Heart Health Booby Traps

Well-intentioned health practices can inadvertently lead us down the path of booby - traps - unexpected pitfalls in health that impair health, rather than enhance it.

I encounter these health booby traps every day in my experiences with patients. Let me list some of the most common.

Reduce salt

Public health messages urge us to reduce salt and sodium in our diet, since overuse of salt increases blood pressure, causes fluid retention, and can accelerate osteoporosis.

Curiously, for the first half of the 20^th century, the public health message was to increase salt usage. Why? Because public health officials recognized that goiters (enlarged thyroid glands from iodine deficiency) were rampant, affecting nearly a third of the population, resulting in fatigue, weight gain, poor mental performance in schoolchildren, and even mental retardation. In 1924, the FDA introduced a program of salt iodization as a solution to deliver iodine through a commonly used food vehicle, table salt. And it worked: goiter essentially disappeared, the extremes of thyroid dysfunction with it.

In 2009, the public health message has changed to reduce salt and sodium - but what happened to the iodine? No surprise, iodine deficiency is increasing, with 11.3% of the U.S. population now severely deficient (National Health And Nutrition Examination Survey, 2003-2004), a quadrupling since the 1970s. Goiters are now coming back, along with an increase in thyroid disease.

Avoid tap water

Many Americans, leery of the quality of their city tap water due to fear over pesticide contamination, the presence of chlorine or fluoride, organisms like Cryptosporidium, or simple bad taste or smell (e.g., sulfur), have turned to bottled water in some form. Some have resorted to the single use bottles purchased in bulk quantities, while others use large containers of bottled water purchased or delivered to the home or workplace.

Bottled water packs a three-punch hit to our health: 1) Bottled water has been found to be commonly contaminated with organic chemicals (Environmental Working Group, 2008); 2) Much bottled water is filtered or distilled, meaning minerals have been removed, especially magnesium, an essential mineral that is increasingly deficient in Americans; and 3) plastic water bottles, especially the large ones used for water coolers, are frequently made with polycarbonate, the plastic that leaches out bisphenol A (BPA), shown to be associated with increased likelihood of heart attack, diabetes, abnormal liver tests, and disruption of thyroid function. 

Avoid sun

Dermatologists advise us to avoid sun. Some say avoid it altogether, while others say just avoid the midday sun when it is at its most intense. They say that exposure to the ultraviolet radiation increases risk of skin cancers, including melanoma. They advise use of sunscreens if you are out in the sun.

But this is surely a case of well-intended advice backfiring. While there might be a reduction in the incidence of some skin cancers (like the relatively benign squamous cell carcinoma, which rarely spreads or causes death), sun avoidance causes (or, more likely, worsens) vitamin D deficiency. Anyone who has been following the fascinating vitamin D discussion knows that deficiency leads to heightened risk for colon, breast, and prostate cancers; osteoporosis and arthritis; higher blood sugars and diabetes; higher risk for heart attack; greater risk for multiple sclerosis; winter "blues" and depression; and inflammatory diseases.