many packaged and prepared foods. During processing, typically a large amount of salt (and, therefore, sodium) is added to foods, while any natural potassium may be stripped away. In contrast, many unprocessed whole foods — fruits and vegetables, in particular — contain adequate levels of potassium but little sodium.

In fact, the vast majority of salt in your diet comes not from your salt shaker, but from processed foods. And some of the biggest sources may surprise you: bread and rolls, prepared pasta dishes, and fresh poultry, for example. Others are less surprising — like cold cuts and cured meats, canned soups and sauces, and snack foods like chips, pretzels and popcorn. So you can optimize your potassium intake and minimize sodium intake by emphasizing fruits and vegetables, whole grains, low-fat dairy, beans, fish and lean meat in your daily diet.

Here are some examples of high-potassium foods followed by healthy alternatives that you can substitute:

  • High-potassium foods (at least 250 mg/serving): wholegrain breads, wheat bran and granola; peanut butter; fruits like apricots, bananas, melon, mango, oranges and pears; vegetables like potatoes, tomatoes and tomato sauces, parsnips, cooked spinach and broccoli, and raw carrots; milk and yogurt.
  • Low-potassium foods (less than 250 mg/serving): White bread and rice; some fruits like apples, berries, grapes, pears and peaches; some vegetables, such as asparagus, green beans, cooked carrots and cabbage, cauliflower, corn and eggplant; poultry, tuna and eggs.

It’s Official: The Boomerang Kids Won’t Leave – NYTimes.com

It’s Official: The Boomerang Kids Won’t Leave – NYTimes.com.

One in five people in their 20s and early 30s is currently living with his or her parents. And 60 percent of all young adults receive financial support from them. That’s a significant increase from a generation ago, when only one in 10 young adults moved back home and few received financial support. The common explanation for the shift is that people born in the late 1980s and early 1990s came of age amid several unfortunate and overlapping economic trends. Those who graduated college as the housing market and financial system were imploding faced the highest debt burden of any graduating class in history. Nearly 45 percent of 25-year-olds, for instance, have outstanding loans, with an average debt above $20,000. (Kasinecz still has about $60,000 to go.) And more than half of recent college graduates are unemployed or underemployed, meaning they make substandard wages in jobs that don’t require a college degree. According to Lisa B. Kahn, an economist at Yale University, the negative impact of graduating into a recession never fully disappears. Even 20 years later, the people who graduated into the recession of the early ’80s were making substantially less money than people lucky enough to have graduated a few years afterward, when the economy was booming.

Read the entire article for a lesson in how to put a positive spin on our new Culture of Dependency.  Watch the slideshow of a dose of reality.  Then read the reader comments and decide for yourself if this “new and permanent life stage” is truly a “potentially thrilling economic evolution”.

Or not.

Managing the “Invisibles” – Harvard Business Review

What Does It Mean to Be an Invisible?

Many of the Invisibles I met with are at the top of their fields; some are in charge of complex operations and of scores, even hundreds, of workers; many are well remunerated. I wanted to know: How is it, in an age when seemingly everyone is aggressively self-promoting, when we’re told that in order to get ahead we must have a brand or a “platform,” that these people—consummate professionals all—are satisfied with anonymity? How can they have the confidence to do their demanding jobs and yet not the ego to want to be widely known for their work? Despite the diversity of their careers, I found that all Invisibles share certain traits, with three in particular at the core.

Ambivalence toward recognition. We all do work that is anonymous to some extent, but most of us strive for recognition. That is how we feed our sense of self-worth. Invisibles take a different approach. For them, any time spent courting praise or fame is time taken away from the important and interesting work at hand. In fact, their relationship with recognition is often the inverse of what most of us enjoy: The better they do their jobs, the more they disappear. It may only be when something goes wrong that they’re noticed at all.

via Managing the “Invisibles” – Harvard Business Review.

Johns Hopkins Health Alert – Updated Guidelines for Knee OA

Updated Guidelines for Knee Osteoarthritis

Many nonsurgical treatments are touted as being able to ease the symptoms of knee osteoarthritis, but which ones really work? Last year, the American Academy of Orthopaedic Surgeons (AAOS) issued revised recommendations, updating its 2009 guidelines. The group made two important changes that may affect the way you manage knee osteoarthritis.

  • First, if you use acetaminophen (Tylenol) for osteoarthritis pain relief, take no more than 3,000 mg per day. The AAOS formerly advised not exceeding 4,000 mg daily. The change was made to reflect the Food and Drug Administration’s current guidelines for safe use of acetaminophen.
  • Second, the AAOS found insufficient evidence that intra-articular hyaluronic acid provides significant symptom relief for knee osteoarthritis so the organization no longer recommends the therapy.

The AAOS continues to give a thumbs-up to some familiar commonsense strategies, such as exercising and a minimum 5 percent weight loss for people whose body mass index (BMI) is greater than 25.

Other highlights: The AAOS is unable to recommend for or against the use of bracing, growth factor injections and/or platelet-rich plasma knee osteoarthritis. In addition, although acupuncture continues to grow in popularity, there is not sufficient scientific evidence to support its use in patients with knee osteoarthritis.

Published online in Treatment of Osteoarthritis of the Knee. Evidence-Based Guideline, 2nd Edition, May 18, 2013

http://www.aaos.org/Research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf

Here’s the link if you want to download the entire set of guidelines in pdf format.

Demystifying the Congenital Long QT Diagnosis

Demystifying the Congenital Long QT Diagnosis.

The incidence of the congenital long QT syndrome is about 1 in 2500 births. This is likely an underestimate as sudden death with a normal autopsy may be the first and only presentation. There are 12 genes responsible for 3 main types of c-LQTS. The presentation is one of aborted sudden death or brief arrhythmia. This usually manifests as sudden, without warning syncope, near syncope or prolonged syncope with seizures. Many are misdiagnosed with seizure disorder or vasovagal syncope.