Avoid this ‘fancy' seasoning to protect yourself from heart disease and stroke: cardiologist

It's time to spice things down.
Seasoning is arguably the most exciting part of eating food, as it has the power to enhance natural flavors and add complexity to any dish.
But one cardiologist is sounding the alarm on a supposedly upscale seasoning — and, fair warning, her advice might leave you feeling salty.
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3 Seasoning is arguably the most exciting part of eating food, as it has the power to enhance natural flavors and add complexity to any dish.
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While salt is an essential electrolyte that plays a crucial role in fluid balance and nerve and muscle function, too much of it can spike your blood pressure, thereby increasing your risk of heart disease and stroke.
The American Heart Association advises limiting sodium intake to no more than 2,300 milligrams per day — roughly one teaspoon of table salt — with an ideal target of 1,500 mg for most adults, especially those with high blood pressure.
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However, the average American consumes around 3,400 mg of sodium daily.
And not all salt is created equal, either.
While coarse salt has been deemed the most sophisticated choice of sodium chloride, mostly thanks to its popularity among professional chefs — and the cute little ramekins they use to store it in — it might not be the healthiest option.
Dr. Susan Cheng, a cardiologist in the Smidt Heart Institute at Cedars-Sinai in Los Angeles, told Today.com that the crunchy texture of this 'fancy' salt might make it easier to overindulge.
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3 Too much salt can spike your blood pressure, thereby increasing your risk of heart disease and stroke.
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'The less expensive regular salt you get from the grocery store that is not so fancy or coarse gives you as much taste for much less volume of salt. You're ingesting less salt,' Cheng told the outlet.
Cardiologist Dr. Evan Levine has also previously warned his nearly 225,000 TikTok followers against jumping on the trendy salt train.
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In a video on the biggest TikTok healthcare lies, he ranted against the Celtic sea salt craze, which has gained traction because it's less processed and contains negligible amounts of minerals.
'Guess what? It's sodium chloride like your salt,' he said.
'It has trace — little itsy bitsy — amounts of calcium, potassium … and that's it.'
3 'The less expensive regular salt you get from the grocery store that is not so fancy or coarse gives you as much taste for much less volume of salt. You're ingesting less salt,' Cheng said.
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Experts generally agree that regular table salt is actually the healthiest choice for most people.
That's because it's fortified with iodine, an essential mineral that helps prevent iodine deficiency, which can lead to thyroid problem.
Many gourmet salts — such as Himalayan, Kosher or sea salt — don't contain added iodine.
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Table salt has smaller, uniform grains, so you're more likely to use less without sacrificing flavor.
And it's regulated for purity and consistency, which means fewer contaminants or trace heavy metals that can sometimes show up in unrefined salts.

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Medscape

16 minutes ago

• Medscape

Should CV Risk Equations Add Lp(a)?

Whether to measure Lp(a), a lipoprotein associated with increased cardiovascular risk, and how to use that information in risk assessment is a hot topic in cardiovascular medicine. The American Heart Association recently introduced the Predicting Risk of Cardiovascular EVENT (PREVENT) equations — an update to the pooled cohort equations. Neither risk calculator includes values for Lp(a). A recent study looked at whether adding Lp(a) to the PREVENT equations would improve risk prediction. It found that including the lipid parameter yielded a modest improvement at a population level but appeared to be more useful for personalized risk assessment, particularly among lower-risk individuals. 'Our results validate the PREVENT equations on a population level and show that they perform well, both in people with and without high levels of Lp(a),' lead author of the study, Harpreet Bhatia, MD, University of California San Diego, told Medscape Medical News . 'While I think our results would not support adding Lp(a) to the PREVENT equations, they confirm that on an individual-patient basis Lp(a) can add information,' he commented. Bhatia explained that the PREVENT risk equations are going to be the future paradigm of risk stratification in the primary prevention setting in the US, eventually replacing the pooled cohort equations which have been used for many years. The reason that Lp(a) wasn't included in either risk score, he suspects is because the datasets on which the risk equations are based would not have these values available. The PREVENT equations removed the consideration of race or ethnicity, as there is now acknowledgement that race is more of a social construct, but it is known that Lp(a) levels vary by ancestry, he said. Bhatia believes that Lp(a) should be routinely tested at least once in all adults; 'For those of us who practice preventive cardiology and lipidology, it can alter our clinical management.' Current American Heart Association/ American College of Cardiology cholesterol guidelines from 2018 do not recommend universal testing of Lp(a) but include it as a risk enhancing factor; updated guidelines are expected within the next year. Guidelines from the European Society of Cardiology and Canada and the US National Lipid Association do recommend measuring Lp(a). For the current study, Bhatia and colleagues examined data from the Multi-Ethnic Study of Atherosclerosis, a US study of 6670 people started in the year 2000, and the UK Biobank, a study of over 500,000 individuals from the UK started around 2006. Participants had no known cardiovascular disease at baseline and most had an Lp(a) measurement. Bhatia noted that his study used risk thresholds established for the pooled cohort equations, but it has not yet been decided what the cut points will be for the PREVENT equations. Low risk was defined as < 5%; borderline as 5%-7.5%; intermediate as 7.5%-20%, and high as ≥ 20% predicted 10-year risk for cardiovascular disease. 'PREVENT Equations Generally Do A Good Job' 'Essentially, what we saw was that the PREVENT equations generally do a good job of putting people into those 10-year risk categories across the board,' Bhatia said. However, they also found that within each category and across the board, if Lp(a) was high, then the cardiovascular risk was increased compared to individuals with a lower Lp(a) and sometimes quite significantly increased. The researchers also tried to establish whether Lp(a) could improve risk prediction on top of the PREVENT equations, using the Net Reclassification Index (NRI) which looks at the percentage of people who would be reclassified based on the new model (the proportion who move up minus the proportion who move down). They found that Lp(a) levels led to a modest improvement in risk prediction according to the NRI. In terms of atherosclerotic cardiovascular disease (ASCVD), including elevated Lp(a) on top of the PREVENT equations appropriately reclassified about 6% of people. With regard to coronary artery disease, which Lp(a) is most strongly associated with, the NRI was about 8%. Another measure of how well a new model predicts risk — the C index — found that the addition of Lp(a) did not significantly modify results. 'Our results suggest there does seem to be some improvement in risk prediction with Lp(a) for some individuals, particularly those at lower cardiovascular risk,' Bhattia said, an observation he described as 'intriguing'. He does not believe that new equations are needed that incorporate Lp(a). He pointed out that statin therapy for prevention is more strongly recommended in intermediate/higher risk patients, with a weaker recommendation for those at lower risk when there's the presence of an additional risk enhancing factor. 'It may be that someone at low risk in the equations with an elevated Lp(a) may be eligible for starting statins.' Bhatia already considers Lp(a) levels in this way in his clinic. He said that Lp(a) testing is simple and widely available, and the majority of people will only need to be tested once in their lifetime. He explained that most people who have low or high levels would stay in those categories long term, while people who have intermediate or borderline levels (30-50 mg/dL or 75-125 nmol/L) may need repeat testing if something changes that can affect Lp(a) levels longer term such as going through menopause, or the development of kidney or thyroid disease. Lp(a) Testing Worthwhile In an editorial accompanying the publication, Donald M. Lloyd-Jones, MD, Framingham Center for Population and Prevention Science, Boston University, Framingham, Massachusetts, and Amit Khera, MD, University of Texas Southwestern Medical School, Dallas, said the results are a useful validation of the PREVENT risk equations in contemporary broad populations and large real-world clinical samples. In terms of whether Lp(a) should be incorporated directly as a variable in the PREVENT equations, the editorialists have a similar view to Bhatia. 'That appears unnecessary,' they wrote. But, like Bhatia, they believe that Lp(a) should be measured once in everyone to help understand and individualize risk. 'Lp(a) is indeed a risk-enhancing, likely causal, factor for ASCVD. Its absence does not exonerate traditional risk factors, but its presence can amplify and personalize that risk, and help guide clinicians and patients regarding use and intensity of preventive therapies,' they concluded. Also commenting on this latest study, was Nathan Wong, PhD, from the University of California Irvine School of Medicine. He told Medscape Medical News that the analysis shows that the PREVENT risk score predicts ASCVD outcomes similarly in those with and without elevated Lp(a) levels. The stronger prediction of Lp(a) in lower risk people 'argues for the need to promote increased screening in the broader population, including those at lower risk' he said noting that most recommendations in the past have focused on people at higher risk such as those with a personal history of ASCVD. Wong agreed with Bhatia that the value of Lp(a) is more at the individual level than at the population wide level. But he does believe a risk score incorporating Lp(a) could be helpful for personalizing treatment strategies in certain individual patients, particularly for those with elevated Lp(a) levels who may not already be identified as high risk. Indeed, Wong and colleagues recently published such a score and showed that incorporating Lp(a) into ASCVD risk prediction models developed using a real-world clinic population moderately improves performance over 10 years, with good generalizability when applied to other US population cohorts. In that paper, a 25 mg/dL increment in Lp(a) was associated with a 23% increased risk for incident ASCVD. Levels ≥ 75 mg/dL conferred a near two-fold greater risk for ASCVD, including a 2.5-fold greater risk for stroke compared with Lp(a) levels < 25 mg/dL. They also demonstrated that adding Lp(a) to the pooled cohort equations ASCVD risk calculator correctly reclassified 45% of borderline-intermediate risk patients who experienced incident ASCVD as high-risk. However, about 24% who did not experience events were incorrectly reclassified high-risk (for an NRI of 21%). He cited a use case of a Black man aged 65 years with an Lp(a) of 80 mg/dL and a 10-year ASCVD risk of 18% without considering Lp(a) who would be up-stratified to 24% after factoring in Lp(a). 'Based on current guidelines, this person would now be clearly recommended for a statin to lower his ASCVD risk which may not have been as certain based on the risk not incorporating Lp(a),' he said. Recent studies have also shown identification of elevated Lp(a) levels can result in greater use of lipid-lowering therapy, he added. Wong also agreed with Bhatia on the distinction between risk prediction in populations vs individuals. 'We don't practice medicine on populations. We practice it on individuals and for certain individuals a risk score that incorporates Lp(a) can reclassify their risk category significantly dependent on how high their Lp(a) is,' he stated.

USA Today

5 hours ago

• USA Today

Medicaid handouts only create dependency. Able-bodied adults should work.

Does Medicaid need an overhaul? Does Republicans' proposed $800 billion cuts go too far – or not far enough? Readers respond in USA TODAY's Opinion Forum. With the deadline for President Donald Trump and Republicans' "One Big Beautiful Bill Act" on the horizon, Americans are turning their attention to a major provision of the budget bill: changes to Medicaid. The bill calls for sweeping changes, including cuts of nearly $800 billion to the program, a mandatory work requirement of 80 hours per month, and an overhaul of the current Medicaid and Medicare systems – consolidating them for the purpose of centralized enrollment. Additional changes include banning federal funding for gender-affirming care and transitioning procedures and reducing the amount of federal funding allotted to states for noncitizens. As Congress debates these provisions before a final vote in the Senate, Americans are sounding off – largely in support of the program. More than 71 million Americans benefit from Medicaid, and new polls from KFF Health found 83% of respondents have a favorable view of Medicaid. More than half of respondents who are enrolled in Medicaid say changes to the program will make it "very difficult" to afford medications (68%), see a health care provider (59%) or get alternate insurance coverage (56%). A June 11 Quinnipiac University poll found half of American voters polled said funding for Medicaid should go up, not down, while an Associated Press-NORC Center for Public Affairs Research poll released June 16 found that 50% of Americans think we spend too little on Medicaid. But we wanted to hear from you, our USA TODAY readers, directly. We asked what changes, if any, you want to see to the program and how Medicaid has impacted your life or the lives of those you know. Do the proposed cuts go too far? Or not far enough? Here's what you told us for our Opinion Forum. I couldn't have made it as a mom ‒ or cancer survivor ‒ without Medicaid As a Stage 3 breast cancer survivor, mother to a son with profound disabilities and a full-time working member of society, I've had to navigate the unimaginable. Without Medicaid, I could not have managed any of it. The program covers our son's in-home care, and it gave me the ability to focus on both my treatment and career. For families like mine, Medicaid is not a luxury ‒ it is the foundation that holds everything together. Proposed cuts threaten the care millions rely on. We must protect Medicaid so parents are not forced to choose among their health, their job and their children's needs. — Caroline Johnson, Louisville, Kentucky Able-bodied people should be working. Entitlements weren't meant to last forever. As I understand it, the only people who would be cut from Medicaid are able-bodied adults who would need to work a minimum number of hours a week to keep receiving it. I don't believe that disabled people, older folks and children would be affected. Also, illegal migrants would be kept off, because American taxpayers are not responsible for paying their way. We have enough American citizens who need help. Those who are not supposed to get these entitlements should be cut. These entitlement programs were never meant to be a way of life. They were supposed to be a safety net only for those who really needed them. Able-bodied adults should work. There is pride in working for what you need or want. Handouts only cause dependency, which is not good for anyone. Every citizen who is able should strive to be independent. The same should go for food stamps. It should only be for the really needy disabled, elderly and children with low incomes. — Renee Bertoni, Holley, New York Real government waste is MAGA's excess I am a retired Health and Human Services Department worker. I think this administration is so shortsighted about Medicaid and food assistance cuts for working families and individuals. If low-income people and working families have inadequate food and no medical coverage, it hinders their ability to work and function in society. All people deserve medical coverage and nutritious foods! I don't think I will ever support Republicans again. This is supposed to be a government for the people, by the people and of the people. These MAGA supporters are all lacking in human decency. Yes, I believe they will cut more and more because they are focused on self-indulgence. Increase taxes for the wealthy who have too much and know that "trickle-down economics" is just a buzz phrase. It doesn't work. Big cuts were made to the federal work force with no strategy and no concern for talented and dedicated employees, along with lots of publicity for fake fraud claims that didn't exist. The minions are hard at work trying to sell the public on their distorted strategy: more for them and less for everyone else. Let's think about the waste of the Trump military parade. That's what's shameful. — Joyce Schulz, Tawas City, Michigan As an ER doctor, I saw what cuts to Medicaid would cost us all As an emergency physician, I cared for uninsured patients who were signed up for Medicaid insurance in the emergency department. Medicaid health insurance allowed these patients to follow up with primary care doctors and providers who otherwise could not afford to care for uninsured people. Studies show that adding Medicaid insurance saves lives. And taking away Medicaid insurance leads to worse health outcomes. I am very concerned that any cuts to Medicaid insurance would lead to avoidable illness and even death for newly uninsured patients. Primary care physicians and specialists cannot afford to care for patients who lose their Medicaid health care coverage. Also, rural hospitals and rural clinics would lose a significant portion of their financial support from Medicaid. Primary care providers and rural hospitals would be forced to close their doors, leaving uninsured patients without access to care. I am afraid that Republican politicians will choose tax cuts for the rich over Medicaid health insurance for the poor. I think that Republican politicians should have their own government health insurance taken away from them. Why should taxpayers pay for the health insurance of these well-off Republicans who are voting to take away Medicaid from poor people? — Gary Young, Sacramento, California I've worked hard to get everything I have. Democrats don't seem to see people like me. I don't see the problem with having work requirements. If you can work, why not? As a taxpayer, I pay for my own medical insurance. I am single and have no dependents. I have no fault with us having a Medicaid program for the elderly, children and disabled, but that should be it unless you are working and need a short-term helping hand. I have been working full-time since I was 22, so I don't understand people having an issue with a work requirement to get medical coverage. I think we have to cut spending across the board. I hear Democrats talking about taking things away, but I don't seem to hear anything from them about how to cut spending. We are over $36 trillion in debt. If spending is not controlled, our country could go bankrupt, and then no one would have any programs to use. What is the Democrats' plan to get the debt under control? They had the past four years to do it, and you see where we are. I'm tired of the talk about these cuts going to the billionaires. We don't know for sure where it's going, and you can't understand how tired of this rhetoric people are. Additionally, I would like to see the cuts to the U.S. Agency for International Development and Department of Education all codified so these programs do not exist. There seems to have been a bit of waste and abuse over many years that needs to be dealt with. I make under $70,000 a year, so I have worked hard to get where I am. I was a Democrat for over 35 years, and about five years ago, I went Republican, as parties seem to have switched. I believe that the Democrat Party is full of elitists who feel we poor peons will do what they tell us, rather than realizing a lot of peons can think for ourselves and should not be condescended to and not told we are bad peons if we disagree with them. — Teresa Loy, Tucson, Arizona My brother was saved by Medicaid. Many more would die without it. My brother had AIDS/HIV and AIDS-related cancer. He was too sick to work and relied on Medicaid for all his medical benefits, both physical and mental. He eventually worked for the nonprofit Hope and Help in Orlando. He was a mentor to others, a champion, an activist, an orator and a published writer. He died in August 2020. All his efforts and the efforts of many would die in vain without their medication that was available through Medicaid. I'm extremely worried. The effects aren't self-contained, and the negative effects would permeate into an already strained system. Medical insurance is unaffordable in this country's economy, and it only gets worse. The Republicans need to vote according to the wants and needs of their constituents and reinstall empathy in their party. Maybe that will resonate and 'trickle down.' We have to limit tax cuts for the wealthiest. And here's a novel idea: Let's go back to a time when employers paid for employees' health care and pensions. Those two items can't be supported by today's salaries. — Karen O'Donnell, Lake Mary, Florida

Business Journals

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3 simple steps for employers to lower health care costs and ensure better employee care

It's no secret that the current health care system is unsustainable. Nearly half of Americans receive health care coverage through their employer and over the past two decades, employer-sponsored health care costs have risen by over 200%. Many businesses can no longer front the costs — and the burden is being shifted onto employees. The result? Health care has become unaffordable for many working Americans — for some employees cost shifting has made engaging care unaffordable and 40% of American adults are struggling with medical debt — a shockingly high number. Despite this astronomical rise in cost, most brokers and benefits consultants haven't changed the solutions they present to clients in decades. In our experience, only about 5-10% of brokers are offering their clients innovative alternatives and even fewer have fully embraced a different approach, leading to poor implementation and support when they do try something new. The reality is that health care operates as an inefficient market. Unlike most industries, higher costs do not necessarily equate to higher quality care — in fact, it can often be the opposite. We believe that by being proactive, transparent and strategic, employers can reverse this trend by reducing costs while ensuring their employees receive top-quality care. However, achieving transformational results demands a completely different approach. The four of us have spent years in this industry and have tailored a unique approach that enables us to achieve superior results. We've seen what works and what doesn't and the ineffective options continually peddled to employers. That's why we've joined forces to help employers to take control of their health care spend and save real money. Our approach We don't believe in a one-size-fits all health plans and we partner with HR leaders to bring their health care strategy to life while directly administering the change. This includes educating employees on what they need to know to make the most of their benefits. When you show people exactly how they can receive better care at a lower price, everyone wins. Our model is built on three pillars: education, pharmacy platform and Medicare Plus. Education: We empower members to navigate the health care system effectively and steer them towards high quality and cost-effective options. Navigating the health care system is hard and we take a hands-on approach, which helps members understand their choices and make informed decisions. This extra effort improves health outcomes while ensuring the best experience possible. According to publicly available data compiled by Image360, CT scans in Tampa, Florida, are typically billed between $4,500 and $9,700. Even after PPO discounts, health plan members and businesses still pay $2,200 to $4,800. The problem is, there's little transparency in pricing and high cost doesn't guarantee high quality. Imagine360 changes that. With Imagine360, the average cost for the same CT scan at the same facility drops to under $200. This translates to significant savings for the employee and the business. Pharmacy platform: Pharmacy spend is the fastest-growing expense when it comes to a health plan. Traditional solutions often lack transparency and instead function as profit centers. We craft innovative solutions to manage pharmacy costs, ensuring that members have access to affordable medications without compromising on quality. Medicare Plus: We provide a thoughtful alternative to conventional PPOs. This model offers robust coverage at significantly lower costs by anchoring reimbursements to fair, Medicare-based rates. The above approach collectively has proven to cut costs by nearly 25% on average. Through this approach, we've reduced the cost of health care so drastically that some clients now offer no-cost health care to all of their employees. At a time when most companies are forcing employees to pay upwards of thousands of dollars per month on health insurance premiums, our clients pick up the full cost of premiums for their employees. This difference is life-changing for many families. By adopting a three-pillar approach to health care benefits, these businesses have become highly sought-after employers in their communities. And it's not just beneficial for employees — it's advantageous for the health plan as well. When health care premiums are overpriced, only the highest utilizers enroll, which makes sense; you would only pay thousands of dollars a month in premiums if you anticipated high health care expenses. However, when coverage is affordable and well-structured, everyone participates, creating a healthier, more predictable and sustainable plan. If this sounds too good to be true, you're not alone. One employer came to us frustrated and skeptical. Every broker had pitched the same traditional solutions, none of which solved their problem. Their chief financial officer knew that if they could not control hospital claims costs, the business would be in trouble. We introduced Medicare Plus pricing as a strategic solution. We helped manage the learning curve for the first few months — but once leadership committed to the solution, the plan started working. Three years in, premiums, deductibles and copays have all dropped. Employees are getting better coverage, and the company has even added new benefits — while most of their peers are cutting back. Using an independent TPA Working with an independent third-party administrator (TPA) opens the door to a different and better playbook. Yes, it takes more work upfront — more education, communication, teamwork — but the payoff is worth it: a more flexible employee benefits solution that can lead to better care, lower costs, and long-term consistency. No more carrier swaps or yearly overhauls. We currently support 25 clients on this platform. With dedicated service teams, personalized enrollment education and long-term strategies, we help employers innovate — without impacting employee satisfaction. The result is a smoother, more positive experience. The road ahead We're all fighting the same fight: pushing back against a system that hides cost, limits choices, wastes money and is driving people to choose little or no coverage due to cost. But it doesn't have to be this way. With a three-pronged approach including employee education, pharmacy and Medicare Plus pricing, we're helping employers take back control of their health care costs. By putting people first and staying committed to value-based solutions, employers and brokers can finally break free from the old playbook — and build something better. McGriff is a Marsh & McLennan Agency LLC Company. Our solutions include commercial property and casualty, corporate bonding and surety, cyber, executive risk, management and professional liability, captives and alternative risk transfer programs, employee benefits, small business and personal lines insurance.