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Spinal Cord Stimulators for Chronic Back Pain Win FDA Approval

  Spinal Cord Stimulators for Chronic Back Pain Win FDA Approval On May 16, 2023, the U.S. Food and Drug Administration (FDA) approved spinal cord stimulation (SCS) devices from the pharmaceutical company Abbott to treat chronic  back pain  in people who have not had or are not eligible to receive back surgery, per a  press release from Abbott . Approval was granted after a six-month study of 200 participants showed that spinal cord stimulation provided significant relief and improvements in pain, function, quality of life, and mental health.Those enrolled in the trial had experienced an average of nearly 13 years of disabling chronic back pain. Participants were not eligible for corrective back operations because they were either medically frail or they had numerous degenerative changes in their spine, none of which were severe enough to qualify for corrective surgery but are nonetheless causing significant symptoms. After half a year, 85 percent of those implanted with Abbott’s SCS d

What Is the DASH Diet? A Guide to the Scientific Plan for Lowering Blood Pressure

 

What Is the DASH Diet? A Guide to the Scientific Plan for Lowering Blood Pressure


The Dietary Approaches to Stop Hypertension, or DASH, diet has been consistently ranked by U.S. News & World Report as a top diet overall, and that comes as no surprise.

 Unlike fad diets that call for extreme calorie or food-group restrictions without scientific evidence that supports their efficacy, the DASH diet involves manageable dietary changes that are flexible and rooted in proven nutritional advice.
This has made the eating plan popular among doctors, dietitians, and other health professionals in the United States, where heart disease remains the No. 1 killer among men and women.

 High blood pressure (hypertension) is a big contributing factor to heart disease and affects an estimated 50 percent of American adults. One in three of those people don’t know they have hypertension.

 Heart disease is also the leading cause of death around the world.

 The good news is that lifestyle changes, including the switch to a healthy diet, may help lower blood pressure in patients with resistant hypertension, which is blood pressure that remains elevated despite medication, research suggests.

Whom Is the DASH Diet Good for Exactly, and What Variations Are There?

The DASH diet was developed specifically to help people lower high blood pressure and is promoted by the National Heart, Lung, and Blood Institute (NHLBI), which is part of the National Institutes of Health.

 Blood pressure readings higher than 130 millimeters of mercury (mmHg) for systolic blood pressure (the top number) and higher than 80 mmHg for diastolic (the bottom number) are considered high.

The food options available on the DASH diet closely mirror the eating plan recommended in the U.S. Department of Agriculture’s MyPlate, with a focus on whole foods, such as fruit and veggies; fat-free or low-fat dairy; whole grains; and lean meats, fish, and poultry.

 Meanwhile, the plan requires cutting back on, or preferably eliminating, processed foods, like sugary drinks and packaged snacks, and limiting red meat, which has been linked to increased risk of coronary heart disease.
The DASH diet specifically meets the sodium requirements that can give people an edge over hypertension.

This means it’s a great diet for people who have high blood pressure or are looking to reduce their risk of heart disease, as well as those individuals who may be at risk of type 2 diabetes or are currently managing the condition.

DASH Diet Types

Depending on your health needs, you can choose from two forms of the DASH diet.

The standard DASH diet This plan limits sodium consumption to 2,300 milligrams (mg) per day.

The lower-sodium DASH diet This version calls for limiting sodium consumption to 1,500 mg per day.

The daily DASH eating plan also involves, on average:

  • 6 to 8 servings of grains, preferably whole grains
  • 6 or fewer servings of meat, poultry, and fish
  • 4 to 5 servings of veggies
  • 4 to 5 servings of fruit
  • 2 to 3 servings of low-fat or fat-free dairy products
  • 2 to 3 servings of fat or oils
Here are some of the other estimated daily nutritional goals of the DASH diet plan.

  • Total fat is about 27 percent of calories
  • Saturated fat is 6 percent of calories or less
  • Protein is about 18 percent of calories
  • Carbohydrates are about 55 percent of calories
  • Cholesterol is limited to 150 mg
  • Fiber is 30 grams (g) or more
Depending on your weight loss or weight maintenance needs, you can choose a DASH diet plan that provides 1,200, 1,400, 1,600, 1,800, 2,000, 2,600, or 3,100 calories per day.

How Does the DASH Diet Lower Blood Pressure?

The DASH diet works by limiting not only sodium but also saturated fat — both of which can be detrimental to heart health, says Kimberley Rose-Francis, RDN, CDCES, a dietitian and diabetes educator in Sebring, Florida. A diet that's heavy in salt can drive up blood pressure, which puts unnecessary strain on the heart muscle, Rose-Francis says. Saturated fat, on the other hand, can increase cholesterol levels. “Cholesterol has the potential of blocking or decreasing the flow of blood to the heart,” Rose-Francis says, adding that restricted blood flow can lead to heart attack and stroke.

The DASH diet also works by increasing foods that provide fiber, lean protein, and other nutrients thought to help lower blood pressure.

People who want to lower their blood pressure should combine the diet with other healthy lifestyle approaches to manage hypertension, such as getting more exercise, losing weight, cutting back on alcohol consumption, and managing stress levels. Quitting smoking and getting plenty of sleep are also recommended and can improve your overall health.

A 7-Day Sample DASH Diet Menu You Can Follow

The DASH diet calls for lots of fresh veggies and fruits, but requires only a moderate amount of whole grains, as well as lean sources of protein and healthy fats, such as those from fish and nuts, respectively.

 This distinguishes the DASH diet from other popular plans, such as the Atkins diet and the  ketogenic diet, or the high-fat, low-carb diet.

Here’s a typical week of meals on the DASH diet.

Day 1

Breakfast

  • 1 whole-wheat bagel with 2 tablespoons (tbsp) peanut butter (no salt added)
  • 1 medium orange
  • 1 cup fat-free milk
  • Decaffeinated coffee

Lunch

  • Spinach salad made with 4 cups of fresh spinach leaves, 1 sliced pear, ½ cup canned mandarin orange sections, ? cup slivered almonds, and 2 tbsp red wine vinaigrette
  • 12 reduced-sodium wheat crackers
  • 1 cup fat-free milk
    • 1 cup fat-free, low-calorie yogurt
    • 4 vanilla wafers

    Dinner

    • 3 ounces (oz) herb-crusted baked cod
    • ½ cup brown rice pilaf with vegetables
    • ½ cup steamed green beans
    • 1 small sourdough roll with 2 teaspoons (tsp) olive oil
    • 1 cup fresh berries with chopped mint
    • Herbal iced tea

    Day 2

    Breakfast

    • 1 cup fresh mixed fruits topped with 1 cup fat-free, low-calorie vanilla-flavored yogurt, and ? cup walnuts
    • 1 bran muffin with 1 tsp trans-fat-free margarine
    • 1 cup fat-free milk
    • Herbal tea

    Lunch

    • Curried chicken wrap made with a whole-wheat tortilla, ? cup chopped chicken, ½ cup chopped apple, 1½ tbsp light mayonnaise, and ½ tsp curry powder
    • ½ cup raw baby carrots
    • 1 cup fat-free milk

    Snack

    • Trail mix made with ¼ cup raisins, about 22 unsalted mini twist pretzels, and 2 tbsp sunflower seeds

    Dinner

    • 1 cup cooked whole-wheat spaghetti with 1 cup marinara sauce, no added salt
    • 2 cups mixed salad greens topped with 1 tbsp low-fat Caesar dressing
    • 1 small whole-wheat roll and 1 tsp olive oil
    • 1 nectarine
    • Sparkling water

    Day 3

    Breakfast

    • ¾ cup bran flakes cereal with 1 cup low-fat milk
    • 1 medium banana
    • 1 slice whole-wheat bread with 1 tsp trans-fat-free margarine
    • 1 cup orange juice

    Lunch

    • Tuna salad made with ½ cup drained, unsalted water-packed tuna, 2 tbsp light mayonnaise, 15 grapes, and ¼ cup diced celery served on top of 2½ cups romaine lettuce
    • 8 Melba toast crackers
    • 1 cup fat-free milk

    Snack

    • 1 cup light yogurt
    • 1 medium peach

    Dinner

    • Beef and vegetable kebab, made with 3 oz of beef and 1 cup of peppers, onions, mushrooms, and cherry tomatoes
    • 1 cup cooked wild rice
    • ? cup pecans
    • 1 cup pineapple chunks
    • Cran-raspberry spritzer made with 4 oz cran-raspberry juice and 4 to 8 oz sparkling water

    Day 4

    Breakfast

    • 1 cup oatmeal topped with 1 tsp cinnamon
    • 1 slice whole-wheat toast with 1 tsp trans-fat-free margarine
    • 1 banana
    • 1 cup fat-free milk

    Lunch

    • ¾ cup chicken salad with 2 slices whole wheat bread and 1 tbsp Dijon mustard
    • Salad with ½ cup cucumber slices, ½ cup tomato wedges, 1 tbsp sunflower seeds, and 1 tsp low-calorie Italian dressing
    • ½ cup fruit cocktail, juice pack

    Snack

    • ? cup unsalted almonds
    • ¼ cup raisins
    • ½ cup fat-free, no sugar added fruit yogurt

    Dinner

    • 3 oz roast beef with 2 tbsp fat-free beef gravy
    • 1 cup green beans sautéed with ½ tsp canola oil
    • 1 small baked potato with 1 tbsp fat-free sour cream, 1 tbsp reduced fat cheddar cheese, and 1 tbsp chopped scallions
    • 1 small apple
    • 1 cup low-fat milk

    Day 5

    Breakfast

    • ½ cup instant oatmeal
    • 1 mini whole-wheat bagel with 1 tbsp peanut butter
    • 1 medium banana
    • 1 cup low-fat milk

    Lunch

    • Chicken breast sandwich with 3 oz of skinless chicken breast, 2 slices whole-wheat bread, 1 slice reduced-fat cheddar cheese, 1 large leaf of romaine lettuce, 2 tomato slices, and 1 tbsp low-fat mayo
    • 1 cup cantaloupe
    • 1 cup apple juice

    Snack

    • ? cup unsalted almonds
    • ¼ cup dried apricots
    • 1 cup fat-free, no sugar added fruit yogurt

    Dinner

    • 1 cup spaghetti with ¾ cup vegetarian spaghetti sauce and 3 tbsp Parmesan cheese
    • Spinach salad with 1 cup fresh spinach leaves, ¼ cup grated carrots, ¼ cup sliced mushrooms, and 1 tbsp vinaigrette dressing
    • ½ cup corn (cooked from frozen)
    • ½ cup canned pears, juice pack

    Day 6

    Breakfast

    • 1 slice whole-wheat bread with 1 tsp margarine
    • 1 cup fat-free, no sugar added fruit yogurt
    • 1 medium peach
    • ½ cup grape juice

    Lunch

    • Ham and cheese sandwich with 2 oz low-fat, low-sodium ham, 2 slices whole-wheat bread, 1 large leaf of romaine lettuce, 2 slices tomato, 1 slice reduced-fat cheddar cheese, and 1 tbsp low-fat mayonnaise
    • 1 cup carrot sticks

    Snack

    • ? cup unsalted almonds
    • ¼ cup dried apricots
    • 1 cup low-fat milk
    • 1 cup apple juice

    Dinner

    Day 7

    Breakfast

    • 1 low-fat granola bar
    • 1 medium banana
    • ½ cup fat-free, no sugar added fruit yogurt
    • 1 cup orange juice
    • 1 cup low-fat milk

    Lunch

    • Turkey breast sandwich with 3 oz cooked turkey, 2 slices whole-wheat bread, 1 large leaf romaine lettuce, 2 slices tomato, 2 tsp low-fat mayonnaise, and 1 tbsp Dijon mustard
    • 1 cup steamed broccoli (cooked from frozen)
    • 1 medium orange

    Snack

    • 2 tbsp unsalted peanuts
    • 1 cup low-fat milk
    • ¼ cup dried apricots

    Dinner

    • 3 oz baked fish
    • 1 cup scallion rice
    • Spinach sauté with ½ frozen spinach, 2 tsp canola oil, and 1 tbsp slivered, unsalted almonds
    • 1 cup carrots (cooked from frozen)
    • 1 small whole-wheat roll with 1 tsp margarine
    • 1 small cookie

Possible Pros of Following the DASH Diet: What the Research Says

The DASH diet is recommended for people who want to lower blood pressure, but it's also a great option for anyone who wants to adopt a healthy diet. Because it emphasizes whole foods that are naturally low in unhealthy fats and added sugars, as well as moderate portions, it may also lead to weight loss, as it did in a population of people with nonalcoholic fatty liver disease, one study shows.

There are several benefits to the DASH diet.

The DASH Diet Tends to Be Sustainable

The diet offers variety and is easy to follow as a lifelong dietary choice.

It’s Designed to Help Lower High Blood Pressure

Studies have shown that people who stick to this diet can lower their blood pressure. One, for example, found the blood-pressure-lowering effects to be most pronounced among people with systolic blood pressure above 150 mmHg.

It Can Help Boost Heart Health Overall

In another study, women with type 2 diabetes who followed the DASH diet had a lower risk of cardiovascular disease than women who did not prioritize fruit, vegetables, and whole grains.

 Meanwhile, other research found that the DASH diet with sodium reduction lowered the risk of cardiac injury and strain.

Improved Management of Type 2 Diabetes 

Other research found that when paired with a weight loss plan and exercise regimen, the DASH diet was linked with reduced insulin resistance, which is the hallmark of type 2 diabetes.

Better Nutrition

The DASH diet emphasizes eating whole and fresh foods because processed and prepackaged foods often have the most added salt, not to mention added sugar. A diet high in foods like these is nutritionally balanced, and tends to be high in vitamins, minerals, and fiber.

The Possible Cons of Following the DASH Diet: Notes From Experts

There are few drawbacks to the DASH diet. But some people may be troubled by the fact that it does not outline a specific way to lose weight.

“It is not designed for weight loss, per se, but it offers different numbers of servings for the food groups for different calorie levels, so you could follow a [more targeted] weight loss diet with this plan,” says Nancy L. Cohen, PhD, RD, a professor emerita of nutrition at the University of Massachusetts in Amherst.

Other people may find it hard to adjust to eating as much fiber as the DASH diet recommends. Try gradually adding high-fiber foods, such as whole grains, fruits, and vegetables, and drink plenty of water while doing so to avoid bloating, cramping, gas, and physical discomfort.

The Potential Short- and Long-Term Effects of the DASH Diet

Research suggests the DASH diet can be a practical, sustainable, and healthy eating plan for lowering blood pressure, and potentially losing weight, in the short and long term.

For example, sticking with the DASH diet for only about a month led to health benefits. One study found that participants who followed the DASH diet had biomarkers linked to heart injury that were lower by 18 percent and inflammation lower by 13 percent, while those following a low-sodium version of the diet (50 millimoles per day) saw even more benefits and reduced their biomarkers for heart strain by 23 percent and heart injury by 20 percent.

    
Those heart benefits continue if you keep up with the diet for the long run. Other research looked at nearly 4,500 individuals from multiple ethnicities between ages 45 and 84 who followed the DASH diet for 13 years. The researchers found the DASH diet helped prevent heart failure in the under-75 group.


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