There is more and more scientific evidence supporting the link between salt intake and cardiovascular disease. In November 2009 a meta-analysis was published in the British Medical Journal showing that a high salt intake is associated with significantly increased risk of stroke and cardiovascular disease (CVD).
The study also indicated that each year a 5 gram reduction in daily salt intake at the population level could prevent one and a quarter million deaths from stroke and almost three million deaths from CVD worldwide.
Although a small amount of salt is essential for our wellbeing, many South Africans eat far more salt than what they need. Most adults eat between 7 – 10 grams of salt per day, while the healthy recommendation is that adults consume less than 1 teaspoon (6 grams) of salt per day and children much less.
Most people know that a low salt diet can help reduce blood pressure, but more and more research is showing that a low salt diet can have benefits other than cardiovascular health.
The theme for World Salt Awareness Week 2010 is "Salt and your health" and includes all the other health conditions related to too much salt in the diet.
High blood pressure
High blood pressure is the leading cause of death in the world due to the strokes and heart attacks it causes. People who eat a lot of salt or salty foods are more likely to develop high blood pressure. It is estimated that about a quarter of all South Africans, 15 years and older, suffer from high blood pressure. Cutting down on salt intake can help prevent high blood pressure and significantly decrease it if already present.
Heart attacks, heart failure and stroke
High blood pressure is a major risk factor for heart disease, heart attacks and heart failure. Stroke is a leading cause of disability and the third largest killer in South Africa, where high blood pressure is the single most important risk factor.
40% of strokes can be prevented by managing high blood pressure. Professor of Cardiovascular Medicine and Chairman of WASH (World Action on Salt and Health) group, Graham MacGregor, says, "Eating too much salt puts up our blood pressure, the major risk factor of CVD. This leads to millions needlessly suffering and dying from heart attacks, heart failure and strokes each year. If we reduce our salt intake by just a few grams a day, we can all reduce our risk of CVD."
The obesity pandemic is a major global public health concern and statistics in South Africa are alarming, where 56% of women, 29% of men and 17% of children are overweight or obese. While salt does not cause obesity, it increases thirst and the amount of fluids consumed – especially sweetened soft drinks.
Reducing salt intake may contribute to a reduction in the intake of sugary drinks in both adults and children. Studies in the UK have shown that a reduction in sweetened soft drink intake is likely to reduce the number of children developing obesity.
Other effects of salt on our health:
High salt intake may increase calcium losses from bones, so may contribute to osteoporosis, bone fractures and breakages. High blood pressure is a major risk factor for kidney disease. A high salt diet leads to water retention, which also increases the risk of kidney disease. People who suffer from water retention, for example heart failure patients and women with premenstrual water retention, may find an improvement in symptoms when reducing salt intake.
"Everyone should take responsibility for changing their lifestyles in an effort to improve their health”, says Erika Ketterer, Registered Dietitian at the Heart & Stroke Foundation SA. Remember that most people eat more salt than what they need without even realising it. Around 75% of the salt we eat is hidden in the foods we buy.
"Try to aim for an overall healthy diet and watch your sodium (salt) intake by focusing on eating more natural products and limiting processed or refined foods. The best way of avoiding foods containing hidden salt is by reading labels and choosing products with lower sodium content. Also try cooking with less salt and don’t add extra salt at the table," says Erika.
Simple ways to lower your salt intake
Cut down on foods that are high in salt (anchovies, bacon, biltong, cheese, coated chicken/nuggets, crisps, extracts such as marmite or bovril, gravy powders, ham/polonies/salami, olives & capers, pickles & gherkins, salted nuts, sausages, smoked chicken/fish, soya sauce, stock cubes, take away foods, canned meat)
Compare labels on products – some brands are high in salt (e.g. baked beans, biscuits, bread, burgers, crisps, pies, ready-made convenience meals, salad dressings, soup, sauces e.g. tomato sauce/cook-in sauces)
Eat unprocessed and fresh foods regularly (fresh fish/chicken/meat, fruit & vegetables, pasta & rice, oats, plain cottage cheese, pulses, unsalted nuts & seeds, yoghurt)
Develop a habit of using less salt when preparing your food. Remember that when you reduce your salt intake, food may taste bland initially, but after a few weeks your taste receptors will become more sensitive
Use new ways of flavouring your food when cooking (use fresh/frozen/dried herbs, salt free spices, pepper, curry powders, chilli, garlic, ginger, lemon or lime juice, vinegar)
Try to do more home-cooking – making your own bread, pasta sauces, soups and cakes can drastically reduce your salt intake
Read food labels and choose foods with less salt or sodium.
This is a lot: 1.25 g of salt or more OR 500 mg of sodium or more.
This is a little: 0.3 g of salt or less OR 120 mg of sodium or less
Choose Heart Mark approved products as these are lower in sodium as well as saturated fat, cholesterol, added sugar and are higher in fibre (where applicable)
The Heart and Stroke Foundation SA recommends that people follow a diet that is low in sodium, coupled with general healthy eating principles and increased physical activity.
Let 2010 be the year you change your diet for the better…you can start by eating less salt!
For further information on reducing salt intake and for heart healthy recipe books, visit www.heartfoundation.co.za or chat to a Dietitian via Heart Mark Diet Line on 0860 223 222.
(Heart and Stroke Foundation SA, January 2010)