High blood pressure and possible ethnic differences

On page 66 of a new book Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways, by Thomas Bollyky, it is mentioned that early Western medical personal working in Africa in the 1920s were surprised to find no cases of hypertension/high blood pressure among the native African people. Only one native woman was known to be overweight and it was noted that she worked in a brewery which led the medical person in the document to speculate whether beer drinking could be fattening (yes it can). The first case of hypertension in a native African person wasn’t noted until the 1940s.

Question: Does the Western style of living or working or export of Western products cause hypertension in native Africans? If native Africans living in their traditional environment using their traditional diet have no risk for hypertension then what changed that caused an increased risk? This topic is also important for prenatal health as preeclampsia can include hypertension/high blood pressure and it does tend to be an increased risk for women with African American ancestry. The DASH diet may be helpful, for more on preeclampsia risk factors and possible tips for prevention or management, see Preeclampsia & TRP Channelseffectivecare.info

I’ve discussed this topic in my early days of blogging when I found a research article from ~ 1970s that noted ethnic differences in health outcomes but did not take into account possible differences in average ethnic diet at the time. (I haven’t found that article in my files yet. I will update this post if I do find it.) To get to the point directly – native African groups may have kidney differences that conserve calcium better, and possibly not conserve as much magnesium, as other ethnic groups. This would be protective when calcium was not very available in the diet but then would be an increased negative health risk if the diet contained a lot of calcium or phosphorus.

Low magnesium levels, particularly when there is also plenty of phosphorus may increase cardiovascular risks. Adequate magnesium levels are protective and elevated magnesium is unusual and may be increase cardiovascular risks. In good health the body maintains magnesium and other electrolyte levels within specific ranges. (5) Higher magnesium levels have also been associated with higher levels of potassium and of albumin, a blood plasma protein, (6), which is important for fluid balance and transport of a variety of chemicals in addition to magnesium (such as steroids, fatty acids, and thyroid hormones (wikipedia/serum albumin), about 30% of serum magnesium is carried in a non-electrically active form on proteins, primarily albumin (Clinical Biochemistry/serum magnesium) (9).

There may be differences in rate of urinary loss of albumin in different ethnic groups. With the presence of excess abdominal weight participants in a renal study of Hindustani-Surinamese, or African-Surinamese ancestry had an increased likelihood of albuminuria than participants of Dutch ancestry with the greatest risk found in the Hindustani-Surinamese group. (7) Asian Americans and African Americans were found to have better blood albumin levels in a renal study and the Asian Americans had better renal biomarkers compared to other ethnic groups in the study. (8)

When looking at hypertension and high blood pressure risk with the same diet in modern research there is a significant increased risk for African Americans to have high blood pressure and to have it occur earlier in life than in whites. (prevalence in the U.S. of hypertension in adults was “42 % for blacks and 28 % for whites,” (2011-2012)). (2)

So it is a good question – how did hypertension frequency in Africans in the 1920s change from zero to 42% for African Americans in the United States, in 2011-2012? Diet differences that were noted in 2009-2010 between white groups and African American groups were more cholesterol and sugar and less fiber, whole grains, nuts/beans/seeds, fruits and vegetables for the African Americans on average. Dairy intake was not mentioned as being significantly difference. In another research comparison calcium intake was lower on average in African Americans but so was magnesium (Table 1). (2)

Within the introduction and Diet and Blood Pressure sections of the article it is mentioned that ethnic differences in cardiovascular metabolism has been noted in African American groups and that their reduction in blood pressure when following the DASH diet was even better than the reduction in people of other ethnic background who followed the diet (it includes a magnesium rich Beans/Nuts/Seeds group as a daily/weekly recommendation). The INTERMAP study found an increased Sodium to Potassium ratio in urinary excretion and less total Potassium urinary excretion for the African American participants than white participants. (2)

Other research has also supported the idea that high blood pressure may have more to do with excess sodium (salt) intake in relation to low potassium intake than just having to do with the amount of sodium in the diet. Potassium is found in all vegetables and fruits in varying amounts, beans/nuts/seeds, and in liquid milk and yogurt. (Kidney dialysis and other patients with Chronic Kidney Disease have to avoid excess potassium so this article includes a list of potassium rich foods for the purpose of educating regarding what needs to be limited but for people of average kidney health it is a list of good sources to include in the diet: Potassium and Your CKD Diet, National Kidney Foundation.

Learning is an ongoing process, in the meantime some possible health tips for people of any ancestry:

  1. Adequate magnesium is essential for kidney and heart health and high blood pressure is an early symptom of low magnesium levels. Dietary sources may not be sufficient if intestinal absorption is poor or if renal losses are excessive. Epsom salt baths or footsoaks or magnesium chloride are topical forms. Adequate protein and phospholipids in the diet are also important to provide the albumin and other specialized transport molecules that carry magnesium and other chemicals within the vascular or other fluids of body tissue. More information about magnesium sources and symptoms of deficiency are available in a previous post: To have optimal Magnesium needs Protein and Phospholipids too.
  2. Adequate calcium and vitamin D are needed for health however excess may cause an imbalance between calcium and magnesium levels as magnesium is excreted along with excess calcium by the kidneys and less magnesium may be absorbed by the intestines as vitamin D causes increased absorption of calcium and magnesium but calcium may be more available in a modern processed food diet. For more information about vitamin D sources see: Light up your life with Vitamin D, peace-is-happy.org. Deficiency of calcium or of vitamin D can cause secondary hyperparathyroidism which can also be more common in renal failure due to excess phosphorus buildup and deficiency of active vitamin D. The healthy kidney is involved in activating vitamin D. (Secondary hyperparathyroidism, National Kidney Foundation) Calcium is plentiful in most dairy products and is also found in almonds, sesame seeds, beans, dark green leafy vegetables and other produce. Variations of a 2000 calorie menu plan shows that even a vegan diet can provide 1000 milligrams of calcium per day and a menu with dairy products can provide an excess with over 1600 milligrams of calcium, see: Healthy Hair is the Proof-of a healing diet.
  3. The DASH diet (Dietary Approach to Stop Hypertension) may help because it encourages potassium and magnesium rich vegetables, fruits, beans, nuts and seeds. Calcium is provided without being over recommended with two to three servings of dairy group foods. See example daily/weekly diet plan recommendations here: What is the DASH diet?, dashdiet.org.
  4. Adequate without excess protein helps protect the kidneys from having to overwork excreting nitrogen from excess protein breakdown. Adequate water is essential for kidney and vascular health as it helps with excretion of toxins and transport of nutrients and oxygen in the vascular system. More information about protein and water recommendations are available in a previous post: Make every day Kidney Appreciation Day.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

  1. Thomas Bollyky, Plagues and the Paradox of Progress: Why the World is Getting Healthier in Worrisome Ways, 2018, MIT Press, https://mitpress.mit.edu/books/plagues-and-paradox-progress
  2. Chan Q, Stamler J, Elliott P. Dietary factors and higher blood pressure in African-Americans. Curr Hypertens Rep. 2015;17(2):10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315875/“Marked ethnic differences exist in bone metabolism and development of calcified atherosclerotic plaque (CP). Relative to European-Americans, African-Americans have lower rates of osteoporosis (despite ingesting less dietary calcium), form fewer calcium-containing kidney stones and manifest skeletal resistance to PTH (1,2,3). Systemic differences in regulation of calcium and phosphorus appear to be involved (4). Related phenomena may include the markedly lower amounts of calcified CP in African-Americans, despite the presence of more severe conventional cardiovascular disease risk factors (5,6,7,8,9). Together these observations suggest biologically mediated ethnic differences in the regulation of bone and vascular health.” […]  “The DASH/DASH-Na diet BP reduction was more pronounced for blacks compared to whites [313637]. Although the DASH dietary approach has been incorporated into lifestyle changes recommended for patients with HTN [3], data show that few hypertensive Americans consume diets even modestly concordant with the DASH diet and less so for blacks [38]. Only about 19 % of individuals with known HTN from NHANES 1999–2004 had DASH-concordant diets.”
  3. Barry I. Freedman, et al, Vitamin D, Adiposity, and Calcified Atherosclerotic Plaque in African-Americans,J Clin Endocrinol Metab. 2010 March; 95(3): 1076–1083. [ncbi.nlm.nih.gov/pmc/articles/PMC2841532/?tool=pubmed]  
  4. Potassium and Your CKD Diet, National Kidney Foundation, https://www.kidney.org/atoz/content/potassium
  5. Ryota Ikee, Cardiovascular disease, mortality, and magnesium in chronic kidney disease: growing interest in magnesium-related interventions, Renal Replacement Therapy2018 4:1,   https://rrtjournal.biomedcentral.com/articles/10.1186/s41100-017-0142-7
  6. Noriaki Kurita, Tadao Akizawa, Masafumi Fukagawa, Yoshihiro Onishi, Kiyoshi Kurokawa, Shunichi Fukuhara; Contribution of dysregulated serum magnesium to mortality in hemodialysis patients with secondary hyperparathyroidism: a 3-year cohort study, Clinical Kidney Journal, Volume 8, Issue 6, 1 December 2015, Pages 744–752, https://doi.org/10.1093/ckj/sfv097
  7. van Valkengoed IG, Agyemang C, Krediet RT, Stronks K. Ethnic differences in the association between waist-to-height ratio and albumin-creatinine ratio: the observational SUNSET study. BMC Nephrol. 2012;13:26. Published 2012 May 7. doi:10.1186/1471-2369-13-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492102/
  8. Frankenfield DL, et al., Differences in intermediate outcomes for Asian and non-Asian adult hemodialysis patients in the United States, Kidney International, Vol 64, Issue 2, Aug. 2003, pp 623-631 https://www.sciencedirect.com/science/article/pii/S0085253815493706
  9. M H Kroll, R J Elin, Relationships between magnesium and protein concentrations in serum. Clinical Chemistry Feb 1985, 31 (2) 244-246; http://clinchem.aaccjnls.org/content/31/2/244.long

Integrity and health

Integrity – has a two part definition – 1) regarding personal characteristic the aspect of honesty and having values – 2) regarding the physical state of wholeness, the person or substance or nation is complete and undivided.

Currently there is too much division in many areas between groups of people with different beliefs. Race,  religion, science, whatever the difference there is something in common, we share one planet. Infertility is increasing in humans and in many other species. Loss of insects causes a ripple effect up the food chain as plants are not pollinated and other species don’t have adequate food either from the loss of plants or the loss of insects. Infertility treatments are a costly procedure that is becoming common enough that some governments with nationalized health insurance have to decide about paying, which then leads to a question of who deserves the treatments and how many times. Five million dollars is the cost of fertility treatments in some areas of the world and there is no guarantee that it will work. How many treatments to attempt?

My own field of work experience could be described as a fertility expert – not an infertility expert who helps people conceive, instead a counselor who helped people who already had conceived have the healthiest pregnancy possible, or counseled about preparing for a healthy pregnancy for their next child. Something I heard frequently enough to stand out in my memory was something like, “I wasn’t trying to get pregnant, I had just worked really hard to get healthier and had lost weight and was exercising and now here I am pregnant.” Tragedy for many is not being able to conceive even with a variety of interventions. (information and statistics about infertility, cdc.gov) Focusing on health first was what seemed a successful method from a retrospective point of view. Tragedy did visit some, who was likely to miscarry? Not typically those who had achieved health first. The last post suggests also that adequate iodine and thyroid function may be part of the answer.

Self respect – confidence and faith in your own abilities and value.

How can I help you,” was recommended as a valuable question to ask for leadership or business. It is helpful in many roles. People don’t want to feel coerced or manipulated and are more likely to accept or participate with plans that they have had a part in making. The flaw in overly depending on the strategy is when people don’t know what they don’t know – if they don’t know about the possibility or value in something new than how can they ask for help with it? Horseless carriages and electric light-bulbs are two inventions that people were initially skeptical about trying. Elevators initially had elevator operators to push the buttons, in part to help people feel safer about riding in the new-fangled contraption, in part because the doors were not automated. A few elevator operators still work in higher price buildings, it adds a level of security as well as a prestige service. (The Benefits of an Elevator Operator).

If I felt that I could help and didn’t I wouldn’t feel good about myself however I can only help within my ability to help and continue to take care of myself. Mothers learn that being sick is no vacation from motherhood.

My goal with writing online and trying a few different website formats is for the purpose of trying to share self care information with those who seek it out. The preventative education prenatal/early childhood program in which was very effective and to me seemed even better than the care I had received from my health insurance covered medical care. Preventative health education takes time that typical medical appointments don’t have to spare. Providing self directed educational resources online can allow adult learners to access the information that they are interested in as they need it, as they develop the interest in seeking it out – answering their own question of “How can I help myself?

The Science of Self-Care: How climate researchers are coping with the U.N. report, Eric Holthaus @EricHolthausgrist.org.

Sea-level rise and flooding is one thing, people get wet, immigrate, and create huge problems. Loss of biodiversity means the human species as a whole is threatened to disappear. No joke. This is not discussed enough in the media.” – Eric Rignot @erignotgrist.org.

/Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Is Success Money? Happiness? Survival? Promoting Change?

The definition of success varies for different people. As a public health educator I always felt successful when I heard ideas I had recommended being recommended to me – smile and nod and say What a great idea, do you mind if I share that with others?

Survival with health issues or other types of crisis often means making changes to old ways of doing things. Learning what works for some people in some situations can help others in similar situations or may be the idea that leads to their own adaptation of the idea to better suit their needs. I’ve had health problems all of my life, not too severe but often effecting my daily ability to breathe or think or move comfortably. I’ve had to make many changes and recognize when something is better for me to avoid than to try. Reading about the experiences or research of others has helped me improve my own health.

Many people can have similar great ideas, thinking and trying things is free. Sharing great ideas can help increase the number of people or places benefiting from the information.

My goal for success is survival of the planet and as many of its species as possible. Tragedy is occurring too often. Wildfires are part of the natural cycle of forest growth but become more dangerous when more people live in the area. The risk of wildfires occurring in Southern California and elsewhere in the dry areas of the southwest are expected to double by 2050 with the changes occurring in climate patterns. “The risk of devastating fires in Southern California will double by 2050. Southeastern states will also see more wildfires in the coming years.”  See: 13 Dire Impacts Outlined in the New Climate Report, politicalchange.org.

  • Building or rebuilding with more disaster or wildfire resistant construction and landscaping (including a perimeter of no vegetation around the building) is a topic with more information available, some links available here: Peace is privacy and shelter from weather.  Learning from a children’s story – don’t build with straw or wood, build with brick if you want durable construction. Buildings are made with fire alarms and sprinkler systems to reduce risk of fire spreading. Watch towers are placed intermittently throughout forests with a person to watch for signs of fire. In the days of early settlers townpeople or individuals would make fire breaks around settled areas to reduce the risk of wildfires spreading into the settled area. Sod construction was messy but less of a risk for fire except for the thatched roof. (Sod House/Wikipedia) Building in floodzones risks frequent flooding, more people in those areas are building on stilts or building floating houses, or the areas are being rezoned for other construction or are being restored as wetlands which help protect nearby areas from flooding. Adapting to the changing times in advance saves money and trauma later. (Knightsen Wetland Restoration and Flood Protection Project, Balance Hydrologics)
  • Links regarding trauma and recovery here: Peace is recovering from trauma.
  • This month’s tragedy was also a previous year’s tragedy and the goal is to have better plans in place for the future as the risks increase with warmer drier weather patterns. Information about volunteering or donating money to help with the current wildfire crisis in California can be found here: (California Volunteers).
  • Ideas about improving the early warning system for wildfire risk is discussed in this article: Response to California Fires: A New Warning System?, Guy on Climate.
  • How climate change can affect wildfire risk on the west coast of the U.S. and severe snowstorm risk on the east coast at the same time is discussed in the article: Consequences of the November Dipole, Guy on Climate. It isn’t discussed in detail in that article but the air mass over the west coast is likely increasing drought (Causes of Extreme Ridges That Induce California Droughts, Journal of Climateit is complicated).

The human impact on the planet and its species is undeniable. Just how fast or how severe and whether the rate matches predictions or not is splitting hairs. The fact is extreme weather events are increasing in frequency and severity and the ocean is becoming warmer and more acidic and pollution is showing up basically everywhere on the planet that has been monitored.

Currently the air quality is not very safe for breathing in many areas of California where wildfires occurred. For my personal health it wasn’t that good to begin with in some areas. I was congested within six hours visiting the Los Angeles area – I later spent a lot of time thinking and then writing down some ideas of my own and others regarding large air purification systems: Imagining Windmills – Solar Sail Revolving Ones. I can’t think well when I don’t have clean air, let alone breathe well, or do any other activities. My favorite places to visit in California included some national forests and a shady countryside walk along a creek.  I cannot survive well in a polluted area or where it is too hot, dry and sunny. Heat adds to inflammation for people with autoimmune problems. People are unlikely to enjoy themselves if they are overheated or disoriented from bad air conditions.

Some points from previous posts about health and air quality:

  • Information about smog: (Causes and Effects of Smogconserve-energy-future.com)
  • Having adequate B vitamins which are important for all aspects of metabolism and energy production in the body may help reduce the harmful health effects of breathing smog-laden air: (Could a Daily Vitamin Curb Smog’s Health Effects? webMD.com)
  • Banning indoor smoking helps a lot. Some states have banned indoor smoking in all public places but some still allow. I’m updating this post in a location that allows it in a section of the building and the odor is obvious to me throughout the main area of the building. It is a health risk that may be worse for people who have deficiencies or metabolic differences in B vitamins such as folate and B 12 which are discussed in more detail later. Other tips for reducing formaldehyde are discussed in this post: formaldehyde-health-risks-and-environmental-and-dietary-sources/
  • Formaldehyde is a common chemical in polluted or smoky air and folate is needed to help the body detoxify and excrete formaldehyde. It may be an underlying factor in risk for autism development as housing with poor air circulation and/or some types of new vinyl flooring is associated with a greater risk for autism in the family. Other pollutants that may effect children are included in this post: environmental-toxins-and-neurodevelopmental-disorders-in-children/
  • Genetic screening might be helpful for people living in smog areas -methylation differences can leave people unable to use the common supplemental type of folate called folic acid or vitamin B12. Methylated forms of both are available or both can be found in some typically used foods but if you did have a genetic difference in ability to methylate then it is better to avoid using the supplemental folic acid or un-methylated B12. It is like filling the body with puzzle pieces that fill the receptor spots that are open but which then can’t connect properly to other pieces. The unusable forms compete with any methylated vitamin that was available from dietary sources of B12 or folate that had been eaten that day. (Selfpay, for research purposes onlygenetic screening panel that I have used – meaning it isn’t approved as a diagnostic tool that you could get your health insurance to cover or doctor to prescribe.) We need to try new strategies if we hope to get different results.

People value different things, and that is valuable and looking at different ways to do things can help us adapt to a changing world.

Experience nothing – Visit Padasjoki, Finland. (Padasjoki.fi/fi)

Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes