There are three or four nutritional requirements for each nutrient, essential and non-essential

The US government’s single nutrient requirement for each essential nutrient, with no more variation in the recommended amount other than by age, sex, and body size, and their mistaken idea that all non-essential nutrients have no nutritional requirements (amount required = 0 for all of them) for the maintenance of good health is too narrowly conceived, if not downright erroneous.

Example vitamin C. There are at least three separate nutritional requirements.

Requirement No 1 – the minimum requirement, the amount necessary to avoid scurvy. Roughly 10 mg per day.

Requirement No. 2 – the RDA, about 100 mg per day, the amount required to support basic immune and antioxidant functions, and enough to maintain bodily pools at these levels.

Requirement No. 3 – the optimal amount, approximately the amount the body is trying to absorb, which depends on conditions, more when we are sick (colds and flus), and much more when we are very sick (cancer cachexia). This is the amount needed to keep the body’s mucus flowing smoothly, by thinning the body’s entire lining of mucus, and is grams per day. It will not prevent a cold, but if you get a cold, you will find considerably more relief from about 3-6 grams a day, as per Requirement No. 3, than from the 100 mg of Requirement No. 2.

Similarly for all other nutrients, both non-essential and essential. If the body makes specific receptors for any nutrient, it is important to health, even if the body already makes a make-do amount. Some adverse consequence, perhaps psychiatric (who notices these, given that moderns are rather crazy to begin with?), perhaps only distantly related to the shortfall, will ensue, if one does not give the body what it is looking for, and that includes cholesterol and non-essential fats.

At least three levels, with the optimal level often close to what the body is trying to absorb. An obvious exception: the body is trying to absorb considerably more of certain nutrients like Na+, Cl-, and I-, and the explanation may be in the deep evolutionary past. We must give the body at least the first level of these nutrients, although the body will clearly take up to at least the third level of these nutrients.

Similarly for iodine/iodide. While the US RDA of 150 micrograms of iodide is generally enough to keep the thyroid gland functioning properly, it is not enough for breast health, and probably not enough to meet the requirements for brain health and oral health. The body is trying to absorb milligrams of Iodide, and that is nearer the optimum amount. Some experiments of Dr. Guy Abraham suggest that the body will readily absorb nearly 50 mg of an iodide/iodine mixture (since about 45 mg per day is excreted in a 24 hour urine), even when its thyroid is well-supplied with iodide.

As noted above: with NaCl, the body goes after iodide with abandon. No doubt the system evolved under stresses of rather severed deprivation, and this aggressiveness in the absorption of these nutrients is not really necessary when there is such abundance available to us that we have to be sensible in the amount of Na+, Cl-, and I- we give to our bodies.

When 150 micrograms of iodide a day is not enough for thyroid: when a person is overdosed with goitrogens, like F, Br, SCN, ClO4. For example, some people consume so much bromated white flour products that they have to be dosed with milligrams of iodide a day to compete with Br- for uptake at the sodium iodide symporter and to compete with Br- for oxidation by thyroid peroxidase in the thyroid follicle lumen, along with about 10 grams of NaCl per diem to drive the excess Br- into the urine, as in the protocol of Dr. Guy Abraham. He also uses 3 grams of vitamin C a day to help prevent oxidation of the halide binding site in the sodium iodide symporter (more of a problem when F- and ClO4- are also present at levels that interfere with normal thyroid function).

 

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A brighter future requires brighter gatekeepers

Innovators are often small fry. Sometimes they do not even have college degrees, but they can see how to make things better, while layer upon layer of management does not.

As a rule, gatekeepers are neither innovative nor bright. They will not fund a novel idea unless their boss somehow likes it, and bosses of gatekeepers were once gatekeepers themselves, equally or perhaps more uninspiring., and some of them were promoted in part because of their tight-fisted control of the budget.

Gatekeepers tend to be clueless. That is why we have hundreds of such follies as the ubiquitous foxes guarding henhouses, superfund cleanup sites, speed bumps, audible car alarms, squeezable mayonnaise, brominated flour, 100% locally grown produce, choline-is-not-an-essential-nutrient-until-1998, and dietary-cholesterol-is-still-a-toxin. Gatekeepers cannot see the follies that we innovators immediately detect. We are bright sparks; they are not.

Until innovators hold the purse strings, the future of the world remains dim at best.

If you are a CEO and an intelligent risk taker, try giving a few purse strings to innovators or former innovators rather than to toady gatekeepers.

Nature plays with fire

Imagine a nutrient so vital that nature keeps its concentration near its saturation limit. Imagine further that when this nutrient massively precipitates in the kidneys (as during an episode of tumor lysis syndrome, when tumor cells are killed too rapidly and release massive amounts of uric acid from the breakdown of nucleic acids), it can actually kill a person. Doctors of course will treat this vital nutrient as a toxin.

As a rule, doctors think of the marvelous machine, the human body, as a right idiot. As a rule, doctors misunderstand everything they study.

When nature plays with fire, pay attention – the fire is so important as to be vital to health. We have to be proper stewards of our bodies. We have to give our bodies what they need and not a whole lot else.

The fire is not a toxin, and many factoids will tell you that this fire is not a toxin, if you do not filter them out of your interpretation, the ways doctors routinely do, whenever matters get a bit too intricate for them.

Synovial fluid is an ultrafiltrate of plasma. Its normal concentration of uric acid is roughly the same as plasma, nearly twice that in whole blood.

The normal concentration of uric acid in the synovial fluid of the average man is close to the saturation limit of uric acid in pure water at 25 degrees C. The solubility limits are not the same. Synovial fluid is not water, and biological tissues, even extremities like big toes, do not normally reach down to 25 degrees.

And even when saturation has been reached, crystallization does not necessarily and immediately occur. Often agitation is required to crystallize a supersaturated mixture. The stubbing of a big toe may be just the thing to trigger it.

When a toe is wounded, as part of the healing process, the marvelous machine acidifies the site of the wound, increasing the odds of precipitation of the uric acid as sodium urate.

Keeping external wounds properly acidified to aid healing and to keep infection risk as low as possible is something doctors pay too little attention to. Take a lesson from the marvelous machine, doctors! Ascorbic acid and citric acid are two acids I would try to apply repeatedly to every external wound during the healing process.

An infection in or near synovial fluid that produces acid could trigger precipitation, as could a non-acid producing infection that produces a sufficiently acidic response in the host. When the cells that line the synovial joint are injured or actually die, they release uric acid. This could be part of the trigger mechanism for precipitation of uric acid crystals in synovial fluid.

Whatever explains a particular case of gouty arthritis, one focuses on the site of occurrence. One does not treat circulating uric acid as a toxin, when kidney reabsorption alone says otherwise, and one does not refer solely to systemic events to explain local occurrences. Local occurrences occur because local conditions are in some way different from systemic conditions. Systemic conditions feed local occurrences, but the local situation is always at least subtly different. Small differences matter. Many small differences matter a lot.

Rule: scientists lack imagination

Most scientists have sufficient intellectual discipline, but lack imagination and intellectual honesty. They conceive of phenomena too narrowly, often causally, when there are correlations that are better modeled without invoking causation, and lacking intellectual honesty, when their personal agendas are satisfied, scientists are satisfied with views that are flat-out contradicted by other data.

Philosophers, artists, and saints – Nietzsche’s triad of worthy human beings, scientists deliberately excluded – have too much imagination and not enough intellectual honesty and intellectual discipline.

Is there any person in the history of our world who has intellectual discipline, intellectual honesty, and sufficient imagination? Will there ever be?

To be in my list of worthy human beings, minimally, all three are required. I am still looking for an example.

Hyperuricemia does not cause gout

To be a scientific term, a term must have the same meaning every time it is used. Is causation a scientific term? No – in actual usage, it does not have the same meaning. There is no definition that fits the following two statements:

  1. The motion of the eight ball was caused by a collision with the cue ball (almost true).
  2. Smoking three or more packs of cigarettes per day causes lung cancer (nonsense, there is a contingency table of possible outcomes, and 20% of all lung cancers occur in non-smokers).

But here is a scientific definition, illustrated with two related phenomena, hyperuricemia and gout.

By definition, hyperuricemia causes gout if there is SIN:

  1. S = sufficiency. No one with hyperuricemia does not have gout. Hyperuricemia is sufficient to produce gout all by itself. AND:
  2. I = immediacy. The instant that uric acid concentration exceeds the solubility limit, it precipitates and causes gout. AND:
  3. N = necessity. There is no route to gout that does not precede through the cause, hyperuricemia.

Looking at the data from NHANES 2007-2008 (Arthritis Rheum. 2011 Oct;63(10):3136-41. doi: 10.1002/art.30520. PMID:  21800283):

  1. S = sufficiency is not met: 21.2% of American men have hyperuricemia (> 7mg/dL), while 5.9% have been diagnosed with gout. The correlation is strong, but it is not causal.
  2. I = immediacy is not met by the same data. If it were, there would be 21.2% gout among American men.
  3. N = necessity is not met because roughly a quarter of people with acute gout do not have hyperuricemia. Ref: Schlesinger N et al. Serum urate during acute gout. J Rheumatol 2009 Jun; 36:1287. “Of 339 patients who presented with acute gout, 14% had serum uric acid levels ≤6 mg/dL, and 18% had levels between 6 mg/dL and 8 mg/dL. Mean uric acid level was about 8.3 mg/dL (7.2 mg/dL in patients taking allopurinol, and 8.5 mg/dL in patients not taking allopurinol).” – as summarized by Dr. Allan Brett, https://www.jwatch.org/jw200906300000002/2009/06/30/uric-acid-levels-during-acute-gout-attacks). Sorry, this reference takes 8 mg/dL as the definition of hyperuricemia. To be consistent, as an estimate, let us divide by two the 18% with serum uric acid in the 6-8 mg/dL range. This suggests that roughly 23% of all acute gouty attacks occur in people with serum uric acid in the normal range. In the discrepant cases, did the uric acid spike just before the attack and then subside? I don’t know. But even if it did:

There is no SIN. There is definitely no S, definitely no I, and apparently no N – there is no causation if one of the three is missing.

There is a contingency table of outcomes, gout vs no gout, hyperuricemia vs normouricemia. There is no contingency table describing the outcome of a collision between a cue ball and an eight ball. This physics experiment nearly has all three aspects of causation nailed down. It almost has SIN. Hyperuricemia does not have SIN in the etiology of gout. Biology is a bit more complicated than physics, as in every biological process, many factors oppose many other factors. In biology, outcomes are always a vector sum of the opposing forces and are described by contingency tables. Such is life.

By definition, any phenomenon with a contingency table of outcomes is not causal. All by themselves (sufficiency) causes necessarily (necessity) and immediately (immediacy) produce their effects.

Barking up the wrong tree

Rule 1: The body has it right.

Exception to rule 1: Occasionally, the body has it wrong, especially when harmful substances that look like nutrients are absorbed by nutrient receptors. In these cases, we must keep these harmful substances out of the body.

Corollary of rule 1: when scientists disagree with the body, the rule is that scientists have it wrong, misled as they often are, by missing a single key fact.

Habitually, scientists try to make toxins out of molecules that the body is clearly saying are not toxins. But scientists think they know so much more than the marvelous machine.

The following quote is typical scientific rubbish:

“Fasting is generally thought of as a tool to facilitate detoxification, promoting the mobilization and elimination of endogenous substances such as cholesterol and uric acid and exogenous substances such as dioxin, PCBs, and other toxic chemical residue.”     (http://www.healthpromoting.com/learning-center/articles/fasting-back-future)

Dioxin and PCBs, have relatively low LD50s, and unfortunately get into the body, most likely by mimicry. Cholesterol has no LD50, and is avidly absorbed with specific cholesterol receptors.

Uric acid is only mildly toxic to animals. Uric acid has an LD50 of about 5g/kg body weight: (“Toxicity to Animals: Acute oral toxicity (LD50): 5040 mg/kg [Rat].” (http://www.sciencelab.com/msds.php?msdsId=9925393)).

Uric acid is approximately 90% reabsorbed by the kidneys. The four substances are not all of the same ilk.

Scientists have cast cholesterol in a toxic role in heart disease, when the gut, given more than one gram of dietary cholesterol, will absorb a gram of it, equal to what it makes every day. To the body, dietary cholesterol is a macronutrient, not a toxin.

The body treats cadmium and fluoride as micronutrients or toxins, excluding roughly 98% of the daily ingested doses. Scientists consider cadmium as a toxin, targeting bone and kidney, and fluoride as an essential nutrient because they do not realize that fluoride is not necessary for good oral health (all we need is proper nutrition. Weston Price gives us about 2 dozen examples). Do scientists make any sense? The body does; scientists do not.

The body treats some toxins as if they were nutrients because of mimicry. Cysteine-derivatized dimethylmercury looks enough like methionine to fool the marvelous machine.

Scientists have cast NaCl as the cause of hypertension. The body’s aggressive absorption of it and its reabsorption when dietary sources are low should caution against this approach. But it does not – the facts of physiology are routinely ignored. Overdoses of nutrients pose problems for the body, especially when it is weakened by poor health, following years of poor nutrition with considerable toxicity. Overdoses of NaCl are not an exception to the rule. Overdoses of NaCl increase the odds of edema and hypertension, but overdoses of salt per se do not cause them, as the study on the isolated island Kuna, with a whole foods diet to which salt is liberally added. Look for a real toxin, something the body does not absorb, or something that gets into the body only because of mimicry, or something that the body does not reabsorb, or something that comes out of the body (as salt no doubt does) during a period in which nothing is going in (as in Dr. Goldhamer’s 11 day distilled water fast), and hypertension is being drastically reduced. Look to the weaknesses in the defense systems that a poor diet, overloaded with salt, exacerbates. High salt is a strong correlate of a poor diet, which is rich in real toxins, and poor in body-repairing nutrients. Thus, a high salt diet will almost always correlate with a poor diet.

Scientists have tried to sell us the idea that uric acid is a toxic cause of gout, and all kinds of CV problems. The 90% reabsorption rate by the kidneys should discourage them, but they persist.

Diseases have no single cause. Diseases result when genuine toxins (hint: not something the body is absorbing or reabsorbing with great efficiency) exploit weaknesses in our defense systems over time.

Uric acid is not the toxin in the etiology of gout. I do not know what toxins are involved in the etiology of gout (acid-generating microbes in synovial joints might precipitate the uric acid crystals, and the acidic response of the immune system would aid this in the case of non-acid-generating microbes and general wound-healing, and the concentrated uric acid may actually help kill the microbes, which may be cleared prior to scoping the joints, but at any rate would be detectable by PCR but not by culture techniques).

Uric acid precipitation is a marker of the severity of gout, not the cause of gout, and higher circulating uric acid concentrations in many gout patients may reflect larger bodily pool sizes due mostly to poor kidney function, leading to numerous trapped precipitates, and when any one of these precipitates becomes severe enough, gouty inflammation occurs.

Poor kidney function is a potent source of higher circulating concentrations of toxins, any one of which may be involved in precipitating urate crystals in synovial joints.

I do not know what toxins are involved in CAD, but cholesterol is not it. Atheroma is there shoring up weakened connective tissue (sometimes the weakness is a microscopic tear, as Virchow envisaged). Yes, atheroma contributes to CAD, but without it, hemorrhage would almost certainly have already occurred. Quicker death or slower death? Is the body really trying to do us in quickly? Or is the body doing what it is always doing, trying to keep us alive in spite of the fact that we – scientists included- are royal screw-ups?

A mountain of evidence for causation taken down by a single stick of dynamite

It is the little fact that does not fit that takes down the mountain of evidence for causation. We must then revise our model from causal toward contributory.

Consider this article that claims that consumption of salt greatly in excess of the body’s needs causes high blood pressure. Change the word “causes” to “contributes to” and the article would be A-OK.

The Salt Institute is wrong in denying that overconsumption of salt contributes to high blood pressure. Experiments with the DASH diet say otherwise. The mountain of data presented in this review says otherwise. The review is: “Diet, Hypertension and Salt Toxicity By James J. Kenney, PhD, RD, LD, FACN Copyright 1998-2011 Food & Health Communications, Inc. This CPE course has been approved by the American Dietetic Association for 8 unit hours. Good through 7/7/2013.”

In Kenney’s own words, “As this review will demonstrate the preponderance of scientific evidence links excessive salt intake to a wide variety of disease processes” and “A recent survey found that only about 10% of Americans are concerned about their salt intake. However, as we shall see, more than 90% of Americans will develop HTN at some point in their lives and excessive dietary salt is the primary causal agent.”

A mountain of evidence, indeed!

The American Dietetic Association approved of this – wow! Imprimatur!

Unfortunately, the mountain of evidence for causation at best leads to the idea that:

  1. Overconsumption of salt contributes to high blood pressure, as the facts of physiology begin to work against the person consuming high salt.
    1. When we are healthy, per Guyton, we can move half a mole of salt out of our bodies each day per liter of urine produced.
    2. As our health declines, so does this number, and if salt consumption does not decrease to below the new levels of salt removal capability, edema and higher pressures are almost a certainty
      1. In this model, edema helps to relieve high blood pressure by draining salty fluid out of the bloodstream (mechanistically, high BP is more likely pushing salt water out of the bloodstream).
      2. These increases in edema and BP are reversible over time when salt is reduced. This is the basis of “salt-sensitive hypertension.”
      3. The irreversible damage done in part by long term over-consumption of salt is not reversible by the DASH low salt diet. This is the basis of “salt-insensitive hypertension” that nevertheless may have a component of its etiology in the chronic over-consumption of salt.
      4. This irreversible component may not be that large. Consider the following study in which almost all of the excess BP was removed by a drastic diet.
      5. A diet with an 11 day medically supervised distilled water fast, sandwiched between low salt, low fat vegan dieting, was able to achieve remarkable reductions in hypertension. Upon entry to the study, only 6% of the patients were on hypertensive medication. All of them were able to discontinue them. The data are shown below.
      6. Conclusion: Medically supervised water-only fasting appears to be a safe and effective means of normalizing blood pressure and may assist in motivating health-promoting diet and lifestyle changes.” (J Manipulative Physiol Ther 2001;24:335-9).
      7. Unfortunately, fasting on distilled water does a lot more than eliminate excess salt from the body. The effects on BP are likely to be pleotropic.
      8. Urinalysis should have been done to document what was coming out of the body when nothing but distilled water and air was going in.
      9. It would be interesting to see how much NaCl was in all of the urine they excreted during 11 days.
      10. The Goldhamer group repeated this study on pre-hypertensive individuals and was able to normalized the blood pressure on 82% of them. THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE. Volume 8, Number 5, 2002, pp. 643–650.
    3. The time required for our health to decline explains why this effect, in part due to over-consumption of salt, kicks in after age 60 for most people.
    4. A pure salt effect should be much more rapid and should significantly increase BP in youth. But:
  2. Is there a slow toxic side reaction to the overconsumption of salt, even when the body is able to move it all out each and every day?
    1. Possibly, a slowly progressing fibrosis throughout the arterial system has been suggested, and if so, this complicates even the interpretation of the isolated Kuna Indian data – how long had they been enjoying high salt in their diet when they were surveyed in 1997 and found to be almost free of hypertension in their 60s and beyond? All we have to go on is lore: “Lore has it that the most dramatic changes in lifestyle have occurred in the past two decades.” ().
  3. The etiology of medical conditions and diseases is relatively simple: toxins exploiting weaknesses in our defenses over time. There is no such thing as an instant disease. There is no such thing as a disease without toxins and there would be no disease, no aging, and no death, if our defenses were perfect in every way.
    1. Defective genes are toxins.
    2. Various pollutants in air and water are toxins.
    3. Various viruses, bacteria, fungi, parasites are toxins.
    4. Even at low doses, poisonous chemicals, chemicals with LD50s, including salt, which is weakly toxic in an acute manner and perhaps more toxic in a chronic sense, contribute to the total toxic load challenging and weakening the body’s defenses, and perhaps stiffening its arterial vessels with progressive fibrosis right down to the arterioles.
    5. All foods contain some toxins.
      1. Even organic vegetables contain toxins: natural plant-produced pesticides and antibiotics, and although some of the chemicals can also be useful, they burden the body’s defense systems.
    6. The most vital of nutrients, oxygen, can be quite toxic when the defenses are weakened.
      1. The case of scurvy.
    7. When the defenses are seriously weakened, even minor league toxins like Salmonella can produce serious diseases, and even death.
      1. A person on immunosuppressants can easily die from a week-long bout of diarrhea, after consumption of food tainted with minor league toxins such as Campylobacter, Salmonella, Listeria, Shigella, or toxigenic E. coli.
      2. Add acid blockers and/or antibiotics (that is, antibiotics to which the pathogen is resistant) to make the person’s defenses  even weaker, increasing his vulnerability.
      3. Add electrolyte deficiencies at the time of the infection, and death is becoming nearly certain.
  4. Most of the salt in the modern diet is coming from processed and prepared food, and thus salt consumption correlates with the consumption of this food. If over-salting was the only problem with this food, the case against salt would be stronger.
    1. Processed and prepared foods are generally higher in toxins and lower in body-sustaining nutrients.
      1. Consider French fries prepared in polyunsaturated oils exposed to light, oxygen, and heat.
    2. When fortified, processed food tends to be nutritionally unbalanced, and this too contributes to health problems.
    3. Yes, processed and prepared foods are also higher in salt than whole foods.
    4. Years of consumption of processed food runs the body’s health down, and eventually it is not even very good at removing the salt in these foods anymore.

Kenney’s review does not mention these facts of physiology, and in fact, states, errantly:

“It seems likely then that the human body is biologically designed to handle far less salt than is now the norm in modern diets”, but unlike other reviews of hypertension, it does mention the isolated Kuna living their traditional lifestyle, eating their traditional food. However it misrepresents the 1997 findings. In 1944 the isolated Kuna had a diet that was low in salt and their blood pressure was healthy even into old age, 60+.

But by 1997, they had secured a source of salt by trading shellfish for salt with Colombians, and had begun to salt their foods liberally. Their average 24 hour urinary output had nearly 3x more Na+ than K+ (a ratio typical of Western diets) and the amount of sodium in their 24 hour urine samples averaged about 0.135 moles per gram of creatinine. Using about 1.2 grams of creatinine per day as the average production, this would argue for a consumption of about 0.16 moles of NaCl per day. This is a high salt diet. This is over 9 grams of salt a day, about the same as modern Americans. The 1997 study found the same healthy blood pressure in the 60+ group. Had they been consuming the high salt long enough to have the posited long-term toxic effect? Don’t know.

Populations like the isolated Kuna who consume whole foods with high salt enable us to isolate the effects of high salt on BP without the many complications of highly salted processed and prepared foods.

Subsequent studies by this group on the isolated Kuna have tried to make the consumption of cocoa the cause of their healthy BP at 60+. No – at most a contributor, a few points lower, as much as adherence to the DASH diet can lower BP by.

The facts of this study are distorted by this review as follows:

“By contrast, many Kuna Indians of Panama who were moderately obese but ate a diet that was low in salt have a very low incidence of HTN. In this population less than 1% of adults had HTN and BP did not rise significantly with age. Today, many Kuna Indians have adopted a more Westernized diet higher in salt and now experience a significant rise in BP with age. However, among Kuna Indians the incidence of HTN still remains lower than that seen in populations who have consumed a high-salt diet throughout life.”

The significant rise in BP was seen only in Kuna who moved to Panama City and its suburbs, and who had adopted a Westernized lifestyle, including the consumption of processed food, which has a higher toxic load, is less nutritious, and higher in salt than whole foods. Kuna living in the Caribbean Archipelago, eating their traditional foods, but salting them liberally, did not experience a significant increase in BP in their 60s. The review seriously distorts the facts.

Here are the relevant data from the 1997 paper. Kuna Nega is the suburb of Panama City and the data may be combined with the data from Panama City, and opposed to the isolated Kuna living on the islands in the Caribbean Archipelago:

TABLE 1.

Kuna: Location, Demographics, and Blood Pressure by Age Group

Index Island Kuna NEGA Panama City
<40 y (n=35) 41–60 y (n=68) >60 y (n=39) <40 y (n=45) 41–60 y (n=31) >60 y (n=14) <40 y (n=46) 41–60 y (n=29) >60 y (n=9)
Age, y 29±2 50±1 71±2 29±0.7 49±0.8 69±2.0 29±0.1 51±0.3 65±0.4
BMI, kg/m2 23.8±1.5 22.4±0.5 21.9±0.9 22.7±0.6 23.8±0.7 22.1±0.1 23.2±0.1 25.1±0.2 23.9±0.5
MBP, mm Hg 81±2 77±1 80±2 82±1.4 83±1.4 92±4.3* 82±0.2 88±6.3 96±2*
  • BMI indicates body mass index; MBP, mean blood pressure.

  • * P<.001 (correlation with age).

And the data on the high salt in the urine of the Island dwellers:

TABLE 2.

Chemical Findings in Serum and Urine in Island-Dwelling Kuna

Serum 24-h Urine
Na, mEq/L K, mEq/L Urea, mg/dL Creatinine, mg/dL Volume, mL Na, mEq/g Creatinine K, mEq/g Creatinine Mg, mg/g Creatinine Ca, mg/g Creatinine Urea, g/g Creatinine
Study results 138±0.2 3.9±0.04 9.9±0.4 1.1±0.02 1320±84 135±15 47±3 63±4 104±9 5.3±0.3
Lab usual Range 136–142 3.5–5.0 9–25 0.8–1.3 75–200 40–80* 120–245* 50–400* 6.0–17.0*
  • * Not normalized to gram creatinine.

Estimates of nutrient intakes, based on 24 hour recall and a host of assumptions:

TABLE 3.

Kuna Nutrient Intake in San Blas Islands

Index Mean±SEM* Average US Intake (Mean±SEM)
Kilocalories 2221±117 1914±10
Protein, g 67±3.8 75.3±0.5
Protein, % 12.2±0.3 15.7
Total fat, g 56±3 78.4±0.5
Fat, % 23±0.8 36.9
Cholesterol, g 390±23 209±1.1
Cholesterol, % 70.6±2.3 44
Dietary fiber, g 23.3±2.5 15.9±0.1
Calcium, mg 617±50 736±6.4
Potassium, mEq 98.6±9.1 62±0.4
Magnesium, mg 368±22 296±2.8
Sodium, mEq 210±22 121.5±77
  • n=50.

  • * Based on single 24-hour recall.

  •  All averages calculated from NHANES II, except magnesium and fiber, which were calculated using advanced data from NHANES III (male and female adults, all income levels).