Shaking up salt recs; risks of secondhand marijuana smoke

Q: I’m confused about whether or not it makes sense to reduce salt if you want to protect your heart. Recent reports seem contradictory. Can you explain? — Greg T., Myrtle Beach, South Carolina

A: I think you’re referring to two recent studies on sodium and heart health — one that said cutting sodium is very beneficial for preventing strokes in folks at high risk for stroke and the other that said reducing sodium intake didn’t reduce the risk that heart-related problems would send a person with heart failure to the ER or hospital.

The first study, published in Circulation, reconfirmed that switching to salt substitutes reduces stroke risk by 14% and found that doing so lowers health care costs significantly — for individuals and providers.

The second study, published in the Lancet, found that reducing sodium did improve heart failure patients’ quality of life by reducing symptoms of the disease, such as fluid retention and difficulty moving around and breathing. It also helps lower blood pressure. But it did not produce statistically meaningful differences in cardiovascular-related admissions to hospital, cardiovascular-related emergency department visits and all-cause death. The study target for reduced sodium intake was 1,500 milligrams daily for 12 months — the participants’ median daily intake achieved 1,658 milligrams.

So … if you’re at high risk for stroke — or have high blood pressure — reducing sodium intake is essential. If you have heart failure, discuss your target sodium intake with your doctor. And everyone — with diagnosed heart issues or not — should pay attention to the sodium content of prepared foods. One study found the biggest sodium bombs in sauces and spreads (1,283 milligrams sodium per 3-ounce serving) and processed meats (846 milligrams sodium per 3-ounce serving).

You can make your own salt substitutes using an almost infinite blend of herbs and spices to impart flavor and zip to any dish. Try my favorites: ancho and guajillo chili pepper sauce and harissa spice blend from my “What to Eat When Cookbook.”

Q: They’ve just made marijuana legal in New York, and I’m stunned by how many people I know think nothing of lighting up when other folks are around. I don’t want to inhale their secondhand smoke. What can I tell them to get them to cut it out? — Cheryl K., Hyde Park, New York

A: We have long known that secondhand tobacco smoke is related to more frequent and severe asthma attacks, respiratory infections, ear infections and sudden infant death syndrome, as well as coronary heart disease, stroke and lung cancer. But people who would never smoke cigarettes or be in a room loaded with tobacco smoke often think nothing of filling a room with pot smoke. That needs to change.

Research shows that marijuana smoke is also loaded with several hundred health-damaging toxic chemicals and carcinogens, many at higher concentrations than tobacco smoke. We also know that lab studies show that secondhand exposure can trigger significant endothelial dysfunction (arteries don’t dilate properly) for a longer time than tobacco does.

Now researchers have published a study in JAMA Open Network that measured fine particulate matter (PM2.5) levels in the home from social bong smoking. They found that a room’s pollution level increased 100-fold to 1,000-fold in three-quarters of the smoking sessions that were monitored.

Particulate air pollution is well recognized as a direct cause of cardiovascular disease and death, at least 11 types of cancer and dementia.

My thoughts … we need more data, but when I add this cannabis study’s info to the study findings we talked about a couple weeks ago on medical marijuana’s risk for cannabis use disorder and its lack of effect in treating pain, I worry that a lot of harm can come from today’s unbridled advocacy of smoking marijuana for medical benefit or stress relief. If you feel it helps you, go for gummies and spare those around you (and yourself) from the cardiac, cancer and dementia risks from high levels of PM 2.5 particulates in marijuana smoke.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@greatagereboot. com.