New research shows that salt reduction seems to save lives

Today sees the publication of a study which appears to show that reducing salt consumption can save lives. The research, conducted at Harvard medical school in the USA has found that individuals who reduced their salt intake from about 10 g to about 7 gram per day (a 30 per cent reduction) see a 25 per cent reduced risk of developing cardiovascular disease (such as heart disease) and were at 20 per cent reduced risk of dying from cardiovascular conditions such as heart attack and stroke, though this reduction in deaths was not statistically significant.

Previous studies have shown that salt restriction can help reduce blood pressure. The difference about this study is that it appears to prove that any reduction in blood pressure leads to meaningful reductions in the risk of actual disease.

While the salt lobby has traditionally attempted to cast doubt on the relationship between excessive salt consumption and ill-health, the research has been steadily mounting up over the years which has made it increasingly difficult to defend its corner. This latest study delivers, I think, a serious blow to those who would have us believe that salt is, essentially, harmless.

For those keen to do what they can to moderate their salt intake I have added below a piece below about this. Generally speaking, the great majority of the salt in our diet is to be found already-added in processed foods. To my mind, this is the place to look, not the salt we may be inclined to sprinkle on our salmon or steak, if we want to bring about meaningful reductions in our salt intake.

For more information, see the Consensus Action on Salt and Health website http://www.actiononsalt.org.uk/


References:

1. Cook NR, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). British Medical Journal 2007; BMJ Online First.

Why cutting down on processed foods in the key to reducing salt in the diet

23 October 2005

This month, renewed calls have come from health professionals for us to reduce the amount of salt we consume. Currently, the average salt intake for a UK adult stands at about 10 g per day, and recommendations are that we should cut our daily intake to no more than 6 g. It is believed that this level of constraint would lead to global reductions in blood pressure that, in time, would translate into significant reductions in the rates of cardiovascular conditions such as heart attacks and strokes. Recently, I read that some doctors have become frustrated that their efforts to encourage individuals to eat less salt have not been helped by TV chefs who heartily recommend rock salt and sea salt in preference to regular table stuff.

While such salts may be more desirable from a culinary perspective, the fact is their negative effects on blood pressure are likely to be similar to those of table varieties. Personally, I am relaxed about celebrity chef salt recommendations, on the basis that the salt we add during cooking or at the table accounts for only about 10 per cent of the total salt we consume. The fact is, the great majority of our salt intake comes via processed foods. Therefore, it makes sense for those aiming to significantly reduce their salt intake to target not so much the salt they add themselves, but the salt in foods already added by the food industry.

Recently, the Food Standards Agency (FSA) urged the food industry to make significant reductions in the salt it adds to food. However, when supermarkets and food manufacturers objected to this on the basis of ‘technical’ and ‘consumer taste’ issues, the FSA lamely relaxed the proposed targets. It is perhaps no surprise that that food industry might be putting profit before public health but, personally, I had hoped for a little better from the Government agency chiefly responsible for food policy in the UK.

I suggest that those keen to reduce their salt consumption should vote with their feet by simply consuming less salt-laden processed fare. It is sometimes useful to compare the saltiness of foods with sea water, which contains about 2.5 g of salt per 100 g. Bread contains about half this level of salt, while some foods such as cornflakes, sausages and other processed meat products can contain salt levels equivalent to or even higher than sea water. Food manufacturers have got into the habit of listing the salt content of food not as salt itself, but as sodium. Watch out for this, as the sodium level must be multiplied by 2.5 in order to calculate the equivalent amount of salt. Avoiding salt-saturated processed food should help to protect us from the unsavoury effects of high blood pressure.

5 Responses to New research shows that salt reduction seems to save lives

  1. Neil 20 April 2007 at 1:19 pm #

    I thought that salt reduction had only a minor effect on BP apart from susceptible individuals. Gary Taubes the science journalist did a thorough review only a few years ago.

    http://www.junkscience.com/jan01/saltwars.html

  2. Dr John Briffa 20 April 2007 at 5:05 pm #

    Neil
    My understanding is that relatively small reductions in blood pressure are thought to translate into quite large reductions in cardiovascular disease risk.

  3. Neil 20 April 2007 at 6:23 pm #

    Hi John
    I can’t claim to read everything current on the ramifications of small increases or decreases in BP, but what follows reflects what I feel has more of a ring of truth to me.

    “……when you read ‘reduction in CV events’ this doesn’t mean reduced rate of death from Coronary Heart Disease (CHD). It primarily means reduced rate of death from stroke….. ”

    “…CHD (or atherosclerotic plaques) causes a high blood pressure, and not the other way round.”

    “The example of high blood pressure serves as a lesson in how to turn an ‘associated symptom’ into a disease, and how to get cause and effect hopelessly mixed up.”

    and from the European Heart Journal Issue 20, October 2000.

    ‘No randomized trial has ever demonstrated any reduction of the risk of either overall or cardiovascular death by reducing systolic blood pressure from our thresholds to below 140mmHg.’

    ‘Most importantly, the current paradigm considerably over-estimates the risk in the mid-range of pressure (roughly 125 ” 180mmHg). This has major consequences. The vast majority of the population falls into that mid-range and the cut-point of 140mmHg lies towards its lower end. Consequently, a large proportion of the population considered at increased risk with the current cut-point are in fact at no increased risk.’

    all the above taken from Malcolm Kendricks ‘thincs.org’ essays

    also by Dr Kendrick
    http://www.opinions3.com/malcolmkendrick.htm

    I’d also strongly question the accuracy of readings, especially where we are talking about health benefits from reductions in single figures of mmHg. This is from my own experience of taking readings, as well as the following by Sandy Szwarc regarding BP measurement in children. I don’t see any reason why the errors reported here can’t be extended to adults, in their many shapes and sizes.

    http://junkfoodscience.blogspot.com/2007/03/helping-to-protect-children-from-wrong.html

    ” The second study, led by Dr. Amber Podoll, M.D., at Baylor College of Medicine in Houston, Texas, examined the inaccuracies in pediatric blood pressure (BP) measurements. The researchers evaluated the BPs obtained during standard practice at the pediatric hypertension clinic at Texas Children’s Hospital in Houston. They found 74% of the BPs taken by the clinic staff at the vital sign station were inaccurately high. When taken by medical personnel in accordance with the guidelines in the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents, established by the U.S. Department of Health and Human Services, the differences were significant. Systolic readings differed by about 13.2 mmHg and diastolic 9.6 mmHg.

    As this study was conducted at a hypertension clinic, the researchers noted that their clinic’s emphasis on BP measurements mean their readings would likely be more accurate than those found in other settings. Still, even in their clinic, the inaccuracies were significant enough to lead to substantial misdiagnosis of children with normal blood pressures as being hypertensive and exaggerations of the degree of hypertension in those with high blood pressures.”

  4. Audrey 21 April 2007 at 11:42 am #

    Hello John,

    I had an ileostomy in February and found the diet difficult at first, but now I can eat more a more normal diet with fruit and vegetables

    My niece, who is studying nutrition gave me a print out of some lecture notes. It said that salt was important in ileostomy patients. I wasn’t told this by the stoma nurse.

    The food in hospital was dire and when I mentioned it to a doctor, when he asked how I was, I told him this. He said it was just a social complaint! I lost 18lbs in just under 3 weeks.

    A lot of the food was salt free, but they did serve a little sachet of salt with the food. I only use salt in cooking at home and don’t have a salt cellar on the table.

    I took a friend to a herbal clinic when I was doing herbal training at a clinic in Leeds. She told me on the train that she filled her salt cellar everyday. She also ate a whole jar full of olives every day. She never mentioned it in the consultation and presumably the GP had never asked her about nutrition. She was being treated for high blood pressure.

    In hospital they took my BP three times a day. It varied so widely that you do wonder about small changes in BP.

    Audrey

  5. helen 22 April 2007 at 11:36 pm #

    All I can say is that I don’t eat processed foods but I do use a little salt to cook & always put salt on my food at the table. It does not appear to change my blood presure one way or the other & the only people in my family to have high blood presure or heart/stroke problems are those that eat no salt whatsoever & are constantly going on about my salt intake!! I did have high blood presure before going low carb & for myself at least I am convinced it is the sugar & other high carb foods that contribute to high blood pressure & heart disease, as well as a host of other health problems.

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