Why Do Plant-Based Diets Help Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic systemic autoimmune disease affecting millions, characterized by persistent pain and stiffness, and progressive joint destruction—particularly in the hands and feet, leading to crippling deformities. What can we do to prevent it and treat it?

In a famous 13-month long randomized controlled trial of plant-based diets for rheumatoid arthritis, patients were put on a vegan diet for three and a half months, and then switched to an egg-free lactovegetarian diet for the remainder of the study. Compared to the control group, who didn’t change their diet at all, the plant-based group had a significant improvement in morning stiffness within the first month, cutting the number of hours they suffered from joint stiffness in half. Pain dropped from five out of ten down to less than three out of ten. A drop in disability; they reported subjectively feeling better, significant improvement in their grip strength, fewer tender joints, less tenderness per joint, and less swelling, with the added benefit of losing about 13 pounds and keeping most of that weight off throughout the year. They also had a drop in inflammatory markers in their blood, sed rate, C-reactive protein, and white count. The question is why. What does diet have to do with inflammatory joint disease?

Well, rheumatoid arthritis is an autoimmune disease in which your body attacks the lining of your own joints. Why would it do that? Well, there’s a different autoimmune disease called rheumatic fever, in which your body attacks your own heart. Again, why would your body do that? It appears to be a matter of friendly fire.

Rheumatic fever is caused by strep throat, which is caused by a bacteria that has a protein that looks an awful lot like a protein in our heart. So when our immune system attacks the strep bacteria, it also attacks our heart valves, triggering an autoimmune attack by “molecular mimicry.” The protein on the strep bacteria is mimicking a protein in our heart, so our body gets confused and attacks both. That’s why it’s critical to treat strep throat early to prevent our heart from getting caught in the crossfire.

So researchers thought maybe rheumatoid arthritis might be triggered by an infection as well. A clue to where to start looking was the fact that women seem to get rheumatoid arthritis three times more frequently than men. What type of infection do women get more than men? Urinary tract infections, so researchers started testing the urine of rheumatoid arthritis sufferers, and lo and behold found this bacteria called Proteus mirabilis. Not enough to cause symptoms of a UTI, but enough to trigger an immune response. And indeed, there’s a molecule in the bacteria that looks an awful lot like one of our own molecules in our joints, so anti-Proteus antibodies against the bacteria may inadvertently damage our own joint tissues, leading eventually to the joint destruction. Therefore, therapeutic interventions aimed at the removal of this bacteria from the bodies of patients, with consequent reduction of antibodies against the organism, should lead to a decrease in inflammation.

Well, as we saw before, urinary tract infections originate from the fecal flora; the bugs crawl up from the rectum into the bladder. And so, how might one change the bugs in one’s colon? By changing our diet. Some of the first studies over 20 years ago on trying to fundamentally shift people’s gut flora were done using raw vegan diets, figuring that’s about as fundamental a shift from the standard Western diet as there is. And indeed, within days one could significantly change someone’s gut flora. And you put rheumatoid arthritis sufferers on that kind of diet, and they experienced relief, and the greater improvements were linked to greater changes in their gut flora. But the diet was considered so intolerable that half the patients couldn’t take it and dropped out–perhaps because they were trying to feed people things like buckwheat-beetroot cutlets buttered with a spread made out of almonds and fermented cucumber juice.

Thankfully, regular vegetarian and vegan diets work too, changing the intestinal flora and improving rheumatoid arthritis, but we didn’t specifically have confirmation that plant-based diets brought down anti-Proteus antibodies, until now. Those who responded to the plant-based diet showed a significant drop in anti-Proteus mirabilis antibodies compared to the control group. Maybe it just dropped immune responses across the board? No, antibody levels against other bugs remained the same, so the assumption is that the veg diet reduced urinary or gut levels of the bug.

A shift from an omnivorous to a vegetarian diet has a profound influence on the composition of the urine–for example, higher levels of lignans in the urine of those eating vegetarian. Up until now, it was just thought that lignans protected people eating more plant-based from getting cancer, but now we know lignans can also have antimicrobial properties as well, so may be helping to clear Proteus from the system. Either way, this suggests a new type of therapy for the management of rheumatoid arthritis. This new treatment includes anti-Proteus measures such as dietary manipulations in the forms of vegetarian diet.

Source:https://nutritionfacts.org/video/why-do-plant-based-diets-help-rheumatoid-arthritis/

How Researchers Are Implementing Food To Treat Depression And Other Chronic Diseases

Ah, comfort food. Who doesn’t have a love/hate relationship with it? For me on a bad day, I find myself craving the perfect storm of fries, pizza, and ice cream. What I don’t realize as I’m dipping my fry into my ice cream is that I might experience an emotional low afterward that’s even worse than how I felt at the beginning. Actually, I’ve noticed that when I have fresh fruits and vegetables, I’m much more vibrant and happy and ready to accomplish the tasks throughout my day.

 That brings up the question: Can the food we eat have a drastic impact on our emotional health? More specifically, can a plant-based, vegan diet reverse symptoms of depression and improve emotional health?

There have been many studies done regarding the influence of diet on emotional health. For example, in January 2017, an issue of the medical journal BioMed Central (BMC) Medicine reported that a team of researchers led by Felice Jacka, an epidemiologist at Deakin University in Australia, studied the effect that diet had on the moods of individuals with major depression. The study had two groups: the initial group received counseling from a dietician and the second group received counseling from a positive social support caregiver.

The results indicated that those who ate a healthy diet were emotionally happier than those who received social support. Also shown was that an unhealthy diet high in processed and refined foods increased the risk for not only depression but other diseases as well. There have been many other studies revolving around this topic that support this research.

Nutritional psychiatry

“Nutritional psychiatry” is a recent development in the medical world, but it’s a rapidly growing research field. Understanding the effects that diet has on mental health is incredibly important – especially now – because there are so many chronic diseases that have become more prevalent because of the highly processed foods consumed by society.

Dr. Jacka is the co-founder of the International Society for Nutritional Psychiatry Research that aims to expand the field by using a multi-disciplinary approach to research connecting emotional and physical health on a new level. The Food and Mood Center was created by Dr. Jacka as a center for studies on how diet influences mental health. Because of the new studies that have been addressed, the American Psychiatric Association has begun to include presentations on nutritional psychiatry at their annual conferences.

Even though diet isn’t the only factor influencing mental health, researchers have found another way to prevent and treat depression. What is it? You guessed it, eating a plant-based diet. A plant-based diet doesn’t only promote good physical health, but it also shows promise in promoting emotional health and well-being. I think we can safely say that fruits and veggies should be the “happy food” to turn to when we’re having a bad day.

Here’s a recipe for a fruit smoothie from Nutriliving that is packed with fresh nutrition and will give you a bright boost to your day. Have a happy and healthy day!

Mood-Boosting Breakfast Blast 

Ingredients

  • ¼ cup blueberries
  • 1 banana
  • 5 walnuts
  • ½ cup oats
  • 1 ½ cups unsweetened almond milk

Instructions

  • Add all ingredients to your blender and blend for 30 seconds, or until smooth.
  • Enjoy!

By Raeann Leal

https://lifeandhealth.org/lifestyle/how-researchers-are-implementing-food-to-treat-depression-and-other-chronic-diseases/1010154.html

Source:

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y?mod=article_inline

High Blood Pressure: The ‘Silent Killer’


I learned about high blood pressure, which is also called hypertension, at a surprisingly early age. My grandmother has had high blood pressure for as long as I can remember. I remember asking my parents about it at a young age, but I never really understood what it was. I grew up with two misconceptions. First, I believed that high blood pressure didn’t seem that bad. Despite my parent’s concerns, it didn’t seem like my grandma’s blood pressure was affecting her much. She was thin, active, mentally sharp, and had a bubbly personality. Second, I had the impression that you couldn’t really do anything to get rid of high blood pressure. I knew that grandma took medicine for it, but the medicine didn’t seem to do anything. If it was really working, why were my parents still discussing it? As I grew up, I kept these (false) thoughts about hypertension with me. It just didn’t seem important. I’m sure my experience is not unique. Many of us still hold on to misconceptions about health stemming from misunderstandings and simply being misinformed. Today, let’s do our part to correct this.

The Truth about High Blood Pressure

High blood pressure is known as the ‘silent killer’. It can cause damage to the body in many ways. High blood pressure increases the risk of heart attack, stroke, aneurism, and kidney failure. If left uncontrolled, it can even cause blindness or heart failure. In the United States, the Centers for Disease Control (CDC) reports that nearly 400,000 deaths are attributed to hypertension each year.

Worldwide, over thirty percent of adults have high blood pressure. The proportion of the population affected increases with age. This means older generations are affected particularly harshly. Once someone enters their 50s, they have about a 50% chance of having high blood pressure. Perhaps the saddest thing about this is that awareness is lacking. About half of the people who have high blood pressure don’t know that they have it. It truly is a silent killer.

That was the bad news, but don’t stop reading yet. There’s good news as well…great news actually. Hypertension is not only treatable, but it is preventable—and that’s not all. This can be accomplished through natural means. You don’t need to rely on drugs or expensive treatments; simple lifestyle changes can have substantial effects.

Here is a list of some things you can do:

Reduce your salt intake. Salt is the major source of sodium in our diets. (Remember, salt is called ‘sodium chloride’.) High sodium intakes are known to raise the blood pressure. By reducing your intake of salt, your blood pressure levels can start to drop after only a matter of days.

Right now, the average American is consuming about 3,400 mg of sodium per day. This is far more than we need. The CDC recommends that adults should consume no more than 2,300 mg a day. However, that recommendation drops to 1,500 if you are over the age of 50, are African American, or have high blood pressure, diabetes, or chronic kidney disease (combined, these groups constitute 50% of the adults in the United States).

Reducing your salt intake is not as hard as most people think. In fact, I can give you one tip that, if followed, will drastically reduce your salt intake: stop eating processed foods. Processed foods, including a majority of meals served at restaurants, are sodium bombs—there is just no other way to describe it. A landmark study on the sources of sodium in the diet found that processed foods contributed to 77% of Americans’ daily sodium intake.

Avoiding processed foods is by far the most important thing you can do to lower your sodium intake. If you do eat something that’s processed, be sure to read the nutrition label carefully. Also, be aware that salt goes by many different names including: monosodium glutamate (MSG), disodium phosphate, baking soda, and a host of other names that begin with ‘sodium’ (e.g. sodium citrate).

Eat a balanced diet. One of the best things you could do to lower your blood pressure is eat a balanced diet, full of fresh fruits and vegetables. Besides lowering your salt intake, diets like this will keep your fat and cholesterol intakes low. Over time, fat (especially saturated fats and trans fats) and cholesterol will clog your arteries and raise your blood pressure.

Studies have shown that minerals such as potassium and magnesium help to lower blood pressure. What foods are high in potassium and magnesium? You guessed it; fruits and vegetables are great sources. In addition to this, eat whole grains instead of refined products. And you know what? Eating a handful of nuts every day will help too.

Be physically active. Exercise is an important factor in lowering blood pressure. You don’t need to sweat hours away at the gym or have impressive athletic ability. Simply go for a walk or light jog during your lunch break or after work. You’ll have time to contemplate your day or talk with family or friends. Incidentally, exercise (as well as diet) will help you lose weight or maintain a healthy weight, which is another factor in lowering blood pressure.

Also remember that even minor changes in our daily routines can have measurable results. Make choices that encourage you to move. Take the stairs instead of waiting for the elevator. Choose a parking space that is far away from the store. (The walking won’t take you any longer than driving around looking for that perfect space anyway). Or simply walk over to a coworker instead of emailing them or shouting across the room.

Avoid alcohol and tobacco. Tobacco products are known to raise blood pressure in two ways. First, tobacco causes a temporary raise in blood pressure after using it. After a while, the blood pressure will drop again. However, because tobacco use is almost always habitual, it’s not likely to stay down for long. Secondly, tobacco also contains chemicals that damage the lining of your arteries. This damage can cause the arteries to narrow, which is another cause of high blood pressure. The CDC offers succinct advice to people seeking to ‘take control’ of their blood pressure: “If you smoke, quit as soon as possible.”

Alcohol is another substance that should be avoided. If you are seeking to lower your blood pressure, many health organizations, (including the WHO and the Mayo Clinic,) advise you to abstain from drinking. Over time, drinking too much has the potential to damage your heart (not to mention your liver). For women of any age, just one drink a day is enough to raise blood pressure levels.  Besides this, alcohol has a high caloric content and can contribute to weight gain. As we mentioned earlier, this is another risk factor for high blood pressure.

Manage your stress. Have you ever been so stressed that you felt your head was going to explode? I recently fiddled around with my cell phone software and almost lost several years of data. Boy was that a high-stress experience. I can testify that I could really feel the pressure building up inside. I guess we shouldn’t be surprised that high stress levels can raise the blood pressure quite dramatically. Although the increase is only temporary, for individuals who lead stressful lifestyles, this is cause for concern. Further complicating the problem is the fact than many people manage stress by comfort eating, smoking, or drinking. As discussed above, these things may only serve to raise the blood pressure even further.

The Results

This year, the World Health Organization is focusing on raising awareness about hypertension. What’s really cool is that they are advocating lifestyle changes, similar to those we detailed above. Why? Because pursuing a healthy lifestyle is the real solution to the problem (not only for high blood pressure, but for heart disease, diabetes, and cancer). Think about it, do we really want to put 1/3 of the world’s population on medication for their high blood pressure when it can be treated and prevented naturally? In addition, this is something that anyone can do regardless of nationality or socio-economic standing. Now, that’s great news!

If you’re looking for more information on reversing hypertension naturally, be sure to check out this excellent resource: Reversing Hypertension Naturally, with Dr. David DeRose.

[1] “CDC Data & Statistics | Feature: Americans Consume Too Much Sodium (Salt).”[2] “CDC – Salt Home – DHDSP.”[3] Mattes, R. D., and D. Donnelly. “Relative Contributions of Dietary Sodium Sources.” Journal of the American College of Nutrition 10, no. 4 (August 1, 1991): 383–393.[4] “CDC – High Blood Pressure Facts – DHDSP.”[5] Sheps, Sheldon G. “Does Drinking Alcohol Affect Your Blood Pressure?” Mayo Clinic.

by Jonathan Ewald

https://lifeandhealth.org/nutrition/high-blood-pressure-the-silent-killer/23292.html  

Top 5 Foods That Help You Fight Coronavirus

corona_virus

Despite our best efforts, we may not be able to prevent getting the novel (new) SARS coronavirus that leads to COVID-19. The good news is, it’s a lot like the common flu and for most healthy people, recovery is quick and it’s not a big deal.  The bad news is, it spreads easily, it has at least 10 times the mortality rate of the regular flu, and we don’t have a vaccine yet.

So, if you are immunocompromised, older, working with the sick, or just interested in boosting your immune system, you might be interested to know about a study back in 2005 that found that the presence of nitric oxide significantly inhibited the replication cycle of SARS coronavirus. In other words, nitric oxide disrupts the virus’ ability to grow.

What Is Nitric Oxide?

Nitric oxide is used by the body for cell signaling, blood vessel dilation to promote better blood flow and there’s evidence that it helps lower blood pressure and improve brain function. How can we get more nitric oxide? We can boost our nitric oxide simply by the foods we eat.

Top 5 Nitric Oxide Sources

Here are the top 5 sources of plant-based nitric oxide, so you can better defend against coronavirus if it ever enters your body. Why wait for a man-made vaccine when we can have, as Hippocrates put it, “food be [our] medicine.”

  1. Beetroot Juice – Beets are the king of raising nitric oxide levels. Beets have a lot of nitrates, which the body converts to nitric oxide. According to one study, consuming a beetroot juice supplement raised nitric oxide levels in the subjects by 21% in 45 minutes. Another study showed drinking just 3.4 ounces of beetroot juice every day significantly raised nitric oxide levels in men and women. 3.4 ounces is about what TSA lets you take on the plane for carry-on liquids so it’s definitely not much.
  2. Garlic – Maybe this is why people have taken garlic for colds for centuries. Garlic boosts levels of nitric oxide by activating nitric oxide synthase, the enzyme involved in the conversion of nitric oxide from the amino acid L-arginine. So if you’re taking arginine supplements, garlic will help turn more of it into nitric oxide. One study showed that aged garlic extract temporarily increased blood nitric oxide levels by up to 40% within an hour and another study found that aged garlic extract also helped maximize nitric oxide absorption by the body.
  3. Leafy Greens – Green leafy vegetables like kale, broccoli, cabbage, spinach, arugula, and celery are packed with nitrates, which are converted to nitric oxide in your body. One study found that regularly eating green leafy vegetables was associated with healthy levels of nitric oxide in the body so this is the single best way to keep elevated levels of nitric oxide in your body. Time to start eating more salads!
  4. Citrus Fruits – Or anything high in vitamin C. But of course oranges, lemons, limes and grapefruit are all excellent sources of vitamin C. Vitamin C plays a critical role in health and raises levels of nitric oxide by increasing its bioavailability and maximizing absorption. Research also shows that it may increase levels of nitric oxide synthase, the enzyme necessary for the production of nitric oxide.
  5. Nuts and Seeds – Almonds, cashews, walnuts, chia seed, flax seed, pumpkin seed, and sunflower seeds have a lot of arginine, a type of amino acid that assists in the production of nitric oxide. Research suggests that getting arginine from foods like nuts and seeds in your diet can help increase nitric oxide levels in your body. For example, a large study involving 2,771 people showed that a higher intake of arginine-rich foods was associated with higher levels of nitric oxide in the blood. Another study found that supplementing with arginine increased levels of nitric oxide after just two weeks.

Now here’s our natural drug disclaimer (just like the one’s on TV). Warning: Eating more of the foods listed in our Top 5 Foods to Fight Coronavirus is not only going to help with coronavirus, but elevated nitric oxide levels may lower your blood pressure, improve circulation, and improve mental cognition.

Effects of weight-control on Typ 2 Diabetes

 

 

 

 

 

 

 

Diabetes Type 2 is a common and widespread disease and it is clearly related to overweight and obesity. The clinical manifestation of diabetes is also related to age. While only 2-3% of people under the age of 50 are afflicted, the prevalence of diabetes is rising continually with the progress of age. At an age of over 70 years, almost 20% are afflicted. So if we speak of a typical Person with diabetes, we think of an elderly person with long-time overweight. But in the last decades also younger people showed an increasing prevalence of diabetes. This may be due to an incline of obesity in our society and due to altered eating habits and less activity today.

While patients with diabetes often suffer under symptoms like chronic fatigue, polyuria and an increase of their thirst, diabetes itself can lead to other secondary illnesses in the long run. It weakens the immune-systems and makes the afflicted person more susceptible for systemic and local infections. It reduces the body’s capacity of healing, so that often time’s chronic wounds are prevalent. Furthermore Diabetes multiplies the risk of developing severe illnesses like stroke, heart-attack, kidney-failure and blindness.

This makes clear how essential it is, to treat the disease well and prevent further damage to the body. While older people often are treated with pills and if necessary also with insulin, especially younger people should be encouraged to change their lifestyle which can improve and in some cases even reverse their diabetes.

A recent study in England addressed the question, to what extend the loosing of weight can influence the diabetes. For this study they recruited 149 people at an age between 20 and 65 and a Body-Mass-Index between 27 and 45 that were diagnosed with non – Insulin – dependent Diabetes in the last 6 years. They gave them a special Formula-low-calorie-Diet which helped them to loose weight. Afterwards they got support in not gaining weight again. The participants of the study got no Diabetes-Medication at all. The results are astonishing: After 1 year 7% of 89 Persons that lost 0-5 kg decreased their diabetes, but already 34% of 56 Persons that had lost 5-10 kg completely reversed their diabetes! 28 people that lost 10-15 kg, 57% of them reversed their diabetes and with the 36 people that lost over 15 kg even 86% of them diabetes was completely reversed. The interesting thing was, that these effects were the same no matter how high the starting-level of obesity was. For example a person that lost from 130 to 115 kg had the same positive effects like a person that lost from 110 to 95 kg.

Altogether almost half of the participants of the study did not only reverse their diabetes, they also felt much better and gained more quality in life.  These results are really encouraging and they shall activate us to motivate Patients in their efforts to adapt to a healthy lifestyle. We should support them in losing weight which by itself can lead to an improvement or even a reverse of diabetes. It will make them feel much better and prevent the emergency of secondary diseases. All together it is the healthiest, cheapest and most natural medication we can offer. Patients should be taught that it is worth it to take responsibility for your life and become active.

 

Source: Lean MEJ, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet Diabetes Endocrinol 2019;7:344–55.

 

Blueberry Oatmeal Pancakes

Instructions

  1. Make the flax egg by mixing the ground flax with 6 tablespoons of water and letting it sit for 10 minutes. The consistency should resemble that of an egg.
  2. In a bowl, mix together the oats, milk, flax eggs, and oil. In a small separate bowl, mix the flour, baking soda, baking powder, sugar, and salt. Then combine both mixtures and stir, adding more milk if necessary for your desired consistency.
  3. Lightly grease a hot skillet or pan with additional oil. Pour ½-cup pancake rounds on the skillet and cook until bubbles form on the surface.
  4. Carefully drop 6–8 optional blueberries onto one side of each pancake, then flip and cook on the other side until golden brown.

Prep Time: approx. 30-40 minutes
Serving Size: 6 pancakes

by Daniel Velez

Source: https://lifeandhealth.org/food/blueberry-oatmeal-pancakes/171229.html

How to Lower Your Sodium Intake

Reduction of salt consumption by just 15 percent could save the lives of millions. If we cut our salt intake by half a teaspoon a day, which is achievable simply by avoiding salty foods and not adding salt to our food, we might prevent 22 percent of stroke deaths and 16 percent of fatal heart attacks—potentially helping more than if we were able to successfully treat people with blood pressure pills. As I discuss in my video Salt of the Earth: Sodium and Plant-Based Diets, an intervention in our kitchens may be more powerful than interventions in our pharmacies. One little dietary tweak could help more than billions of dollars worth of drugs.

What would that mean in the United States? Tens of thousands of lives saved every year. On a public-health scale, this simple step “could be as beneficial as interventions aimed at smoking cessation, weight reduction, and the use of drug therapy for people with hypertension or hypercholesterolemia,” that is, giving people medications to lower blood pressure and cholesterol. And, that’s not even getting people down to the target.

A study I profile in my video shows 3.8 grams per day as the recommended upper limit of salt intake for African-Americans, those with hypertension, and adults over 40. For all other adults the maximum is 5.8 daily grams, an upper limit that is exceeded by most Americans over the age of 3. Processed foods have so much added salt that even if we avoid the saltiest foods and don’t add our own salt, salt levels would go down yet still exceed the recommended upper limit. Even that change, however, might save up to nearly a hundred thousand American lives every year.

“Given that approximately 75% of dietary salt comes from processed foods, the individual approach is probably impractical.” So what is our best course of action? We need to get food companies to stop killing so many people. The good news is “several U.S. manufacturers are reducing the salt content of certain foods,” but the bad news is that “other manufacturers are increasing the salt levels in their products. For example, the addition of salt to poultry, meats, and fish appears to be occurring on a massive scale.”

The number-one source of sodium for kids and teens is pizza and, for adults over 51, bread. Between the ages of 20 and 50, however, the greatest contribution of sodium to the diet is not canned soups, pretzels, or potato chips, but chicken, due to all the salt and other additives that are injected into the meat.

This is one of the reasons that, in general, animal foods contain higher amounts of sodium than plant foods. Given the sources of sodium, complying with recommendations for salt reduction would in part “require large deviations from current eating behaviors.” More specifically, we’re talking about a sharp increase in vegetables, fruits, beans, and whole grains, and lower intakes of meats and refined grain products. Indeed, “[a]s might be expected, reducing the allowed amount of sodium led to a precipitous drop” in meat consumption for men and women of all ages. It’s no wonder why there’s so much industry pressure to confuse people about sodium.

The U.S. Dietary Guidelines recommend getting under 2,300 milligrams of sodium a day, while the American Heart Association recommends no more than 1,500 mg/day. How do vegetarians do compared with nonvegetarians? Well, nonvegetarians get nearly 3,500 mg/day, the equivalent of about a teaspoon and a half of table salt. Vegetarians did better, but, at around 3,000 mg/day, came in at double the American Heart Association limit.

In Europe, it looks like vegetarians do even better, slipping under the U.S. Dietary Guidelines’ 2,300 mg cut-off, but it appears the only dietary group that nails the American Heart Association recommendation are vegans—that is, those eating the most plant-based of diets.

Written By Michael Greger M.D. FACLM

Source: https://nutritionfacts.org/2019/11/19/how-to-lower-your-sodium-intake/