Day: March 9, 2023

Sodium is essential for the smooth functioning of muscles and nerves and maintaining the proper balance of water and minerals. But too much sodium in the diet can kill.

“Almost 2 million deaths each year are associated with excessive sodium intake,” said Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“Too much sodium can lead to high blood pressure and increase the risk of cardiovascular diseases,” he said. “And yet globally, average sodium intake is more than double the WHO recommendation for adults of less than 2,000 milligrams per day, or 5 grams of salt.”

That is equivalent to one teaspoon of salt a day.

A WHO report launched Thursday explores for the first time the progress countries have made in implementing sodium intake reduction policies. A survey of WHO’s 194 member states showed “the world is off track to achieve its global target of reducing sodium intake by 30% by 2025.”

The report finds that only 5% of WHO member states “are protected by mandatory and comprehensive sodium reduction policies,” and 73% of WHO member states “lack full range of implementation of such policies.”

Francesco Branca, director of WHO’s Department of Nutrition for Health and Development, noted that reducing sodium intake is one of the most cost-effective ways to improve health and reduce the burden of non-communicable diseases “as it can avert a large number of cardiovascular events and deaths at very low program costs.”

Cardiovascular diseases are the leading cause of death globally, claiming an estimated 17.9 million lives. WHO reports that more than four out of five of these deaths are due to heart attacks and strokes, with one-third occurring prematurely in people under age 70.

9 nations succeed

The report finds that only nine countries — Brazil, Chile, Czech Republic, Lithuania, Malaysia, Mexico, Saudi Arabia, Spain and Uruguay — have fully enacted WHO’s recommended policies to reduce sodium intake.

Tom Frieden, CEO of Resolve to Save Lives, cites Chile as a leader in the implementation of lifesaving sodium-reduction policies.

Speaking in a webinar among fellow experts that followed the report’s launch, Frieden said Chile had “passed the law of food labeling and advertising that simultaneously required mandatory front-of pack warning labels, including on sodium; restricted marketing of products that have those warning labels; and banned the procurement of the sale of those products in schools.”

He noted that Argentina, Brazil, Mexico and Uruguay had all passed similar policies, following Chile’s lead.

Branca noted that a significant proportion of sodium in the diet comes from processed and highly processed foods sold in many high-income countries and increasingly in low- and middle-income countries.

“Government-led mandatory maximum limits for sodium-processed foods promote industrywide reformulations,” he said. “They create a marketplace that restricts the less healthy food options regardless of where people shop, or how much they understand or have access to information on labels.”

Frieden said self-regulation by the food manufacturing industry has repeatedly proven to be ineffective and “voluntary policies are often ignored.”

“In fact, a mandatory approach creates a level playing field,” because it can keep companies that take positive steps from feeling as though they must conduct business at a competitive disadvantage.

In addition to the existing proven strategies to reduce sodium, Frieden said, countries can consider new, innovative measures, such as increasing the availability and use of sodium and salt substitutes.

“Recent studies show that these substitutes significantly decrease not only blood pressure, and not only heart attack and strokes, but even death from cardiovascular events,” he said.

“Imagine that changing the brand of salt that you use could reduce the risk of death by 10% or 15%.”
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China’s government on Thursday criticized the Netherlands for joining Washington in blocking Chinese access to technology to manufacture advanced processor chips on security and human rights grounds.

A Dutch minister told lawmakers Wednesday that exports of equipment that uses ultraviolet light to etch circuits on chips would be restricted on security grounds. ASML of the Netherlands is the only global supplier. Industry experts say a lack of access to ASML’s most advanced technology is a serious handicap for China’s efforts to develop its own chip industry.

Washington in October blocked Chinese access to U.S. tools to make advanced chips that it said might be used in weapons or in equipment for the ruling Communist Party’s surveillance apparatus. The Biden administration is lobbying European and Asian allies to tighten their own controls.

A Chinese foreign ministry spokeswoman complained that “an individual country,” a reference to the United States, was trying to “safeguard its own hegemony” by abusing national security as an excuse to “deprive China of its right to development.”

“We firmly oppose the Netherlands’s interference and restriction with administrative means of normal economic and trade exchanges between Chinese and Dutch enterprises,” said the spokeswoman, Mao Ning. “We have made complaints to the Dutch side.”

Mao appealed to the Netherlands to “safeguard the stability of the international industrial and supply chain.”

ASML’s extreme-ultraviolet, or EUV, equipment uses light to etch microscopically precise circuits into silicon, allowing them to be packed more closely together. That increases their speed and reduces power demand.

The Dutch government has prohibited ASML from exporting its most advanced machines to China since 2019, but the company is allowed to supply lower-quality systems.

Chinese manufacturers can produce low-end chips used in autos and most consumer electronics but not those used in smartphones, servers and other high-end products.

Dutch Prime Minister Mark Rutte and U.S. President Joe Biden held talks in January on ASML’s chip machines.
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WeightWatchers, the 60-year-old diet firm, announced this week it would acquire a telehealth company whose providers prescribe anti-obesity drugs for growing numbers of eager online subscribers.

The $132 million deal with Sequence is just the latest commercial push into the red-hot market for prescription drugs that promises significant weight loss. For months, the diabetes drug Ozempic has been touted on social media by celebrities, even though it’s not approved for weight loss. The demand for it sparked shortages.

WeightWatchers will be introducing its roughly 3.5 million subscribers to a new generation of medications that go beyond behavioral changes like gym workouts and diet tracking. Obesity experts say the drugs may revolutionize treatment of the disease that affects 42% of American adults.

Here’s a look at the promise of these new medications and cautions about their use.

What are these new diet drugs?

The drugs that have generated most buzz are from a class of medications called GLP-1 agonists. Two of the most popular, Ozempic and Wegovy, are different doses of the same drug, semaglutide.

Ozempic has been used for six years to treat Type 2 diabetes and is not approved for weight loss. Wegovy was approved in 2021 to treat obesity in adults, and late last year to treat kids and teens 12 and older.

Doctors prescribe the medications to people with diabetes alone, or to people who are obese or who are overweight with additional health problems. Most of these types of drugs are delivered through weekly injections.

Supply problems and soaring demand last year led to a shortage of the drugs, but manufacturer Novo Nordisk said those have been replenished.

How do the drugs work?

They mimic the action of a gut hormone that kicks in after people eat, boosting the release of insulin, blocking sugar production in the liver and suppressing appetite.

A newer drug called tirzepatide mimics the action of two hormones for even greater effect. The Eli Lilly and Company drug, sold under the brand name Mounjaro, is now approved to treat diabetes. But the FDA granted fast-track status to review it to treat obesity. A decision is expected this spring.

With lower appetite and a greater feeling of fullness, people using these drugs eat less and lose weight.

How effective are the drugs?

In a clinical trial, adults who took Wegovy saw a mean weight loss of nearly 35 pounds, or about 15% of their initial body weight. Adolescents lost about 16% of their body weight.

A clinical trial of Mounjaro, which is still being studied, saw mean weight loss of 15% to 21% of body weight depending on the dose, compared with a weight loss of about 3% for people taking a placebo, or a dummy drug.

Why not just diet and exercise?

In a typical weight-loss program where participants rely only on diet and exercise, about a third of people enrolled will lose 5% or more of their body weight, noted Dr. Louis Aronne, director of the Comprehensive Weight Control Center at Weill Cornell Medicine.

Most people find it difficult to lose weight because of the body’s biological reactions to eating less, he said. There are several hormones that respond to reduced calorie intake to increase hunger and maintain body mass.

“There is a real physical phenomenon,” he said. “There is a resistance mechanism that is a coordinated effort by the body to prevent you from losing weight.”

What are the side effects of the drugs?

The most common side effects are short-lived gastrointestinal issues such as nausea, vomiting, diarrhea, stomach pain and constipation.

Other possible side effects include thyroid tumors, cancer, inflammation of the pancreas, kidney and gallbladder and eye problems. People with a family history of certain thyroid cancers or a rare, genetic endocrine disorder should avoid the drugs.

What should consumers watch out for?

These new medications could be an effective part of a multifaceted approach to weight loss, said Dr. Amy Rothberg, a University of Michigan endocrinologist who directs a virtual weight management and diabetes program called Rewind.

But she worries that programs like WeightWatchers are primarily interested in boosting enrollment — and profits.

“My hope is that they do their due diligence and have real monitoring of the patients taking the drugs,” she said.

It’s important to make sure that patients are taking the drugs for the intended purpose, to make sure there’s no reason they shouldn’t take the drugs and that they’re monitored for side effects, she said.
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