healthy living

Image result for stethoscope We spend so much on health care, but the USA really lags behind other developed countries in quality of health care. The United States is ranked number 35 on the just released ranking of healthcare quality in 195 countries list. It is called the Healthcare Access and Quality Index, and is a highly regarded and much anticipated analysis, which was just published in the journal Lancet.

How did such health care rankings start? In the late 1970s, some researchers first talked about the idea of “unnecessary, untimely deaths”, and they proposed a list of causes from which death should not occur if the person received "timely and effective medical care". This approach has been modified and extended over time, and now there is a list of 32 medical conditions looked at in 195 countries. The researchers looked at the death rate in each country for the diseases that can be avoided or can be effectively treated with proper medical care. Some of the diseases: diabetes, hypertension, some cancers, appendicitis, etc.

Virtually all the high ranking countries (the top 20) have universal health care, and yet they spend less on medical costs per person. Remember, when one can't afford the costs of medicines or treatments, and consequently dies - then that is the same as a "death panel" or "death sentence". So....is medical care a right for all or a privilege for some? From Medical Xpress:

Which countries have the best healthcare?

Neither Canada nor Japan cracked the top 10, and the United States finished a dismal 35th, according to a much anticipated ranking of healthcare quality in 195 countries, released Friday. Among nations with more than a million souls, top honours for 2015 went to Switzerland, followed by Sweden and Norway, though the healthcare gold standard remains tiny Andorra, a postage stamp of a country nestled between Spain (No. 8) and France (No. 15).

Iceland (No. 2), Australia (No. 6), Finland (No. 7), the Netherlands (No. 9) and financial and banking centre Luxembourg rounded out the first 10 finishers, according to a comprehensive study published in the medical journal The Lancet. Of the 20 countries heading up the list, all but Australia and Japan (No. 11) are in western Europe, where virtually every nation boasts some form of universal health coverage. The United States—where a Republican Congress wants to peel back reforms that gave millions of people access to health insurance for the first time—ranked below Britain, which placed 30th.

The Healthcare Access and Quality Index, based on death rates for 32 diseases that can be avoided or effectively treated with proper medical care, also tracked progress in each nation compared to the benchmark year of 1990. Virtually all countries improved over that period, but many—especially in Africa and Oceania—fell further behind others in providing basic care for their citizens. With the exceptions of Afghanistan, Haiti and Yemen, the 30 countries at the bottom of the ranking were all in sub-Saharan Africa, with the Central African Republic suffering the worst standards of all.

Furthermore, he added in a statement, the standard of primary care was lower in many nations than expected given levels of wealth and development.....Among rich nations, the worst offender in this category [underachievers] was the United States, which tops the world in per capita healthcare expenditure by some measures. Within Europe, Britain ranked well below expected levels.

The gap between actual and expected rating widened over the last quarter century in 62 of the 195 nations examined. "Overall, our results are a warning sign that heightened healthcare access and quality is not an inevitable product of increased development," Murray said.... The 32 diseases for which death rates were tracked included tuberculosis and other respiratory infections; illnesses that can be prevented with vaccines (diphtheria, whooping cough, tetanus and measles); several forms of treatable cancer and heart disease; and maternal or neonatal disorders. [Original study.]

 Once again a great reason to exercise - a study found that adults with the highest levels of weekly physical activity had the longest telomeres, which are markers of overall health and aging. Think of it this way: we all age, but some people seem young for their age, while others seem old for their age. This study looked at differences among groups of people at the cellular level.

The multi-year study looked at both physical activity levels of 5,823 adults and their telomeres. The adults provided DNA samples, from which the researchers measured telomere length. Telomeres are "protein caps positioned at the end of chromosomes". Aging causes telomeres to shorten and results in gradual cell deterioration - thus they are good markers of our biological age, that is, how we're aging (rather than just our chronological age). Study author Larry A. Tucker said “We know that, in general, people with shorter telomeres die sooner and are more likely to develop many of our chronic diseases. It's not perfect, but it's a very good index of biological aging.”

What causes telomeres to shrink faster?  Telomere shortening  can be hastened by things that result in inflammation and oxidative stress, such as obesity, smoking, poor diet, type 2 diabetes, and low socioeconomic levels. On the other hand, this study found that adults with high levels of physical activity had significantly longer telomeres. The longer telomeres found in the active adults reduced cellular aging by about 9 years, as compared to those adults who were sedentary or had low to medium levels of physical activity. Nine years less of biological aging is a lot! The shortest telomeres were in sedentary people.

How much physical activity should one aim for? The study found that activity levels in the study were measured in MET-minutes (metabolic equivalent minutes) - which can sound confusing, but can be achieved by incorporating exercise into daily routines, as well as also doing vigorous activities or exercises. In the present study, men had to attain >1887 MET-minutes per week and women >1375 to be included in the category with the highest activity levels (longest telomeres). It does mean several hours a week of physical activity, which can include gardening, bicycling, walking, vacuuming, exercising, running, etc. From Science Daily:

High levels of exercise linked to nine years of less aging at the cellular level

Despite their best efforts, no scientist has ever come close to stopping humans from aging. But new research from Brigham Young University reveals you may be able to slow one type of aging -- the kind that happens inside your cells. As long as you're willing to sweat. "Just because you're 40, doesn't mean you're 40 years old biologically," Tucker said. "We all know people that seem younger than their actual age. The more physically active we are, the less biological aging takes place in our bodies."

The study, published in the medical journal Preventive Medicine, finds that people who have consistently high levels of physical activity have significantly longer telomeres than those who have sedentary lifestyles, as well as those who are moderately activeTelomeres are the protein endcaps of our chromosomes. They're like our biological clock and they're extremely correlated with age; each time a cell replicates, we lose a tiny bit of the endcaps. Therefore, the older we get, the shorter our telomeres.

Exercise science professor Larry Tucker found adults with high physical activity levels have telomeres with a biological aging advantage of nine years over those who are sedentary, and a seven-year advantage compared to those who are moderately active. To be highly active, women had to engage in 30 minutes of jogging per day (40 minutes for men), five days a week.

Tucker analyzed data from 5,823 adults who participated in the CDC's National Health and Nutrition Examination Survey, one of the few indexes that includes telomere length values for study subjects....His study found the shortest telomeres came from sedentary people -- they had 140 base pairs of DNA less at the end of their telomeres than highly active folks. Surprisingly, he also found there was no significant difference in telomere length between those with low or moderate physical activity and the sedentary people.

Image result for gout in toe Gout is something that is not discussed that much, but it has been increasing in recent years and now afflicts about  3.9% of adults in the US. Gout is a form of inflammatory arthritis, characterized by recurrent attacks of pain, tenderness, and swelling of a joint, frequently the joint of the big toe. It is caused by elevated levels of uric acid in the blood (known as hyperuricaemia).

Gout occurs more commonly in men ages 40 and older, who eat a lot of meat and seafood, drink a lot of alcohol (especially beer) or sweetened drinks, have high blood pressure, metabolic syndrome, or are overweight.  Gout used to be known as "the disease of kings" or "rich man's disease". [On the other hand, past research has shown that consumption of coffee, cherries, vitamin C foods, and dairy products, losing weight and physical fitness seems to decrease the risk.]

Recent research showed that the DASH diet reduces blood pressure and reduces uric acid in the blood, which is why a research team (study in The BMJ) now looked at  whether it lowers the risk of gout. The Dietary Approaches to Stop Hypertension or DASH diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks. On the other hand, the typical Western diet has higher intakes of red and processed meats, sweetened beverages, sweets, desserts, French fries, and refined grains. The researchers analysed data on a total of 44,444 male health professionals, who had no history of gout at the start of the study. During the 26 years of the observational study, they documented 1731 cases of gout.

The researchers found that eating a more DASH type diet - a diet rich in fruits, vegetables, legumes, nuts, whole grains, and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout. On the other hand, a more 'Western' diet is associated with a higher risk of gout. They found that the effects are dose dependent - the more DASH-type diet, the lower the risk of gout. Bottom line: Once again, eating lots of fruits, vegetables, nuts, legumes, and whole grains is linked to health benefits. From Science Daily:

Diet rich in fruit, vegetables and whole grains may lower risk of gout

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout, whereas a typical 'Western' diet is associated with a higher risk of gout, finds a study published by The BMJ.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which leads to uric acid crystals collecting around the joints. The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood. Therefore, the DASH diet may lower the risk of gout.

To investigate this further, a team of US and Canada based researchers examined the relationship between the DASH and Western dietary patterns and the risk of gout. They analysed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts). During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

Image result for gout NHS Credit: Both photos of gout on this page are from NHS.UK

 This is a thought-provoking study that looked at environmental quality and cancer incidence in counties throughout the US. The researchers found that the more polluted the county, the higher the cancer incidence. An increase in cancer rates was associated with poorer air quality and the "built environment" (such as major highways). They correctly point out that many things together can contribute to cancer occurring - and this is why looking at how polluted the air, water, etc. together is important.

They looked at the most common causes of cancer death in both men (lung, prostate, and colorectal cancer), and women (lung, breast, and colorectal cancer). They found that prostate and breast cancer demonstrated the strongest associations with poor environmental quality. [Original study.]

The researchers point out that about half of cancers are thought to have a genetic component, but therefore the other half have environmental causes. Other studies already find that environmental exposures (e.g., pesticides, diesel exhaust) are linked to various cancers. But this study was an attempt to look at interactions of various things in the environment with rates of cancer - because we all are exposed to a number of things simultaneously wherever we live, not just to exposures to one thing. Thus this study looked at associations in rates of cancer. 

Of course there is also a lifestyle contribution to many cancers that wasn't looked at here (nutrition, alcohol use, exercise). They also pointed out that many counties in the US are large and encompass both very polluted and non-polluted areas - and that those counties should be broken up into smaller geographic areas when studied. [More air pollution studies.] From Science Daily:

Poor overall environmental quality linked to elevated cancer rates

Nationwide, counties with the poorest quality across five domains -- air, water, land, the built environment and sociodemographic -- had the highest incidence of cancer, according to a new study published in the journal Cancer. Poor air quality and factors of the built environment -- such as the presence of major highways and the availability of public transit and housing -- -- were the most strongly associated with high cancer rates, while water quality and land pollution had no measurable effect.

Previous research has shown that genetics can be blamed for only about half of all cancers, suggesting that exposure to environmental toxins or socioeconomic factors may also play a role. "Most research has focused on single environmental factors like air pollution or toxins in water," said Jyotsna Jagai, research assistant professor of environmental and occupational health in the University of Illinois at Chicago School of Public Health and lead author of the study. "But these single factors don't paint a comprehensive picture of what a person is exposed to in their environment -- and may not be as helpful in predicting cancer risk, which is impacted by multiple factors including the air you breathe, the water you drink, the neighborhood you live in, and your exposure to myriad toxins, chemicals and pollutants."

To investigate the effects of overall environmental quality, the researchers looked at hundreds of variables, including air and water pollution, pesticide and radon levels, neighborhood safety, access to health services and healthy food, presence of heavily-trafficked highways and roads, and sociodemographic factors, such as poverty. Jagai and her colleagues used the U.S. EPA's Environmental Quality Index, a county-level measure incorporating more than 200 of these environmental variables and obtained cancer incidence rates from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program State Cancer Profiles. Cancer data were available for 85 percent of the 3,142 U.S. counties.

The average age-adjusted rate for all types of cancer was 451 cases per 100,000 people. Counties with poor environmental quality had higher incidence of cancer -- on average, 39 more cases per 100,000 people -- than counties with high environmental quality. Increased rates were seen for both males and females, and prostate and breast cancer demonstrated the strongest association with poor environmental quality.

The researchers found that high levels of air pollution, poor quality in the built environment and high levels of sociodemographic risk factors were most strongly associated with increased cancer rates in men and women. The strongest associations were seen in urban areas, especially for the air and built environment domains. Breast and prostate cancer were most strongly associated with poor air quality.

 The research finding of so many baby foods with elevated arsenic levels (above the legal limit) in the European Union made me wonder about arsenic standards in baby cereals in the US. It turns out that the US has "parallel" standards to the European Union. The EU has "maximum 0.1 milligrams of arsenic per kilogram of rice" (this standard has been in place since January 2016), and in  2016 the US the FDA proposed a "maximum allowed standard of 100 ppb (parts per billion)" in infant rice cereal.

Why is there so much arsenic in baby cereal? It's in the rice - rice plants absorb arsenic from the soil (it may be naturally occurring in the soil or in the soil because of arsenic pesticides that were used for years). And why should we be concerned about arsenic in food? The health effects of regularly consuming infant rice cereal — and other rice-based products —containing traces of arsenic are currently unclear. But...the researchers stated that early-life exposure to arsenic, even at low concentrations, is of particular concern because infants and young children are especially vulnerable to the adverse health effects of arsenic. Arsenic is a carcinogen (causes cancer), and can have "neurological, cardiovascular, respiratory and metabolic" effects.

A Harvard Health Publication (Harvard Medical School) publication in 2016 stated: "In high doses it is lethal, but even small amounts can damage the brain, nerves, blood vessels, or skin — and increase the risk of birth defects and cancer." The FDA found that inorganic arsenic exposure in infants and pregnant women can result in a child’s decreased performance on certain developmental tests that measure learning, based on epidemiological evidence including dietary exposures.

So what should parents do? The American Academy of Pediatricians (AAP) encourages that babies and toddlers eat a variety of foods, and that this will decrease a child's exposure to arsenic from rice. They also encourage other options as first foods (rather than just rice cereal), such as oat, barley, and multigrain cereals - all of which have lower arsenic levels than rice cereal. From Science Daily:

New research shows illegal levels of arsenic found in baby foods

In January 2016, the EU imposed a maximum limit of inorganic arsenic on manufacturers in a bid to mitigate associated health risks. Researchers at the Institute for Global Food Security at Queen's have found that little has changed since this law was passed and that 50 per cent of baby rice food products still contain an illegal level of inorganic arsenic. Professor Meharg, lead author of the study and Professor of Plant and Soil Sciences at Queen's, said: "....Babies are particularly vulnerable to the damaging effects of arsenic that can prevent the healthy development of a baby's growth, IQ and immune system to name but a few."

Rice has, typically, ten times more inorganic arsenic than other foods and chronic exposure can cause a range of health problems including developmental problems, heart disease, diabetes and nervous system damage. As babies are rapidly growing they are at a sensitive stage of development and are known to be more susceptible to the damaging effects of arsenic, which can inhibit their development and cause long-term health problems. Babies and young children under the age of five also eat around three times more food on a body weight basis than adults, which means that, relatively, they have three times greater exposures to inorganic arsenic from the same food item.

The research findings, published in the PLOS ONE journal today, compared the level of arsenic in urine samples among infants who were breast-fed or formula-fed before and after weaning. A higher concentration of arsenic was found in formula-fed infants, particularly among those who were fed non-dairy formulas which includes rice-fortified formulas favoured for infants with dietary requirements such as wheat or dairy intolerance. The weaning process further increased infants' exposure to arsenic, with babies five times more exposed to arsenic after the weaning process, highlighting the clear link between rice-based baby products and exposure to arsenic.

In this new study, researchers at Queen's also compared baby food products containing rice before and after the law was passed and discovered that higher levels of arsenic were in fact found in the products since the new regulations were implemented. Nearly 75 per cent of the rice-based products specifically marketed for infants and young children contained more than the standard level of arsenic stipulated by the EU law.[Original study.]

A 2016 study done in New Hampshire also showed that babies eating rice cereals and other rice-based snacks had higher amounts of arsenic in their urine compared to infants who did not eat rice foods. From JAMA Pediatrics: Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life

 An interesting study looked at what the act of walking does to our brain, and found that it can modify and increase the amount of blood that’s sent to the brain (which is viewed as beneficial for brain function). The study, performed by researchers at New Mexico Highlands University in the United States, found that the foot’s impact on the ground while walking sends pressure waves through the arteries, which can increase the blood supply to the brain. This is referred to as cerebral blood flow or CBF.

These results may help explain other studies that find those that walk frequently (about 6 to 9 miles per week) have "less cognitive impairment" or cognitive decline, fewer memory problems, and greater brain volume with aging.  Another good reason to get out and walk - good for the heart, the body, and the brain. From Science Daily:

How walking benefits the brain

You probably know that walking does your body good, but it's not just your heart and muscles that benefit. Researchers at New Mexico Highlands University (NMHU) found that the foot's impact during walking sends pressure waves through the arteries that significantly modify and can increase the supply of blood to the brain. The research will be presented today at the APS annual meeting at Experimental Biology 2017 in Chicago.

Until recently, the blood supply to the brain (cerebral blood flow or CBF) was thought to be involuntarily regulated by the body and relatively unaffected by changes in the blood pressure caused by exercise or exertion. The NMHU research team and others previously found that the foot's impact during running (4-5 G-forces) caused significant impact-related retrograde (backward-flowing) waves through the arteries that sync with the heart rate and stride rate to dynamically regulate blood circulation to the brain.

In the current study, the research team used non-invasive ultrasound to measure internal carotid artery blood velocity waves and arterial diameters to calculate hemispheric CBF to both sides of the brain of 12 healthy young adults during standing upright rest and steady walking (1 meter/second). The researchers found that though there is lighter foot impact associated with walking compared with running, walking still produces larger pressure waves in the body that significantly increase blood flow to the brain. While the effects of walking on CBF were less dramatic than those caused by running, they were greater than the effects seen during cycling, which involves no foot impact at all.

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Another large recent study found that lowering sodium intakes (less than 2500 milligrams per day) wasn't linked to lower blood pressure. Over the course of 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium. However, the current 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. The researchers felt that based on recent studies with similar findings that the sodium guidelines should be changed.

This 16 year study found that people in the study who had normal intakes of sodium, but also higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the course of the study. And those people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.

Some good potassium foods:  avocado, winter squash, sweet potato, potato, white beans, banana, spinach, salmon, dried apricots, tomato sauce, beans, and milk. Some good magnesium foods: dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried fruit, dark chocolate. Some good calcium foods: milk, cheese, yogurt, kale, sardines, broccoli, white beans, and rhubarb. From Science Daily:

Low-sodium diet might not lower blood pressure: Findings from large, 16-year study contradict sodium limits in Dietary Guidelines for Americans

A new study that followed more than 2,600 men and women for 16 years found that consuming less sodium wasn't associated with lower blood pressure. The new findings call into question the sodium limits recommended by the current Dietary Guidelines for Americans. Lynn L. Moore, DSc, associate professor of medicine at Boston University School of Medicine, will present the new research at the American Society for Nutrition Scientific Sessions and annual meeting during the Experimental Biology 2017 meeting, to be held April 22-26 in Chicago.

"We saw no evidence that a diet lower in sodium had any long-term beneficial effects on blood pressure," said Moore. "Our findings add to growing evidence that current recommendations for sodium intake may be misguided." The 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. For the study, the researchers followed 2,632 men and women ages 30 to 64 years old who were part of the Framingham Offspring Study. The participants had normal blood pressure at the study's start. However, over the next 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium.

Other large studies published in the past few years have found what researchers call a J-shaped relationship between sodium and cardiovascular risk -- that means people with low-sodium diets (as recommended by the Dietary Guidelines for Americans) and people with a very high sodium intake (above the usual intake of the average American) had higher risks of heart disease. Those with the lowest risk had sodium intakes in the middle, which is the range consumed by most Americans.

The researchers also found that people in the study who had higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the long term. In Framingham, people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.....Moore says that there is likely a subset of people sensitive to salt who would benefit from lowering sodium intake, but more research is needed to develop easier methods to screen for salt sensitivity and to determine appropriate guidelines for intakes of sodium and potassium in this salt-sensitive group of people.

 Good news! Once again a study has confirmed that eating fresh fruits is associated with a lower incidence of type 2 diabetes. And even better - there is a dose related relationship - the more one eats daily, the better. So don't worry about the "sugar content" of fruit - the key is to eat fruit (as well as vegetables) to lower the risk of getting diabetes. And if you have type 2 diabetes, it will lower the incidence of death and complications from diabetes.

Here are the numbers for the 7 year study done in China of almost half a million people: eating fresh fruit was associated with a 12% lower risk of developing diabetes (compared to those never or rarely consuming fresh fruit). And in those who already had diabetes at the start of the study, consuming fresh fruit more than three days a week was associated with a 17% lower relative risk of dying from any cause and a 13%–28% lower risk of developing diabetes-related complications than those who consumed fruit less than one day per week.

Yes, I remember the advice that used to be given and is still given in parts of the world - that if you have diabetes, to restrict fruit, but studies are showing that advice to be wrong. Note that eating fresh fruits and vegetables has lots of other health benefits also - including lower rates of heart disease, stroke, and better mental (cognitive) functioning. From Science Daily:

Fresh fruit consumption linked to lower risk of diabetes and diabetic complications

In a research article published in PLOS Medicine, Huaidong Du of the University of Oxford, Oxford, United Kingdom and colleagues report that greater consumption of fresh fruit was associated with a lower incidence of diabetes, as well as reduced occurrence of complications in people with diabetes, in a Chinese population.

Although the health benefits of diets including fresh fruit and vegetables are well established, the sugar content of fruit has led to uncertainty about associated risks of diabetes and of vascular complications of the disease. Du and colleagues studied nearly 500,000 people participating in the China Kadoorie Biobank over about 7 years of follow-up, documenting new cases of diabetes and recording the occurrence of vascular disease and death in people with pre-existing diabetes.

The researchers found that people who reported elevated consumption of fresh fruit had a lower associated risk of developing diabetes in comparison with other participants (adjusted hazard ratio [aHR] 0.88, 95% CI 0.83-0.93), which corresponds to an estimated 0.2% reduction in the absolute risk of diabetes over 5 years. In people with diabetes, higher consumption of fresh fruit was associated with a lower risk of mortality (aHR 0.83, 95% CI 0.74-0.93 per 100g fruit/d), corresponding to an absolute decrease in risk of 1.9% at 5 years, and with lower risks of microvascular and macrovascular complications[Original study.]

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Nothing new here, but good to have it discussed again: eating foods high in potassium and low in sodium (salt) lowers blood pressure. Why should we care? Hypertension (high blood pressure) is a global health issue. The World Health Organization estimates that hypertension is responsible for at least 51 percent of deaths due to stroke and 45 percent of deaths due to heart disease.

Eating the potassium rich foods seems to be key. Some foods high in potassium: bananas, baked potatoes, sweet potatoes, dark leafy greens (e.g., spinach, kale), tomatoes, mushrooms, beans (e.g., white beans, pinto beans), lentils, nuts, broccoli, apricots, milk. In other words, eat an assortment of fruits, vegetables, beans, and nuts to get potassium. And coincidentally these same foods are low in sodium (salt) - a win-win for heath. From Science Daily:

Fruits and vegetables' latest superpower? Lowering blood pressure

Eating potassium-rich foods like sweet potatoes, avocados, spinach, beans, bananas -- and even coffee -- could be key to lowering blood pressure, according to Alicia McDonough, PhD, professor of cell and neurobiology at the Keck School of Medicine of the University of Southern California (USC). "Decreasing sodium intake is a well-established way to lower blood pressure," McDonough says, "but evidence suggests that increasing dietary potassium may have an equally important effect on hypertension."

McDonough explored the link between blood pressure and dietary sodium, potassium and the sodium-potassium ratio in a review article....McDonough's review found several population studies demonstrating that higher dietary potassium (estimated from urinary excretion or dietary recall) was associated with lower blood pressure, regardless of sodium intake. Interventional studies with potassium supplementation also suggested that potassium provides a direct benefit.

McDonough reviewed recent studies in rodent models, from her own lab and others, to illustrate the mechanisms for potassium benefit. These studies indicated that the body does a balancing act that uses sodium to maintain close control of potassium levels in the blood, which is critical to normal heart, nerve and muscle function. "When dietary potassium is high, kidneys excrete more salt and water, which increases potassium excretion," McDonough says. "Eating a high potassium diet is like taking a diuretic." "If you eat a typical Western diet," McDonough says, "your sodium intake is high and your potassium intake is low. This significantly increases your chances of developing high blood pressure." 

But how much dietary potassium should we consume? A 2004 Institute of Medicine report recommends that adults consume at least 4.7 grams of potassium per day to lower blood pressure, blunt the effects of dietary sodium and reduce the risks of kidney stones and bone loss, McDonough says. Eating ¾ cup of black beans, for example, will help you achieve almost 50 percent of your daily potassium goal. [Original study.]

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Is this really a surprise to anyone at this point? According to a recent study: Almost half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases such as heart disease, stroke and type 2 diabetes, have been linked to "suboptimal diets" - that is, to eating poorly and so not getting enough of certain foods and nutrients, and too much of other foods. Deaths due to heart disease, stroke, or type 2 diabete were linked to: high sodium (salt) intake, not eating enough nuts and seeds, a high intake of processed meats, and low intake of seafood omega-3 fats.

The study looked at consumption of 10 foods or nutrients that are associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium. The researchers incorporated data from National Health and Nutrition Examination Surveys, from studies and clinical trials, and from the National Center for Health Statistics. So how should one eat for heath? Lots of fruits and vegetables, legumes (beans), nuts, seeds, whole grains, fish, and less processed food and fast food. (A plus of this is that it also feeds your beneficial gut microbes.) Read ingredient lists and try to avoid whatever foods have ingredients that you ordinarily wouldn't cook with or don't understand what they are (for example, colors, additives, titanium dioxide, artificial or natural flavors, etc.). From Science Daily:

High number of deaths from heart disease, stroke and diabetes linked to diet

Nearly half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases, including heart disease, stroke and type 2 diabetes, have been linked to substandard eating habits, according to a study published in the March 7 issue of JAMA and funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. Of the 702,308 adult deaths due to cardiometabolic diseases, 318,656, or about 45 percent, were associated with inadequate consumption of certain foods and nutrients widely considered vital for healthy living, and overconsumption of other foods that are not.

The list includes foods and nutrients long-associated with influencing cardiometabolic health. The highest percentage of deaths was linked to excess consumption of sodium. Processed meats, sugar-sweetened beverages and unprocessed red meats were also consumed in excess. Americans did not consume enough of some foods that have healthful effects such as fruits, vegetables, nuts and seeds, whole grains, polyunsaturated fats and seafood omega-3 fats.

The study also shows that the proportion of deaths associated with diet varied across population groups. For instance, death rates were higher among men when compared to women; among blacks and Hispanics compared to whites; and among those with lower education levels, compared with their higher-educated counterparts. The authors concluded that "these results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health." The study findings were based on death certificate data collected by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.