Hypertension

Updated 16 November 2015

Is bread killing South Africans?

Bread is one of our staple foods, but it contains a lot of sodium, putting millions of South Africans at risk of high blood pressure and related strokes and heart disease.

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South Africans eat a lot of bread and in many households it is eaten at every meal, according to Dr Vash Mungal-Singh, who is the CEO of the Heart and Stroke Foundation of South Africa (HSF).

Excess salt is known to cause high blood pressure or hypertension, which is a leading cause of heart disease and stroke in South Africa. With Sunday being World Hypertension Day (WHD), South Africans are urged to test their blood pressure regularly as most people have no idea what their blood pressure level is, and could be putting their health at risk.

Read: Regularly salting foods heightens death risk by 50%

Foods with a lot of hidden salt include cereals, processed meat, flavouring, savoury snacks, margarine and butter. And, although few people realise it, bread is the single highest contributor to the total salt intake of South Africans, according to the the Heart and Stroke Foundation of SA.

Salt levels in bread

"Our bread contains high levels of sodium, in fact much more than many first world countries," Dr Mungal-Singh told Health24.

She cautioned that the high levels of salt in bread plus the high quantities of bread consumed means we are eating way too much salt on a daily basis. "We are not even considering the salt in other foods we eat in addition to the bread." It's likely that most South Africans exceed their recommended sodium intake almost every day, sometimes by a substantial margin.

With an estimated 11 million South Africans living with high blood pressure, Dr Mungal-Singh pointed out that many more people are also developing the condition at a young age, putting their health on the back foot early in life.

Read: Types of hypertension

"Most South Africans, even those who know they have hypertension, do not take this seriously enough. It is called the 'silent killer' for good reason," she said.

"We implore people to get tested. It is the only way to know what your blood pressure level is."

How to cut salt intake

Health24's resident doctor, Dr Owen Wiese, said the easiest way to reduce salt intake is to start using less when cooking as this tends to be less obvious when eating and can lead to consistently higher levels of salt.

He said typical symptoms of high blood pressure include fatigue, severe headaches, vision disturbance, irregular heart beat and chest pains. And one of the biggest challenges is that for many people high blood pressure presents with no symptoms.

"One can therefore suffer from the condition without knowing it, until it's far too late."

Check your blood pressure

Dr Wiese added that it is important to check one's blood pressure regularly, especially for people who have a family history of hypertension, heart or kidney disease.

Once hypertension is diagnosed, he advised that lifestyle changes are crucial to managing the condition.

"These include losing weight, following a healthy diet, checking and limiting your dietary sodium intake, engaging in physical activity, using alcohol moderately and not smoking."

Dr Wiese warned that if hypertension is not treated it could lead to coronary heart disease, heart failure, strokes, kidney damage and eye damage.

Legislation for sodium content

To help regulate salt content in foods, the Minister of Health, Aaron Motsoaledi, proposed legislation in 2012 to cut the sodium content of certain foods, including bread.

The rules for an ordinary loaf of bread are 400mg of sodium per 100g by 30 June 2016 and 370mg sodium per 100g by 30 June 2018.

However, with about a year away from the first target, bread producers like Albany, Blue Ribbon, Sasko and Sunbake are making little progress to meet this target.

Health24 failed to get a response from major bread manufacturers Pioneers Foods, Tiger Brands and Premier Foods when contacted for comment.

Also read:

Salt may be bad for more than your blood pressure

Sensitivity to salt puts black South Africans at stroke risk

How potassium fights high blood pressure

Image: A loaf of bread by Shutterstock

 

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Hypertension expert

Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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