Salt and your heart health Part III: What the skeptics have to say

March 16, 2010 by  
Filed under HEART AND STROKE

 Now, it wouldn’t be fair if we don’t tell you what the other side has to say, the other side being the few who are not fully convinced that salt reduction in our diet is warranted for. Thus, this third part is dedicated to what these skeptics have to say.

When I wrote about the salt-reduction efforts in Portugal last June 2009, one reader (Geeta) wrote the following comment:

“Portugal’s PAASH campaign for mass education is indeed a valuable example of the power of media and its need in health education. As we become a technology savvy world, public health campaigns have to learn to effectively communicate their messages through the wide array of media outlets.

The campaign though phenomenal in its reach to 75% of the Portuguese population, I would be interested in the final effects of salt restriction on the hypertension in Portugal. The moment we tag an essential mineral as the primary cause for a disease state like hypertension there is cause for concern. We did it with fats and now it’s salt. Controlled studies on the success of effective long term maintenance of salt restriction by the Portuguese and its effects on the hypertension in the country would be valuable to our understanding of salt and its effects in the human body.

Studies show that most people are not sensitive to salt. Experimental studies of adults with normal blood pressure revealed that a salt restricted diet caused a drop in blood pressure in some but in others to rise. For the majority of cases there was negligible if any change.

For accurate information on salt intake and health please visit www.salthealth.org/

Point taken, Geeta. Indeed, I checked out the abovementioned site which contains a wealth of resources about salt.

Michael Alderman, editor of the American Journal of Hypertension wrote in 2000:

The question, therefore, is whether the beneficial hypotensive effects of sodium restriction will outweigh its hazards. Unfortunately, few data link sodium intake to health outcomes, and that which is available is inconsistent. Without knowledge of the sum of the multiple effects of a reduced sodium diet, no single universal prescription for sodium intake can be scientifically justified.”

More recently, he stated heartwire:

“In folks with a diet like that in the US, there are some studies that show an inverse association—less salt, more heart attacks—so the data are conflicting, and it’s a problem.”

John Mariani wrote in 2008:

This isn’t to say that salt is safe for everyone. Studies show that 30 percent of the Americans who have high blood pressure would greatly benefit from a low-sodium diet. But that’s about 10 percent of the overall population — the rest of us are fine with sodium. And drastically cutting out sodium may actually hurt some people.”

There accusations flying around that these skeptics may have some involvement the Salt Institute, a non-profit trade association whose members are salt producers and sellers. Salt Health (e.g. the site mentioned by Geeta above) is a project of the Salt Institute. The Institute claims it is “dedicated to sound science and SaltHealth.com is a presentation of accurate research condensed for consumers seeking accurate and reliable information.”

Well, readers, the salt debate will get more heated in the coming months. I just hope I gave you enough food for thought in the series to enable you to think objectively and make informed decisions.

Keeping sodium intake down: how difficult can it be?

July 14, 2009 by  
Filed under HEART AND STROKE

salt-and-lightWhy is sticking to a low sodium diet so difficult? Apparently it is difficult mainly because of problems with diet.

The recommended daily intake of sodium for patients with heart failure is 2 g or 2,000 mg. However, many patients take in more than that and only one-third can actually stick to a low sodium diet.

The study looked at 116 heart failure patients, their diet and their sodium intake. The study results showed that the average intake was 2,672 mg per day. This may seem high but looking at the range, the figures are even more shocking. The lowest intake was 522 mg whereas the highest was 9,251 mg per day – more than 4 times the recommended daily rate!

The researchers attribute this high sodium intake to poor diet. This typically consists of foodstuffs with hidden salt content, e.g. fast food meals, bread, pizza, and lunch meat. Furthermore these foods are also high on calories, thus adding insult to injury. The study results clearly indicate that

“Heart failure patients need individualized diet plans that lower sodium and enhance the overall quality of their diet.”

However, keeping sodium intake down is not only recommended for heart failure patients. Everybody has to watch their salt intake for the sake of their cardiovascular health. The American Heart Association (AHA) recommends the following:

  • 2,300 mg of salt per day for health people
  • 1,500 mg of salt per day for high risk individuals, e.g. middle aged and older adults, African Americans and those suffering from hypertension.

According to Dr. Carolyn M. Reilly, coauthor and researcher at Emory University in Atlanta

“The patients themselves were shocked to find out they were eating more than 2000 mg of sodium a day…There is so much salt hidden in foods that patients aren’t aware of. While they may have thrown away their salt shakers, they didn’t know that 70 percent of the sodium in the American diet is in the food, not the shaker. Everything processed has sodium in it to give it a longer shelf life. In addition to safety, sodium is also added to foods to enhance texture and mask bitterness. Some of the big culprits we have identified in this population are cured meats such as hot dogs and bacon, and other processed foods like canned soups, salad dressings and condiments.”

The study results also indicated that higher sodium intake was especially common among those who eat high-calorie diet and fast food, males, and those of lower economic status. Lower sodium intake was associated with low-calorie diet, less carbohydrate an fat intake (but not less protein), females, and those earning at least $35,000 a year.

Battling stroke by fighting salt: the Portuguese strategy

June 23, 2009 by  
Filed under HEART AND STROKE

saltPortugal has one of the highest mortality rates due to stroke in Western Europe and this has been attributed to the high salt intake of the population. Many Portuguese traditional food – including the salted fish delicacy bacalhau (salted cod) – contains high amounts of sodium chloride. However, even the normal daily fare such as bread also contains a lot of salt. The result is that the Portuguese population, take in, on the average, twice the amount of the recommended daily salt intake. -the stroke rate there is twice that of coronary disease.

A group of health led by Dr. Luis Martin of the Fernando Pessoa University formed the Portuguese Action Against Salt and Hypertension (PAASH) and conducted studies on Portuguese salt consumption habits and the health consequences. The results show that:

  • An adult consumes on average 11.9 g of sodium per day, two times the recommended daily intake.
  • Portuguese bread contains an average of 19.2 g of sodium per kg, which is 53% more than what is found in bread in other European countries. This highly contributes (21%) to the daily sodium intake.
  • The amount of salt by consumed by the population correlated with blood pressure and aortic stiffness.
  • In 2007, only 29% of the Portuguese population was aware of the health risks of excessive salt consumption

The PAASH advocates saw an immediate need for action to increase awareness and reduce salt consumption. They estimated that “a reduction of just 1 g per day of salt intake would save almost 2500 lives per year in Portugal, which has a population of around 10 million.”

Dr. Martin then started a massive awareness campaign in print and web media, as well as on on radio and TV. They persuaded politicians and well-known celebrities, including star football players and children’s cartoon characters, to help spread the word about the health risks of salt.

Dr. Martin explains the success of

“If they want to influence the people, they must act like politicians. And to get the attention of the politicians, we needed the media. Without the media in Portugal, it’s not possible.”

It seems that the campaign is starting to bear fruit.

  • A recent survey showed that awareness has increased up to 75% of the population.
  • They persuaded the Portuguese Bakery Association to cooperate by coming up with a recipe that provides for lower salt content without losing taste or quality.
  • They lobbied with legislators, resulting in the passing of a law by the Portuguese Parliament that requires food labels to show salt content of food products as well as and limits the sodium content in processed foods to a maximum of 14 g/kg.

With these results, the Portuguese has set a good example to the rest of Europe and the world that health awareness campaigns do work.

Photo credit: stock.xchng

Watch your salt intake!

March 30, 2009 by  
Filed under HEART AND STROKE

Do you know how saltmuch salt you should take each day? The amount of daily recommended level of sodium is not more than 1,500 mg (equivalent to about 5 to 6 g of table salt). And it seems that most Americans consume more than double of that, according to a Centers for Disease Control and Prevention (CDC) press release.

But why should we pay attention to our daily salt intake?

A diet rich in sodium is not favourable for our cardiovascular health. It increases the risk of high blood pressure, a major risk factor for heart disease and stroke. These diseases are the first and third leading causes of mortality in the United States, respectively.

Researchers at the University of California, San Francisco report that even a small reduction in dietary salt can have far-reaching consequences. They estimate that ” cutting just 1 g of salt a day would prevent a quarter of a million new heart-disease cases and 200 000 deaths from any cause over a decade.”

We may not be aware of it, but most of the salt we consume does not come from our very own kitchen. 80% of salt in Western country’s diet comes from processed and prepared food. It is therefore difficult for people to keep track of their salt consumption.

According to the CDC.

Nationwide, 16 million men and women have heart disease and 5.8 million are estimated to have had a stroke.  People who reduce their sodium consumption benefit from improved blood pressure and reduce their risk for developing other serious health problems. Choosing foods like fresh fruits and vegetables, when eating out, asking that foods be prepared without added salt, and reading the nutrition label of foods before purchasing can improve health for all adults.

However, not all food labels reflect the real salt content and some labels are too complicated for consumers to understand.

The USCSF researchers recommend that public-health types of intervention such as

  • regulatory efforts to restrict salt
  • force labeling of foods based on their salt content
  • encouragement of food manufacturers to reduce salt.

The experience in other countries suggests that with these very small changes we are describing, we will not change the taste of foods or the profit margins of the food industry, but it would be a great benefit for public health.”

Some major players in the food industry have answered the public health issue of salt consumption. The food company Campbell’s has set a good example and came up with a special line of heart-friendly products that contains 50% less sodium. Let us hope that more food companies will follow suit.

Photo credit: stock. xchng

Dangerous combination: salt and metabolic syndrome

February 18, 2009 by  
Filed under HEART AND STROKE

Metabolic syndrome makes you sensitive to sodium, hence salt. This is the result of a Chinese population-based dietary intervention study published in the latest issue of The Lancet. Our common table salt, that white powder that we eat everyday is mainly sodium chloride.

Metabolic syndrome refers to a group of medical conditions that put a person at risk for cardiovascular disease and diabetes. These conditions are:

High blood pressure

High blood sugar levels

High levels of triglycerides, a type of fat, in your blood

Low levels of HDL, the good cholesterol, in your blood

Too much fat around your waist

Researchers from Tulane University in New Orleans report that having a metabolic syndrome increases people’s sensistivity to salt causing their blood pressure to shoot up. This salt sensitivity was described as

as a decrease in mean arterial BP of more than 5 mm Hg during low-sodium intervention or an increase of more than 5 mm Hg during high-sodium intervention.

The dietary intervention study looked at1906 adult participants who received a low-sodium diet for seven days followed by a 6-fold higher sodium diet for another seven days. The results show that those with metabolic syndrome (283 participants) has an almost two-fold higher risk of having salt sensitivity. The more conditions indicating metabolic syndrome a person has, the higher is the salt sensitivity.

The study was conducted in Northern China where salt has been used for centuries as food preservative in rural areas, translating into high salt intake. However, despite the alternatives that technology has brought about (e.g. refrigeration, freezing, canning, and fresh food supply), people still eat high quantities of salt because it has become a dietary habit. There is an urgent need to break this habit as the prevalence of hypertension and other cardiovascular disorders are skyrocketing in China.

Salt reduction strategies have been implemented in many countries with quite some success. These strategies are usually simple, e.g. providing a measuring scoop for cooking, etc.

The authors conclude that “if salt-sensitive hypertension is recorded in Chinese people more frequently than in other countries, then reduction of salt intake should become a national campaign.”

In my upcoming posts, I will be writing more about salt in our diet, the current requirements and some yummy low salt recipes. Stay tuned!

Sodium and Your Health

February 21, 2008 by  
Filed under DIABETES

Get To Know Sodium

Sodium is a mineral that is needed for proper functioning of the human body. This mineral is a part of salt, and if not present in the body can cause health problems. Sodium helps balance the fluids present in the body.

Sodium occurs naturally in foods, so when you add extra salt to a meal you are increasing your sodium intake. An excess of sodium can contribute to health problems such as kidney disease, heart attack, and stroke. Blood pressure is sensitive to sodium intake which is why people with high blood pressure should carefully monitor their sodium intake.

How Much Do I Need?

The minimum required dose of sodium is 400 milligrams. This is based on natural conditions and intake, not extra salting of food. 400 milligrams is equal to less than ¼ teaspoon of salt, basically a pinch! Not very much, hm?

So many people have become accustomed to buying pre-packaged convenience foods without realizing most of these foods are packed with sodium. Our taste buds have become accustomed to the flavors associated with extra salt, so foods may taste bland if salt is eliminated. Processed foods have spoiled us, leading to the avoidance of natural tastes in a well cooked meal. We are consuming more salt today than ever, even with all of the so-called healthy choices available in the grocery stores.

Spice It Up!

Instead of adding salt to the foods you cook, try tossing in other herbs and spices. Fresh herbs and spice mills give a punch without the extra sodium. Instead of buying commercially blended spices for your food, try mixing your own. Montreal Steak Seasoning is delicious, but has a large amount of salt. Mix your own with half as much or maybe with none at all!

Low-Salt Montreal Steak Seasoning (great for chicken, too)

*2 tablespoons paprika
*2 tablespoons fresh ground black pepper
*½ tablespoon coarse sea salt
*1 tablespoon garlic powder
*1 tablespoon onion powder
*1 tablespoon coriander, ground/crushed (coarse)
*1 tablespoon dill
*1 tablespoon red pepper flakes ,crush well

Mix all ingredients and keep in a sealed container away from heat or light.

Items To Watch

Everyday foods have sodium, some might surprise you. Many vegetables and fruit have between 1 and 2 milligrams of sodium. Good examples are: apples-2mg, corn(1 ear)-1 mg, lemon-1 mg. I bet you never thought these fresh foods would contain sodium!

Processed foods have far more sodium, though. Those tasty apple pies from a fast food restaurant? 400 mg of sodium compared to a large slice of homemade apple pie which only has half the sodium! Your breakfast cereal? 1 cup of plain corn flakes contains 256 mg of sodium. Yikes.

When shopping, choose carefully among the pre-packaged foods. Check the nutrition labels for sodium per serving size, then adjust your eating plan to use only the serving suggested. If you are eating a food high in sodium, balance that the rest of the day with low or no salt foods.

Be careful with your sodium intake, it can change your health!

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.