NaCl
It’s been no secret that the U.S. (and Arizona) diet is high in salt- and almost 90% of that salt comes from pre-processed foods (as opposed to the salt that you might add while cooking or eating).  Reducing dietary salt is an important public health target- and it’s among one of the cheapest and easiest public health interventions.  In fact, the cardiovascular benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use, obesity, and cholesterol levels.

A new study this week in the New England Journal of Medicine http://content.nejm.org/cgi/content/full/NEJMoa0907355 found that reducing dietary salt by 3 g per day would reduce the annual number of new cases of coronary heart disease in Arizona by up to 2,400 per year, reduce the number of strokes in AZ by up to 1,300, heart attacks by up to 2,000 and reduce the annual number of deaths from any cause by between 880 and 1,800.  All from a modest reduction in salt intake.

In fact, Japan, the UK, Finland, & Portugal have successfully reduced population-wide salt intake by using a combination of regulations on the salt content in processed foods, labeling of processed and prepared foods, public education, and by collaborating with the food industry to reduce the amount of salt that is added to foods.

The New York City Health Department has been coordinating a nationwide effort to reduce the salt in both packaged and restaurant foods by 25% over five years http://www.nyc.gov/html/doh/html/cardio/cardio-salt-initiative.shtml. Our nutrition team is exploring whether and how we can sign-on to this growing national initiative…  15 state health departments are already among the supporters.  More on this soon.

BPA
On the other end of the risk spectrum is recent concern about a chemical called bisphenol a, which is a plasticizer that’s used in some kinds of water bottles and in plastics that cover processed foods.  Previous studies have found a slight association between urinary BPA concentrations and heart disease, diabetes and liver enzymes in adult participants of the National Health and Nutrition Examination Survey.  A new study out this week published at: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0008673 concluded that “Higher BPA exposure, reflected in higher urinary concentrations of BPA, is consistently associated with reported heart disease in the general adult population of the USA.”

When I heard about this new study I didn’t think much of it, because the association is weak and the risk increase is slight- and because the studies that have been conducted have shown as association– not causation.  But, when I saw my wife throwing away all of our perfectly good plastic water jugs this morning because of something she heard on the radio- I thought I should include something in this week’s update.

You can read the study yourself and do your own research, but I’m not convinced that the low levels that we’re exposed to from containers is a problem.  So, if you see me in the elevator, you will still see me with my bisphenol A containing refillable water bottle (that I fill up with tap water).

CCR
There was a very good article in the paper this week about our efforts to convert the world to using the new CCR to resuscitate adults that have a cardiac arrest.  You can read the full article at: http://www.azcentral.com/news/articles/2010/01/19/20100119cardiacdoc0119.html and you can review the new CCR method at www.azshare.gov.

Extraordinary Measures
A new movie called Extraordinary Measures will be released today.   The film is about a family’s efforts to find a cure for Pompe disease http://en.wikipedia.org/wiki/Pompe_disease (a metabolic disorder), which affects their two children.  In a sense, it’s a public health film, because it’s directly related to our newborn screening program.  There is currently no reliable newborn screening test for this disorder yet (so we don’t test for it yet), but Illinois and Missouri have been mandated to implement the test.   You can read more about Arizona’s Newborn Screening Program on our website.

Budget Requests and Bill Inquiries
Please respond quickly to any request that comes from Duane regarding budgetary or bill information.  The Legislature is now in session, and bills that impact our programs are coming out daily.  It’s critical that we look over the bills and get any feedback to Duane right away so that we can relay and suggestions to the appropriate place quickly.

As I mentioned last week, the Governor recently released her budget for FY ’11 (the fiscal year that begins on July 1, 2010).  The Agency Detail Book contains the budget proposal for the ADHS starting on Page 80.

Congrats…
…  to our team from the Arizona State Hospital that completed the PF Chang’s half marathon.  They got together last summer and started planning and training, with group runs at Papago and South Mountain Parks.  Team Captain Crystal Gilbert led the pack on Sunday when the team took off.  17 people crossed the finish line 13.1 miles later.  Team AzSH placed second in the municipal team category!