Over the last half century, there has been an evolving understanding of dietary science and the role of nutrition in the development of chronic diseases. However, poor health advice from non-experts, often fueled by social media, has led to the rapid growth of misinformation. To combat this epidemic of health misinformation, it is helpful to refocus on the basics: what to eat and drink. Niloofar Nobakht, MD, and Mohammad Kamgar, MD, talk about current nutrition trends and their implications for many chronic illnesses, including ones they see in their practice as UCLA Health nephrologists.
What are the public-health implications of prevalent poor nutrition? Dr. Nobakht: It is very concerning. The potential exists for increasing lifestyle-related illnesses like hypertension and diabetes to eventually overburden the U.S. health care system. Although nutritional intake in the United States has improved in recent years, the general population is still largely falling short of recommended nutritional guidelines. Notably, people do not consume enough vegetables, whole grains and fatty acids, and they eat too many empty calories and salty meals.
Why is too much salt dangerous? Dr. Nobakht: Sodium and potassium exist in a variety of foods, and their imbalance can lead to adverse effects on major organs, such as the brain, eyes, heart and kidneys. Sodium and potassium assist with fluid and blood-volume maintenance and, therefore, impact blood pressure in contrasting ways: excess sodium and low potassium intake can increase blood pressure. Consumption of more than 2 grams of sodium per day has been strongly associated with mortality due to hypertension and cardiovascular conditions. Globally, more than 88% of adults exceed the recommended daily intake of 2 grams of sodium by at least 1 gram.
Dr. Kamgar: Sources of excess dietary sodium can be surprising. Beyond the expected culprits of processed foods and prepackaged meals, which can be part of weight-loss-plan packages, there is hidden salt in store-bought bread, chicken, cheese and restaurant-cooked meals. Given the inextricable link between dietary sodium and the development of chronic illness, such as heart and kidney disease, hypertension and stroke, switching to lower-salt meals can assist with reaching and maintaining normal blood pressure and decreasing morbidity and mortality.
Dr. Nobakht: For healthy individuals with normal kidney function, a diet abundant in potassium is optimal. Due to its role in reducing blood pressure, potassium is an essential electrolyte for promoting cardiovascular health and preventing organ damage. Diets high in potassium also are linked to a reduction in risk for stroke.
How important is adequate water intake? Dr. Kamgar: Water intake and hydration, together with a proper diet, play a very important role in wellness. The adequate amount of water to drink daily can vary depending on age, gender, activity level and preexisting conditions. General guidelines recommend t hat hea lt hy adult men consume about 13 cups of water and adult women about 9 cups of water per day. Minimize daily consumption of sugar-laden drinks and alcohol to two drinks or less for men or one drink or less for women.
Is there an optimal nutrition practice to improve health? Dr. Nobakht: Even simple lifestyle strategies can help prevent chronic illnesses and promote overall wellness. We recommend what is known as the DASH — Dietary Approaches to Stop Hypertension — diet, which supports long-term lifestyle changes with lower-salt, lower-sugar and lower-fat meals. It encourages followers to eat more nutrient-dense foods, particularly those high in fiber, protein and mineral nutrients such as potassium, calcium and magnesium — whole grains and vegetables and dense foods, such as nuts, legumes, lean proteins, fish and low-fat dairy products.
Dr. Kamgar: The DASH diet can improve overall health and wellness, regardless of pre-existing conditions or risk level for chronic diseases. Studies have found that adherence to the DASH diet not only lowers blood pressure, but also can lead to healthy weight loss, improve insulin metabolism, reduce inflammatory markers and reduce triglycerides.