How to Stop Hiccups

Hiccups are caused by a spasm in the diaphragm. The diaphragm is the muscle that separates your thorax (including your lungs and heart) from your abdomen (including your stomach and intestines). When you breathe in, your diaphragm contracts and pulls down and becomes flat in order to make room for more air in the lungs. When you breathe out, your diaphragm expands and forces air out of your lungs.

During a hiccup, your diaphragm spasms causing you to take a quick breath in. This breath in is then interrupted by the epiglottis closing and causing a “hic” sound. (FYI, the epiglottis is a flap that covers the space between the vocal cords).

It is possible to stop them within 60 seconds or so by swallowing a teaspoon filled with dry sugar. Specialists believe the abrupt sweetness on the tongue overloads the nerve endings in the mouth and blocks the hiccup spasm.

A study published in the New England Journal of Medicine and also found on Medicine.net showed when a spoonful of granulated sugar is eaten, it was found to be effective in 19 out of 20 patients.

Cholesterol and Salt

Hooray, bring on the bacon and eggs! Two recent reports are shaking up the food industry. Salt has recently been vindicated by scientists. "Cardiovascular disease, heart failure, or death in older Americans are not linked to salt intake", according to research published in JAMA Internal Medicine on January 19, 2015. This follows last year’s Institute of Medicine report, which also raised questions about sodium recommendations. The IOM committee found that there was no clear evidence to support limiting sodium to 1,500 milligrams or less per day.

The New England Journal of Medicine published a study in August 2014 which reported that people who consume less 1,500 milligrams of sodium are more likely to die than people who eat between 3,000 to 6,000 milligrams of sodium per day.

Now this new report says, cholesterol is no longer a "nutrient of concern," according to the US leading nutritional panel in February 2015.

In its 2015 version of the guidelines from the US Department of Agriculture, it will no longer place an upper limit on cholesterol, "because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol." The draft report said, "Cholesterol is not a nutrient of concern for over consumption." The recommended changes were compiled by 14 nationally recognized nutrition, medicine, and public health experts. It makes Dr. Adkins appear absolutely prescient.

Health experts agreed it is no longer necessary to consider a food's cholesterol content when making dietary decisions. The committee’s new report also advised eliminating 'lean meat'  as well as 'cutting back on red and processed meats' from the list of recommended healthy foods. The panel also said it OK to have three to five cups of coffee per day.

The science connecting high-cholesterol foods to the accumulation of bad cholesterol in the blood is lacking - not conclusive enough to warrant federal intake recommendations. Even the predictive value of bad cholesterol levels in looking at heart attack risk has shown to be weak by recent studies.

The new enemy is increased carbohydrates, according the current analysis of government data. It says that, "over the past 50 years, we cut fat intake by 25 percent and increased carbohydrates by more than 30 percent." That is what has led to the increase in obesity.

Other countries that offer dietary guidelines have long abandoned specific caps on cholesterol. According to David Klurfeld, a nutritional scientist at the USDA, "The US is the last country in the world to set a specific limit on dietary cholesterol." Finally science begins to trump headlines. Many of my friends know I have been a Cassandra of cholesterol for years. I wonder how long it will take for 'artery clogging' to be banished from the lexicon.

Another Salt Study

Adding to the library of salt studies is yet a new one which again finds that salt is not that bad and that too little salt may be as bad for us as too much salt. The same can be said for calories or carbohydrates.

More than 100,000 people from the general public in 17 countries were observed for nearly four years and sodium levels were determined from urine tests. The researchers found people who consume 3 to 6 grams of sodium a day (salt contains about 39% sodium by weight) had the lowest risk of heart problems or death from any cause. About three-fourths of the world's population is in the ideal range, including the US, which averages 4 grams a day salt consumption.

The new study published this week in the New England Journal of Medicine suggests the US's daily consumption of about 3,400 milligrams is not only perfectly fine, but may be healthier than abstaining. It suggests eaters should shoot for between 3,000 and 6,000 mg of salt each day. Dr. Suzanne Oparil, a cardiologist at the University of Alabama, Birmingham, who wrote an editorial accompanying the publication, added, "Japan, one of the highest salt consumers, has one of the longest lifespans."

Table salt also contains iodine, and desiccants to keep it from clumping. Sodium is essential for human nutrition, but too much sodium or too little sodium raises health risks. Sodium levels generally correlate with the risk of high blood pressure, but correlation (are related) is not causality (one causes the other). Chlorine is also important to overall health. Our bodies, like salt water swimming pools separate sodium from chlorine for use.

Potassium, found in vegetables and fruits appears to lower blood pressure and heart risks, and offsets sodium's effect. Potatoes, bananas, avocados, leafy greens, nuts, apricots, salmon, and mushrooms are high in potassium.

Determining that worldwide deaths are caused by one ingredient, without relation to complete diet, or other factors, is like saying global warming is caused only by CO2, or that drinking only diet soda makes us fat.

As with all studies, results 'should be taken with a grain of salt'. Reducing or increasing one item from the panoply of food we ingest is interesting fodder for highly funded studies, but taking results too seriously can be hazardous to our health.

Modern Medicine

A study in the New England Journal of Medicine found that when nearly 1,700 patients were discharged for heart failure and had intensive telemonitoring (daily call-in to deliver weight and symptoms info), there was no benefit in mortality or hospital-readmission rates. Seems the government and  insurance companies love new bureaucratic rules because it makes them feel good.

Electronic Medical Records

Only a small number of hospitals in the United States have comprehensive electronic health record systems currently in place. The biggest obstacle to adopting such systems are costs, which can run as high as $20 million to $100 million, plus the reluctance of doctors to change their ways. The report is published in the March online edition of the New England Journal of Medicine.

Researchers questioned 3,049 US hospitals about their electronic health record systems. They found that only 1.5 percent had comprehensive systems. A comprehensive system was defined as hospital-wide clinical documentation of cases, test results, prescription and test ordering, plus support for decision-making that included treatment guidelines.

Eight percent of hospitals have electronic records that include physician and nursing notes, but these systems do not have decision support.

The new healthcare bill aims to change all that within the next five years, by offering incentives for implementing electronic medical records systems. Some see difficulties remaining, with the incentives falling way short of costs. In addition, it can take multiple years to implement a comprehensive system.