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FAQ (7)

What’s the Latest on Salt Intake?

New findings reported at the American Heart Associations Annual Conference on Cardiovascular Disease Epidemiology and Prevention (March 10-14, 2009) suggest that excess salt may be a bigger concern that we thought. Cutting down on sodium intake may do more good than expected.

I rarely add salt to anything, so I’ve never worried much about salt intake. Much of the excess salt we eat is buried in processed and prepared foods. If you eat mostly whole foods, salt isn’t likely to be a problem. Except for salt sensitive people with high blood pressure (less than one-fourth of people with high BP), salt concerns are sometimes overblown—or so we thought. (People who avoid processed and prepared food and rarely add salt are, of course, still in the clear.)

A salty diet can do harm—sodium pulls water from the cells increasing blood pressure—and cutting out unnecessary salt has always made sense. Now, it may make even more sense than we knew. Many of us would probably benefit greatly by being more careful about salt intake.

The eye-popping findings, reported by Dr. Kirsten Bibbins-Domingo (University of California, San Francisco) and her colleagues, come from the Coronary Heart Disease Policy Model, a computer simulation of heart disease in the US adult population, and an extension that assesses stroke.

The findings can be stated in a few simple sentences. Keep in mind that one-fourth teaspoon of salt equals 1.5 grams—or 590 milligrams of sodium.

Cutting just 1 gram of salt a day would prevent a quarter of a million new heart-disease cases and 200,000 deaths from any cause over a decade. What’s more, a 3 gram daily reduction in salt would give the same benefits as eliminating smoking. African Americans (who are more sensitive to salt), women (more strokes), and people under 65 (high BP is often their only risk factor), would benefit even more.

The model suggests that more than 800,000 life-years could be saved between 2010 and 2019 for each gram of salt cut from the diet. That's a reduction of less than a quarter teaspoon of table salt.

Okay, how much salt are we eating? Bibbins-Domingo says Americans currently eat 9 to 12 grams of salt per day, “an amount far in excess of the 5 to 6 grams per day that is recommended by most health organizations.” That latter would be about one teaspoon of salt or 2360 milligrams of sodium. Body size and weight also makes a difference; smaller people are likely to have a lower tolerance.

We are apparently consuming twice the recommended maximum; some of us are getting even more, of course.

How much sodium do we actually need? Sodium is, of course, an essential nutrient for the body. Walter C. Willett, MD, a world leader in nutrition from the Harvard School of Public Health, says: “The average person needs less than 1 gram of sodium a day to keep systems in good working order.” Table salt is one-third sodium, so 1 gram of sodium is equal to 3 grams of salt or one-half teaspoon.

Obviously, we are using way too much salt for our own good.

It’s hard to know just how accurate these figures are—computer models are only as accurate as their programming—but it seems pretty clear that it’s time to start checking food labels more closely for sodium content. The USDA RDA for sodium is no more than 2,400 milligrams of sodium per day, which is just a tad more than a teaspoon of table salt. That’s the maximum. A better target would be around 1,500 milligrams of sodium per day or a few grains over one-half teaspoon of salt.

While you’re at it, make the salt shaker hard to find. Think at least twice before adding salt to anything.

Saving Your Joints

Q: What’s the best way to preserve the joints? I’m a 65-year-old man from the UK, and I can’t afford a joint replacement. I’ve heard that you’ve had a hip replacement, and I want to know how to keep that from happening to me.

A: I told about all aspects of my hip replacement, including the possible causes, in the article 161 in the Fitness & Health category on this website. In addition, we have a Success Story coming next month (June 2008) telling how one man has managed to protect his good hip for more than a decade after having the other hip replaced. What I’d like to do here is make a few general comments to ease your concerns and help you stay fit without damaging your joints.

First, you are wise to think about preserving your joints. It is common knowledge that some prominent lifters and bodybuilders have had joint replacements in their later years. I’m not as familiar with other sports, but I believe that is also true of football, basketball, baseball, hockey, and tennis players as well as athletes in many other strenuous sports. I recently heard a pain management doctor comment that the popularity of skateboarding and other extreme sports is going to accelerate the aging of joints and result in many more replacements.

A few days ago, I came across a newspaper article about a celebrated bodybuilder, who still works out (weights and an exercise bike) for about an hour five days a week, at the age of 84. He has had both knees and both hips replaced, and has a bad back; he needs a cane to get around. Asked if he would do it all again, he assured the interviewer that he would—but added that he'd train a little differently and wouldn’t lift so heavy. Hear that; he's telling it straight.

Most doctors will tell you that joints do better when they are used. Our bodies are made to move. Exercise, including weight training, is good for your muscles—and your joints. The key is to use your joints—but not abuse them.

If a movement or activity hurts, change it or don’t do it. If you suffer an injury, and we all do, allow time for it to heal. Training through pain and injury is a very bad idea.

The formula for successful and productive exercise is stress and rest. Don’t forget the rest. It’s generally better to do too little than too much.

So keep training, but listen to your body. Pay attention to aches and pains. IF IT HURTS, DON’T DO IT.

New Tanita Body Segment Monitor

Q: What’s your opinion of the new Tanita Ironman InnerScan Segmental Body Composition Monitor? Is it worth the additional cost to know how your body fat and muscle are distributed?

A: I wondered myself, and recently purchased the new model BC-558. In addition to the variables measured by my earlier model BC-533 (weight, body fat percentage, body water level, muscle mass, belly or visceral fat, bone mass, calorie burn, metabolic age, and physique rating), the new model gives readings for both fat and muscle mass by body segment: left arm, right arm, right leg, left leg, and trunk.

The new body-part model is a technological marvel, for sure, but whether it’s worth the added price and complexity depends on the individual. I’ll give you my impression and you can decide.

One rap against the earlier Tanita models is that the electrodes are under the feet and, presumably, only send electrical current below the waist; they don’t pass current into the upper body. Critics say this skews the readings in favor of the lower body and may not accurately account for people with a marked difference in upper and lower body fat/muscle distribution. This is one of the main reasons I coughed up the money for the new scale; I wanted to test the validity of the criticism..

The new segmental model cleverly addresses this problem with retractable hand grips, which allow the current to pass through the upper body. It’s very neat. You just turn the scale on, pull out the hand-electrodes, and step on the measuring platform. This arrangement allows the current to pass through your feet and hands into your upper and lower body.

My experiment hit a roadblock early on when the scale continually malfunctioned; it gave my weight every time, but frustratingly refused to move on to the body-composition measuring phase most of the time. The times when it did work, however, convinced me that it does some very interesting things. I called TheCompetitiveEdge.com, where I bought the scale, and they kindly arranged for UPS to pick up the defective scale. A few weeks later a new scale arrived, which performs all the advertised functions most of the time. (The feet must be properly aligned on the measuring platform to make solid contact with the electrodes. My feet don’t seem to fit very well—my hip replacement may interfere with the current in some way—but it works for my wife, Carol, every time.) My unplanned encounter with customer service was quite satisfactory. They were courteous and acted promptly.

With that hiccup behind me, I proceeded to evaluate the new body part functions. Basically, I have decided that the added functions—and price—are worthwhile only for those who are comfortable with complexity and have a special interest in monitoring the balance of the left and right side of the body or tracking changes in a particular body part. It seems logical that sending the current through the hands and feet would give a slightly more precise measure of overall body composition. Be that as it may, scales with foot electrodes only are quite adequate for measuring change in response to diet and training—and simpler to use. Tracking as many as nine variables, as the older models make possible, is more than enough bookkeeping for most people. Still, the new model is fascinating and worth considering for those with enough spare change and interest. Carol has shown little interest in our earlier scales, but the new model works for her and she loves all the bells and whistles.

Here are the details.

My total body fat percentage is roughly the same on the old and new scales; at times the two models give exactly the same reading and at other times there is a difference of up to one percent. (Readings vary on both scales, based on the day and time, and hydration level.) Interestingly, the new body-segment scale consistently shows my arms and truck to be leaner than my legs. Not only is that a surprise to me, it suggests that the foot electrodes on the earlier model do, in fact, pass current into the upper body, at least to some degree; otherwise, my body fat reading should be lower on the new scale. The total fat reading on the segmental scale appears to be an average of all body parts. (Body parts, of course, vary in size making a precise calculation difficult.) I’m just guessing that both scales pass current into the upper body, but that’s the logical conclusion. Significantly, nowhere in the literature that comes with the new scale does Tanita claim that the segmental scale gives a more accurate total body-fat reading. For me, at least, the hand electrodes don’t seem to make any significant difference.

Dr. McFarlin at the Cooper Clinic has observed that I am very right handed based on the relative size of my right and left wrist; my right wrist is significantly larger. That’s apparent from comparing my arms; it was no surprise to me. Well, the new scale confirms that my right arm is both leaner and more muscular than my left; one reading showed that my right arm is 4.2% fat and contains 9.2 pounds of muscle versus 6.4% and 8.4 pounds, respectively, for my left arm. That’s interesting, but doesn’t really tell me anything I didn’t already know.

The new scale shows that I have a similar, but smaller, difference in my right and left legs. For example, one reading showed that my right leg contains slightly more muscle than my left, 23.7 pounds for the right compared to 22.9 for the left; the difference in the readings was never more than one pound. Frankly, I thought the difference would be greater due to my right-side my hip replacement. Any distortion in the readings caused by my hip replacement seems to be negligible. That’s good news.

Keep in mind that these readings are mine. Your numbers may be completely different. You can decide whether to pay up to find out.

Finally, the new scale has one feature that I do not like. As I reported in my earlier discussion (FAQ 6, Item 3), the Tanita scale I purchased in early 2006, model 533, gives me the same body fat (and muscle mass) reading for age 30 as for my true age; for me, that’s the way it should be. As I say in my new book, Great Expectations, most people gain fat and lose muscle with age, but it does not have to be that way. The new scale says I am almost 2% fatter when I tell it I’m 70 than when I enter my age as 30. In my view, that’s a flaw. There should be only one total body-fat reading; age should make no difference—especially on a scale that purports to take into account all parts of the body.

For that reason mainly, but also because recording body-part readings is tedious and time consuming, I plan to continue using the older scale for my weekly weighings. Nevertheless, I’m glad I purchased the body segment model; testing and comparing it to the earlier model was an interesting and worthwhile exercise.

Again, what I have said is based on my own situation; it applies to me. The body segment monitor may suit your needs perfectly. If so, I recommend the scale and urge you to buy one.

(See our FAQ 6, Item 3 for my discussion of Tanita Model BC-533, and www.tanita.com for information on all models.)

More on Exercise and Belly Fat (and Thigh Fat)

Q: Hello, I just had to write. I appreciated reading your article about the differences between men's abdominal fat and female thigh fat [#9, Fat Loss & Weight Control]. I have been training consistently for some time and have had trouble reducing thigh fat, just as you say in the article. My legs are very strong and shapely, but carry extra fat. It throws me off a bit, sometimes, because my upper body is very defined and leaned out. I'm striving for leaner looking legs also -- but patience is what I have to keep in mind. I figure when I can get my body fat percentage down a couple more points, my thighs will appear leaner. Thanks for the article (it encouraged me!). Any good tips to help with the female thigh battle????

A: You have the right idea. As I related in my earlier article, Covert Bailey has found that female thighs start to slim down when total body fat drops to18% or lower. It sounds like you’re already there. Stay consistent with your training (diet and exercise) and continue to bring your body fat down slowly--as you say, patience is the key--and your thighs will definitely look (and be) leaner.

I believe you’ll find a new study on weight training and female belly fat encouraging as well. The study was funded by the National Institutes of Health and presented earlier this year at an American Heart Association conference in Phoenix. The details were reported by The Associated Press.

Overweight and obese Minnesota women (164 ages 24 to 44) were evenly divided into a weight trained group and a control group. The experimental group trained their whole body (lower back, buttocks, thighs, chest, back, shoulders, biceps and triceps) with weights for an hour twice a week for two years. (They apparently did no direct exercise for abs.) They used both free weights and machines and were encouraged to gradually increase the resistance as their strength improved. The controls were simply given a brochure recommending 30 minutes to an hour of exercise most days of the week. Both groups were told not to change their diet.

The study focused on deep belly fat, the kind linked with heart disease. “The more central the fat, the more it’s laid down in the arteries,” cardiologist Tracy Stevens told the AP. “One of the most common complaints in women, especially as we continue to age, is abdominal growth,” she added.

Both groups gained intra-abdominal fat, but the control group gained three times as much, 21% compared to only 7% for the weight trained group. Significantly, the weight trainers decreased their total body fat by almost 4%, while the controls were unchanged. As indicated in our earlier Q & A (FAQ 5, item 3), people who don’t exercise typically show a substantial increase in unsightly and dangerous belly fat as they age, even if their body weight and fat remain the same. (See also FAQ 6, item 2, about the programming of the Tanita Body Fat/Weight scale to assume a gain in visceral fat with age, for men and women.)

You’ll find a comment by epidemiologist and lead author Kathryn Schmitz informative and encouraging: “I think we need to provide people with multiple possibilities, multiple roads to the same end. If this is what you’re willing to do, I’ll tell you what you can get out of it.” In other words, if you are willing to weight train—and nothing else, no aerobics and no diet—here’s what the result is likely to be. You’re obviously willing to do more—and your results will almost surely be better. You’re abs will look leaner—and so will your thighs. It’s up to you.

That’s essentially what Dr. Rita F. Redberg, a cardiologist at the University of California San Francisco, said about the study. “Certainly, any kind of exercise is better than not doing anything. But for maximum benefit, cardio with weight training will get a lot more bang for your buck,” she told the AP.

Weight training alone will increase your muscle mass and speed up your metabolism, curtailing body fat growth. Take a more balanced approach by including high-intensity intervals and a sensible diet and you’ll almost surely become leaner and more defined all over your body, including your thighs. (For specific details, see Lean For Life and Challenge Yourself.)

Enjoy your training—and your results.

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