Monday
We found that adding vitamin D
Cystic fibrosis is an inherited chronic disease that affects the lungs and digestive system of about 30,000 children and adults in the United States (70,000 worldwide), according to the Cystic Fibrosis Foundation. A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections and obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food.
"These important findings by Dr. Kolls' team add to the growing body of evidence showing that vitamin D may play a critical role on immune responses and allergic diseases," said Juan Celedon, M.D., Dr.P.H., chief of the Division of Pulmonary Medicine, Allergy and Immunology at Children's Hospital.
Sunday
Hay feve begins around the middle of August
Hay fever (known as seasonal allergic rhinitis) begins around the middle of August, when ragweed blooms. The typical symptoms sneezing, itching, stuffy nose and watery eyes can make sufferers miserable. Hay fever sufferers who also are allergic to cats, dogs or dust mites develop symptoms faster and (early on) more severely, the research suggests. Treating the cat, dog or dust mite allergy year round may help make the hay fever more manageable.
"People with hay fever react differently when ragweed allergy season arrives. Some start sneezing right away, and others don't, so we wanted to determine what makes certain people develop symptoms more quickly," said allergist Anne K. Ellis, MD, lead author of the study and an ACAAI member. "We tested a number of common perennial allergens and found that having an allergy to cats, dogs or dust mites sets hay fever sufferers up for faster onset of symptoms when exposed to ragweed."
The study included 123 people allergic to ragweed. Of those, 66 percent tested positive for cat allergies, 63 percent tested positive for dog allergies and 73 percent tested positive for dust mite allergies. All were exposed to ragweed for three hours in a special controlled room called the Environmental Exposure Unit (at Kingston General Hospital, Ontario), and completed symptom questionnaires every 30 minutes during exposure.
"On average, those who tested positive for cat, dog or dust mite allergies developed symptoms either faster than, or to a greater degree than those who tested negative for those allergies," said Dr. Ellis. "The differences seen at 90 minutes of exposure were less dramatic after 3 hours of exposure, however. That suggests that once the hay fever season is in full swing, the symptom differences between those with cat, dog or dust mite allergies and those without no longer exist."
To avoid the more intense early reaction, people with cat, dog and dust mite allergies should try to limit their exposure to those allergens before ragweed season starts, said Dr. Ellis. Because that often is not practical when it comes to family pets, an alternative is to treat their cat, dog or dust-mite allergies, she said.
"Allergy immunizations or year-round allergy medication can provide hay fever relief to those sufferers who have ongoing symptoms from cats, dogs or dust mites, even if they think the symptoms are mild and easily tolerated," said Neil Kao, MD, chair of the ACAAI Rhinitis/Sinusitis Committee. "They'll likely find ragweed allergy season easier to endure if they're treating their perennial allergies."
Those who suspect they have hay fever or other allergies should get tested by an allergist a doctor who is expert in diagnosing and treating allergies and asthma.
Friday
Can Turmeric (Curcumin) Help Prevent Cancer?
Turmeric is a spice derived that is a member of the ginger family.
Curcumin is the principal polyphenolic compound in turmeric and is by
itself an antioxidant and also supports the production of glutathione,
another key antioxidant during times of need. In recent years researchers
has revealed that turmeric can play a role in the prevention of cancer
formation.
Wednesday
Can Eating More Broccoli and Cauliflower Reduce the Risk of Cancer?
of Cancer?
There is good reason to include cruciferous (or Brassica) vegetables in
your diet arsenal to support cancer prevention. These vegetables include
broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, arugula,
kale, kohlrabi, mustard, rutabaga, turnips, bok choy, Chinese cabbage,
wasabi, horse radish, radish, and watercress. In addition to key anti-
oxidant vitamins and minerals, cruciferous vegetables are rich sources of
glucosinolates, which are the sulfur-containing compounds responsible
for their pungent aromas and unique taste. Routine preparation of these
vegetables by chopping as well as chewing leads to the breakdown of
glucosinolates which in turn give rise to indoles and isothiocyanates
which seem to help prevent cancer.
Broccoli and cauliflower contain sulfur-based nutrients that can
help defend against cancer.
Sunday
It is truly remarkable what our bodies
and the World We Inhabit
Have you ever stopped and wondered why we (humans) are as we are,
and why we do what we do? It is truly remarkable what our bodies are
capable of doing and how our bodies operate to perform various tasks.
Yet, we are just one of millions of different species inhabiting this planet,
all with a unique story to tell. And, like our fellow planet-mates, we must
abide by the basic objectives of life, namely to function as an independent
being (self-operate), defend ourselves both externally and internally,
nourish ourselves, and of course to reproduce, which is without question
the ultimate objective of all life-forms.
Yet, we are special in that we have a relatively large brain and the intel-
lectual capacity to try to understand ourselves and, in accordance, how we
are to be nourished. In this chapter we will begin to explore the very basis
of our being and the world we live in. This will begin to set the stage for
understanding what it will take to nourish our body for optimal health and
longevity. We will answer questions about basic concepts such as elements,
atoms, molecules, oxidation, chemical reactions, water solubility, and
acids and bases. If you have a science background this site might seem
too rudimentary and you might consider moving on to the next ....
Wednesday
More importantly
is simple : good health ought to be everybody's concern, not solely the medical profession's
business. More importantly, in my own case, I suffered immen- sely, for many years, largely due
to the shortcomings of the modern medical system. In my despair, I earnestly began my study of
natural methods of treatment and cure of disease, as also the ways and means of maintaining
good health. Putting the time-tested nature cure methods into practice proved so beneficial in my
own case, that I took to studying their application for several other diseases as well. What began
as mere jottings was gradually expanded into full-length articles on the subject " Cure Without
Drugs ", several of which were published in "The Economic Times. " The readers' response to
the series was overwhelming and several of them suggested that the articles be complied in
book form, to benefit more people. "Health the Natural Way " was the result. This book as well
as my second book titled " Diet Cure For Common Ailments " published three years laters, was
well received by the press and the public. This fact coupled with the immense popularity of my
articles on health, nutrition and nature cure being published in several leading newspapers and
magazines, have prompted me to write a comprehensive book on nature cure under the present
title for the benefit of the general public.
Where nutrition is concerned
Most members of the "medical" profession do not want to know. They do realise their patients are not losing weight, but they put it down to cheating and secret binges. Some slimming professionals even run group therapy sessions, at which members are applauded when they are able to show they have lost weight and made to feel ashamed of any gain.1 The mental cruelty involved in these practices is positively mediaeval. Moreover, stipulating a 1500 calorie diet without detailing what it is to contain is quite inadequate. It simply serves to focus on the energy value of foods without taking account of their nutritional value.
Apart from a few specialists, doctors tend to be disinclined to update their understanding of these matters and are usually not knowledgeable about them in the first place. Where nutrition is concerned, they seem to have little scientific understanding going beyond the commonly held views.
What is more, it is not a field in which doctors in general are particularly interested. I have noticed that of the twenty or so I have worked with on this book, all of them, without exception, were originally led to research and experiment in the field because they themselves had a serious weight problem to solve.
Tuesday
Sugar-sweetened beverages
Sugar-sweetened beverages, a major source of fructose, raise serum uric acid levels and are associated with an increased risk of gout, hypertension, and diabetes. However, it is unclear whether the associations with hypertension and diabetes are caused by fructose per se, or through some other mechanism. Nevertheless, given their demonstrated adverse health associations and the lack of any health benefit, the evidence favors minimization of sugar-sweetened beverage intake.
Herbal Products
Thistle for the treatment of liver diseases
Silymarin and its major constituent, Silibinin, are extracts from the medicinal plant Silybum marianum (milk thistle) and have traditionally been used for the treatment of liver diseases. Recently, these orally active, flavonoid agents have also been shown to exert significant anti-neoplastic effects in a variety of in vitro and in vivo cancer models, including skin, breast, lung, colon, bladder, prostate and kidney carcinomas. The aim of the present review is to examine the pharmacokinetics, mechanisms, effectiveness and adverse effects of silibinin's anti-cancer actions reported to date in pre-clinical and clinical trials. The review will also discuss the results of current research efforts seeking to determine the extent to which the effectiveness of silibinin as an adjunct cancer treatment is influenced by such factors as histologic subtype, hormonal status, stromal interactions and drug metabolising gene polymorphisms. The results of these studies may help to more precisely target and dose silibinin therapy to optimise clinical outcomes for oncology patients.
How useful condoms are in preventing herpes
Monday
Botanical medicine.
Over 700,000 different plants have been identified, but many more grow in isolated and remote environments, like the Amazon jungle. We have scientific data about only a handful, but even these have proven very useful as many modern pharmaceutical drugs are derived from plants. For instance, digitalis, from the foxglove plant, has been used by herbalists to treat heart disease. Extracts from this plant and its compounds are used in modern heart medications. The herb ephedra has been used in Chinese Medicine for over 2,000 years to treat asthma. The extract, Ephedrine, is used in commercial asthma medications
Though the United States Food and Drug Administration (FDA) does not recognize licenses of drugs from overseas, research in other countries has brought many medicinal plants into modern usage in Europe. Germany utilizes over 600 plants in medicines available by prescription. These plant-medicines are prescribed by over two-thirds of German doctors.
History
Healing with plants has been mentioned as far back as man has been keeping records. Ancient Egyptian papyrus relate recipes for cures using plants, as do medical systems from other cultures, such as Ayurveda in India and Traditional Chinese Medicine. With the advent of modern chemistry, scientists began to analyze the chemical make-up of various plants, and then synthesized compounds for use in pharmaceuticals and medicine. The FDA now classifies many herbs as dietary supplements, since the U.S. Dietary Supplement Health and Education Act (DSHEA) of 1994. Most herbs are sold over-the-counter, that is, without a prescription, and registration as a dietary supplement does not regulate the manufacture of herbal medicine.
Usage
Herbs can be taken internally as tea, tinctures, or extracts. They can also be added to oils or creams and used externally, not only for the hair or skin, but for absorption through the skin to treat various ailments.
Some of the more commonly used herbs in the United States are echinacea, used to boost immunity, and ginkgo bilboa, used for memory retention. Commonly utilized teas include chamomile and peppermint. Food plants such as ginger, chocolate, flax seed oil, and garlic are also classified in herbal medicine because of their healing qualities.
Side Effects from Herbal Medicine
Some herbal remedies do have side effects or allergic reactions, so it is important to talk over health concern with your doctor or health provider before beginning any new therapy. A study in the New England Journal of Medicine suggested that over half of people using herbal medicines did not report the usage to their doctors, and this can interfere with other drugs or medical treatments. You can research warnings and safety advice at the FDA website or the National Center for Complementary and Alternative Medicine.
Integrating natural and conventional treatments is often the most beneficial path to health, as one third of Americans know, so keeping our health providers informed will only speed the integration of herbal medicine into its rightful place as a healing agent
Saturday
Fibromyalgia is notoriously difficult to treat
Fibromyalgia is notoriously difficult to treat. Medication tends to reduce muscle pain, fatigue, and other symptoms of the chronic condition by just 30% to 50%. As a result, many patients turn to diet and lifestyle changes for added relief. Learning which foods to avoid is a good place to start, since fibro patients often have food sensitivities that may not show up in food allergy tests. In one survey, 42% reported that certain foods made their pain and stiffness worse.
Friday
pharmaceutical ingredient
"Herbal Diet Natural" contains an undeclared pharmaceutical ingredient similar to the prescription drug sibutramine. Sibutramine may pose serious health risks, particularly to people with heart problems. Consumers who have purchased "Herbal Diet Natural" are advised to consult with a medical professional if they have used the product or have concerns about their health, says Health Canada.
Sibutramine is a prescription drug used to treat obesity. The use of sibutramine may cause serious side-effects, including cardiovascular reactions, such as increased blood pressure, chest pain, and stroke, in addition to dry mouth, difficulty sleeping and constipation. Sibutramine should only be used under the supervision of a healthcare practitioner. Sibutramine should not be taken by people who have had a heart attack, coronary artery disease, heart-related chest pain, irregular heart beats, congestive heart failure, a stroke or symptoms of a stroke, in individuals with unstable or poorly controlled high blood pressure, or in patients who have clinically diagnosed depression or have a psychiatric illness. Sibutramine is not recommended for women who are pregnant, breastfeeding or planning to become pregnant.
According to the product label, Herbal Diet Natural also contains glucomannan used for the treatment of weight loss. In January 2010, Health Canada advised Canadians that natural health products containing the ingredient glucomannan in tablet, capsule or powder form, which are currently on the Canadian market, have a potential for harm if taken without at least 8 ounces of water or other fluid. The risk to Canadians includes choking and/or blockage of the throat, esophagus or intestine. These products should NOT be taken immediately before going to bed.
Wednesday
Cranberry prevents bacteria from sticking to the bladder wall long enough to cause an infection
Cranberry prevents bacteria from sticking to the bladder wall long enough to cause an infection. Finnish researchers divided 150 recurrent UTI sufferers into three groups. One drank cranberry juice (50 milliliters a day). Another took Lactobacillus. The third took nothing. After six months, 36 percent of the no-treatment group and 39 percent of the Lactobacillus group reported at least one recurrence. Of the juice drinkers, only 16 percent had recurrences. Other options are dried cranberries (Craisins) and cranberry-extract capsules. "I recommend cranberry for UTI," Duke says. "But if you drink the juice, you have to drink a lot. It's usually easier to munch on the dried berries or take capsules."
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Tuesday
VITAMIN B1 (Thiamine) Promotes growth
Buy Vitamin B Complex
VITAMIN B1 (Thiamine) Promotes growth, improves mental attitude, aids digestion, helps strengthen nervous system and prevent stress. HERBAL SOURCES: Alfalfa, bladder wrack, burdock root, catnip, cayenne, chamomile, chickweed, eyebright, fennel seed, fenugreek, hops, nettle, oat straw, parsley, peppermint, raspberry leaves, red clover, rose hips, sage, yarrow, and yellow dock.
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Saturday
Synonyms Echinacea
Synonyms Echinacea
herbal supplements herbal medication weight loss gnc
Study 2010 stop smoke
Doctors say the improvement came even though people who kicked the habit gained an average of 9 pounds. The study at the University of Wisconsin in Madison involved 1,500 smokers who were given one of five methods, such as nicotine patches or lozenges, to help them quit.
About one-third were successful, regardless of which method they used. Ultrasound tests were used to measure the health of their arteries before and after the study.
Results were reported Monday at a cardiology conference in Atlanta.
Stronger placebo effect
Like massage, acupuncture is difficult to study because it's hard to give a "fake" massage or "placebo" acupuncture. Says Clauw: "In 'sham' or placebo controlled trials in chronic pain, more studies have shown that acupuncture doesn't work. But that doesn't necessarily mean that it's not effective—it might be that there really is no such thing as sham acupuncture. Acupuncture might somehow be effective in engendering a placebo response." Whether that matters if someone feels significant pain relief is a question only the patient can answer. "The best evidence that it's effective is that a lot people will pay out of pocket to use it," he says.
Clauw himself conducted a fascinating imaging study of acupuncture, finding that while patients with fibromyalgia reported decreased pain with both fake and real acupuncture, fake acupuncture affected brain opioid receptors in a way that was more comparable to that seen with placebo. "Sham acupuncture may work via placebo effects and active acupuncture may work by more specific effects. That could help explain why trials don't show much difference," he says.
Some have claimed that electroacupuncture—which runs a small current through acupuncture needles—is more effective than needles alone, but Clauw says it's even harder to parse out placebo effects here. "It may give a stronger placebo effect," he says. For people in pain, however, that could be a good thing.
related pain relief:
Friday
Cafergot tablets buy
`
Cafergot tablets buy
Ergotamine/caffeine (Rectal)
Caffeine (KAF-een), Ergotamine (er-GOT-a-meen)
Treats or prevents migraine and cluster headaches.
Brand Name(s):
Cafergot,Migergot
There may be other brand names for this medicine.
When Cafergot Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to ergotamine or caffeine, or if you are pregnant or plan to become pregnant. You should not use this medicine if you have high blood pressure, kidney disease, liver disease, heart disease, blood vessel disorders, or problems with circulation.
How to Use Cafergot:
Suppository
Your doctor will tell you how much of this medicine(Cafergot) to use and how often. Do not use more medicine or use it more often than your doctor tells you to. Never take rectal suppositories by mouth.
Wash your hands with soap and water before using Cafergot. Remove the foil or wrapper from the suppository before inserting it.
To make the suppository easier to insert, you may use a lubricating gel such as K-Y® Jelly, but do not use petroleum jelly (Vaseline®).
Lie on your left side with your left leg straight or slightly bent, and your right knee bent upward. Gently push the pointed end of the suppository into the rectum about 1 inch.
Keep lying down for about 15 minutes to keep the suppository from coming out before it melts. Then, wash your hands again.
How to Store and Dispose of Cafergot:
Store Cafergot at room temperature, away from heat and direct light. Follow the directions on the medicine package label about storing the suppositories in the refrigerator, but do not freeze them.
Keep all medicine out of the reach of children and never share your medicine with anyone.
Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
Make sure your doctor knows if you are also using dopamine (Intropin®), sibutramine (Meridia®), antibiotics (such as Biaxin®, Dynabac®, Ery-Tab®), blood pressure medicine (such as atenolol, metoprolol, Inderal®, Toprol®), medicines to treat HIV/AIDS (Agenerase®, Crixivan®, Invirase®, Norvir®, Rescriptor®, Sustiva®, Viracept®), or other medicines to treat migraine headaches (Amerge®, Imitrex®, Maxalt®, Zomig?).
Do not drink alcohol while you are using this medicine. Avoid caffeine (coffee, tea, soft drinks, chocolate).
Smoking may make your headaches worse or increase the side effects of this medicine.
Warnings While Using This Medicine:
Make sure your doctor knows if you are breastfeeding, or if you have a stomach ulcer, glaucoma, or history of a stroke.
If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
Possible Side Effects While Using Cafergot:
Call your doctor right away if you notice any of these side effects:
Fast or slow heartbeat
Lightheadedness or fainting
Numbness or tingling in your fingers or toes
Pain or discomfort behind your breastbone
Pain, itching, or irritation around your rectum
Skin rash, swelling, or itching
Vomiting, numbness, tingling feeling, or pain and blue discoloration of your hands and feet
If you notice these less serious side effects, talk with your doctor:
Muscle pain
Nausea, vomiting, diarrhea, or stomach pain
Nervousness, irritability, dizziness
Weakness in your legs
If you notice other side effects that you think are caused by this medicine, tell your doctor.
Thursday
Bunch of grapes help to fight high blood pressure
A new study conducted by the University of Michigan Cardiovascular Center gives tantalizing clues to the potential of grapes in reducing the risk of cardiovascular complications. The effect is thought to be due to the high level of phytochemicals, which are naturally occurring antioxidants that grapes contain.
The current study was performed on laboratory rats. The researchers studied the effects that regular table grapes (a blend of black, green and red grapes) that were mixed into the rat diet in a powdered form, as part of either a diet low in salt or a diet high in salt. The researchers then performed many comparisons between the rats that were consuming the test diet and the control rats that were receiving no grape powder—including some that had received a mild dose of a common blood pressure medication. All of the rats were from a research breed that is prone to developing high blood pressure when they are fed a salty diet.
Mitchell Seymour, M.S., who lead the research as part of his doctoral work in nutrition science at the Michigan State University, said that in all, after 18 weeks, the rats that had received the diet with the grape-powder had reduced inflammation in their bodies, lower blood pressure, better heart function, and fewer signs of heart muscle damage that the rats that had eaten the same salty diet but did not receive any grapes. The rats that received the blood pressure pill, hydrazine, along with the salty diet also had lower blood pressure, but their hearts were not protected from damage as the rats in the grape-fed group. "These findings support out theory that something within the grapes themselves has a direct impact on cardiovascular risk, beyond the simple blood pressure-lowering impact that we already know can come from a diet rich in fruits and vegetables."
Steve Bolling, M.D., who is a professor of cardiac surgery at the U-M Medical School, notes that the rats in the study were in a put in a similar situation as millions of Americans, who have suffered from high blood pressure related to their diet, and who develop heart failure over time because of the prolonged hypertension. He also stated that the inevitable downhill sequence from hypertension to heart failure was changed by adding the grape powder to a high salt diet. Bolling explained, " Although there are many natural compounds in the grape powder itself that may have an effect, the things that we think are having an effect against the hypertension may be the flavanoids—either by direct antioxidant effects, by indirect effects on cell function, or both. These flavanoids are rich in all parts of the grape—skin, flesh, seed, all of which were in our powder."
Although the current study was supported in part by the California Table Grape Commission, which also supplied the researchers with the grape powder, the authors note that the commission played no role in the design of the study, analysis, conduct, or preparation of the journal article for publication. Seymour has also received funding from the National Heart, Lung, and Blood institute, which is part of the National Institutes of Health, through a National Research Science Award.
This does not mean it is time to tell patients to throw all of their medication away and just eat grapes. However, the research on the grapes and other fruits that contain high levels of antioxidant phytochemicals continues to show promise. So does the research on the impact of red wine on the heath of the heart, though that issue is also far from being settled.
Bolling suggested that if people wish to lower their blood pressure, reduce the risk of having heart failure, or help their weakened hearts retain as much pumping power as possible should follow tried-and-true advice: Cut down on the amount of salt that you get through your drink and food. "There is, as we know, a great variability, perhaps genetic even, in sensitivity to salt and causing hypertension. Some people are very sensitive to salt intake, some are only moderately so, and there are perhaps some people who are salt resistant. But in general we say stay away from excess salt."
He also notes that the popular DASH diet, which is low in salt and high in vegetables and fruits, has been proven to reduce mild high blood pressure without taking any medications. The dose of whole table grape powder that was consumed in the new study was roughly equivalent to a person eating nine human-sized servings of grapes daily. Currently, five to nine servings of vegetables and fruits are recommended as part of the Dash diet plan.
In all, the researchers say that this study demonstrates that a diet enriched with grapes can have broad effects on the development of hypertension and the risk factor that come along with it. Whether the effect can be replicated on humans, the researchers say, remains yet to be seen.
http://www.healthnews.com/nutrition-diet/grapes-newest-heart-healthy-food-2044.html
Tuesday
Globally more than 30 million people are infected with HIV
http://www.hivplusmag.com/NewsStory.asp?id=21870&StoryDate=03/09/2010
Sunday
Fear of anthrax infection.People Want the Drug Cipro
Related antibiotics
Amoxicillin Trimox Adoxa Zithromax AUGMENTIN Bactrim Myambutol E-mycin
Saturday
Reduce the risks of high blood pressure and heart failure
In the first investigation, Dr. Luc Djousse, from Harvard Medical School in Boston, and colleagues analyzed data from 20,900 men in the Physicians' Health Study I (1982-2008) to assess the link between lifestyle factors and the lifetime risk of heart failure. The subjects were followed for 22.4 years, on average.
The lifetime risk of heart failure, assessed at age 40 years, was about one in seven, the report indicates.
A variety of healthy lifestyle habits were linked to a lower risk of heart failure. These habits included maintaining a normal body weight , not smoking , regular exercise, moderate alcohol intake, consumption of breakfast cereals, and consumption of fruits and vegetables.
Men who adhered to none of the healthy lifestyle factors had the highest lifetime risk of heart failure-21.2 percent--while those who adhered to four or more had the lowest risk-10.1 percent.
The second investigation, conducted by Dr. John P. Forman and colleagues, from Harvard Medical School, Boston, involved an analysis of data from 83,882 women in the Nurses' Health Study (1991-2005). The goal was to assess the impact that various diet and lifestyle factors had, in combination, on the risk of high blood pressure.
The study focused on six factors, previously tied to a reduced risk of high blood pressure: normal body weight, vigorous exercise for an average of 30 minutes per day, consuming a healthy diet, modest alcohol intake, use of pain medications less than once per week, and use of supplemental folic acid, a form of vitamin B .
The presence of 6, 5, 4, and 3 of the factors cut the risk of high blood pressure by 78, 72, 58, and 54 percent, respectively, relative to the complete absence of these factors.
The factor with the single greatest impact on high blood pressure was body weight. Women who were obese were 4.7-times more likely to develop high blood pressure than were women of normal body weight.
The authors conclude that many new cases of high blood pressure could be prevented through adherence to the low-risk dietary and lifestyle factors described. This, they add, could yield major public health benefits.
SOURCE: Journal of the American Medical Association, July 22/29, 2009.