I have to wonder why WebMD is so “sensationalist” … being that it’s the “common man’s version” of Medscape. The only real worth I’ve ever found for WebMD has been the Message Boards - but even there, you need to be very cautious.

Mescape, on the other hand, carries some very interesting and detailed information. It’s even good fodder for non-medical people who are willing to do some research on whatever they don’t understand.

To be fair…on the final page of the salt article they provide comments of a nutrition expert who places this article in the proper context. ( Too bad they chose the last page…but as is true with most media outlets sensational presentations get the most attention …and dollars. )

I think the best sites include http://www.cdc.gov and http://www.nih.gov
……these seem to be more concerned with presenting and explaining the data in proper context.

Thank you for dropping in and leaving a comment.

Everything you’ve said makes a tremendous amount of sense, and your final advice is exactly what I was thinking.

I have a serious problem with places like WebMD, which are trusted by those who are not knowledgeable in medicine, when they publish that sort of article, because it’s misleading to those who don’t know how to interpret it. Now there are going to be a slew of hypertensives putting salt back on the table - and probably not mentioning it to their physicians.

Please drop in again - we haven’t seen you since January. You’ve been missed!

Observational studies are never meant to be definitive. They are only of value in pointing toward areas that might be worth researching i the future.

Observational studies are plagued with innacuracies in almost every way. Data collection using recall of individuals surveyed is highly variable.

The better studies involved prospective , multi center, double blinded, randomized control trials. These studies are expensive and usually they are financed by wall street financed drug companies that have the money to pay for multi-milllion dollar trials.

there are many examples in the literature where observational studies results were found to be in error when randomized double blinded prospective trials were later done.

Beyond the technical epidemiologic and statistical flaws in human studies ( which there are MANY), there are the flaws in that accompany the human condition…honest mistakes, rushed analysis, poor editorial oversight, fear, etc….

Despite these pitfalls there are many outstanding researchers and reasearch findings.

The usual thing I do is to wait 6-12 months after a study is published. In most journals there are letters to the editor which will either point out major flaws of a prior study. These reviews that come after the article is published are often times more valuable than the original research.

To an untrained eye, this might seem very discouraging..but this is the way biological science works;
a hypothesis is formulated, data is collected then analyzed, the hypothesis is supported or not supported. then the study is published …subjected to scrutiny…and then begins a long process of re-study and re- publication. Contradictory results/claims are the norm.

hmm…Thus we see yet another example of the fickleness of human thought.

my take:
High salt intake, indeed may not have deleterious effects on people who have normal heart and kidney function.

High salt intake with a person who already has HTN, chronic renal insufficiency or chronic heart failure can be very damaging.

I would doubt any physician would promote a high salt diet for any individual in the latter situation.

respectfully,

nd…

The thought that overlooking ideas which seem to run counter to common sense could be dangerous makes sense … and frankly, I don’t think I’ve ever seen it in that light before. I thank you for opening my mind to a new idea.

There’s another “tempest” going through the blogs right now … the one about statins. Have you seen Dr. Crippin’s post?

You know, as a patient with a chronic illness, it worries me that so many learned professionals disagree on these subjects. I’m not sure if perhaps what we’re seeing is that that one position or the other is right, or that these medications and dietary restrictions are simply a mixed bag of blessings and banes - and you have to take the bad with the good.

We’re in a time of serious discovery … but we still have so much to learn. Sometimes, I feel like one little guinea pig in a very large lab. Is that why they call it a “medical practice?” >;o)

The major fault I see in the study is that it simply surveys patients to see how much salt they are using. Patients tend to stretch the truth about such things. McDonald’s is the busiest restaurant in my town but you would never know it if you asked my patients what they are eating. I would take any study pretaining to diet and health that relies of patient self-reporting, well, with a grain of salt.

But one warning: a lot of people dismiss medical researh that runs counter to common sense (like the idea that increased salt reduces strokes). This is dangerous, because many of the most startling discoveries in scientific history started out that way, as a experimental result that didn’t make sense. We don’t know everything. Knowledge is always being refined, and sometimes long held ideas are tossed out.

We learn something when we discover that an idea is false, even though that knowledge may not be as flashy as the discovery that a new idea is true.

One of the diets I’m on is called the “Dash diet” … low protein. Actually my diets are restricting everything but my carbs, sweets and fats. I was compensating with starches for a while, and my triglycerides went crazy … so … now I’m down to fats. The joke around here is that I can only have “air and a stick of unsalted butter.” ;-)

However, when they take everything away from you, you still have to eat … so, with the last food group gone, I decided that all food groups were back in by default. I just try to be reasonable. I hardly ever eat meat anymore though, because it no longer appeals to me, or settles well … and salt has some pretty obvious and immediate effects.

Once a patient’s kidneys fail and they begin dialysis, they have to up their protein intake, and restrict their fluids.

You’re sweet TJ, but you don’t want to try to “doctor” me, believe me. I don’t make a very good patient. When I still had a PCP, he used to tell everyone he sent me to that I “hated doctors.” I don’t, of course, but I don’t communicate well with them nose-to-nose, and I never managed to disabuse him of that notion. >:-)

Are your special diets low in proteins? We do that also… lower the protein intake.

Sorry… here I am trying to doctor you.

later…

CRF is managed (slowed) with special diets until the kidney(s) stop functioning, and then the diet changes, and dialysis begins, or the patient recieves a transplant. Secondary problems are managed individually, according to what each one is. HTN means hypertension; it usually goes right along with CRF.

No, I don’t drink a particular amount of liquids each day. I know that once dialysis begins, patients are only allowed a set amount of fluids.

Once you have the secondary stuff managed, and have gotten used to the meds, it’s not really all that bad to live with. I just miss my salty foods … ;-)