After more than a century of debate over the role of salt in human health, new medical evidence suggests that reducing salt in the U.S. diet may pose a greater risk of harm to the average person. Consider these four common myths about salt.
(BPT) - After more than a century of debate over the role of salt in human health, new medical evidence suggests that reducing salt in the U.S. diet may pose a greater risk of harm to the average person. Consider these four common myths about salt:
Myth 1: Salt consumption leads to hypertension
According to the Mayo Clinic, “For most adults, there's no identifiable cause of high blood pressure [hypertension].” Dr. Jan Staessen, head of the Research Unit on Hypertension at the University of Leuven in Belgium, has written that, “The evidence relating blood pressure to salt intake does not translate into an increased risk of incident hypertension in people consuming a usual salt diet.” Having a temporarily elevated blood pressure is not the same thing as having hypertension, as blood pressure varies normally throughout the day depending on a variety of factors.
Myth 2: Americans could massively reduce their salt consumption without any negative health consequences
Dr. Andrew Mente, of McMaster University in Canada, and his team conducted the largest ever epidemiologic study of the impact of sodium intake on blood pressure, cardiovascular disease risk and mortality. “We found that regardless of whether people have high blood pressure, low-sodium intake is related to more heart attacks, strokes and deaths compared to average intake,” he said.
Myth 3: The U.S. population would gain significant health benefits from major population-wide salt reduction
The Food and Drug Administration (FDA) recommends a maximum daily limit of 2,300 mg of sodium per day and a maximum of 1,500 mg for people with certain conditions. Salt is 40 percent sodium. According to Dr. Michael H. Alderman of the Albert Einstein College of Medicine, “Sodium consumption around the globe has a mean of about 3,600 mg/day, and a range from 2,600–5,000 mg/day. This mid-range describes about 90 percent of the world’s population. ... Optimal survival is realized by those whose intake is between 2,800 and 5,000 mg/day. Specifically, there is no evidence of a superior health outcome at intakes less than 2,000 mg/day compared with those in the usual range.”
Myth 4: Americans eat more salt than ever
Military records from the early 1800s up to WWII show that the average soldier was consuming between 6,000 and 6,800 mg/day of sodium. We eat about half of that today, and that number has remained consistent since WWII. The advent of refrigeration meant that we could preserve food with less salt, but salt remains a critical ingredient for food safety and preservation.
Sodium chloride (salt) is a nutrient that the body cannot produce, and therefore it must be consumed. The average American eats about 3,400 mg per day of sodium, according to The National Health and Nutrition Examination Survey, right in the middle of the healthy range.
(BPT) - Haiti has among the highest rates of elephantiasis (lymphatic filariasis), which attacks the lymphatic system, leading to abnormal enlargement of body parts, disfigurement, pain, disability and social ostracism. The World Health Organization estimates that 856.4 million people in 53 countries remain threatened by elephantiasis. The Haitian population also suffers from widespread iodine deficiency. The Haitian Ministry of Health has established a goal to completely eradicate elephantiasis and iodine deficiency disorders in Haiti by 2020. Fortunately, there is a simple cure for these conditions: salt fortified with iodine and diethylcarbamazine citrate (DEC).
Iodine is an essential element for healthy human life, enabling the function of thyroid glands to produce needed hormones for proper metabolism. When children in the womb don’t get enough iodine from their mother, fetal brain development is impaired. During pregnancy, iodine deficiency can cause a child to develop learning and intellectual disabilities as well as developmental problems affecting speech, hearing and growth.
“Iodine deficiency disorder (IDD) is the single greatest cause of preventable mental retardation,” says Kul Gautam, the former deputy executive director of UNICEF. “Severe deficiencies cause cretinism, stillbirth and miscarriage. But even mild deficiency can significantly affect the learning ability of populations. Scientific evidence shows alarming effects of IDD. Even a moderate deficiency, especially in pregnant women and infants, lowers their intelligence by 10-15 IQ points.”
Kiwanis International, a worldwide service organization in more than 82 nations and geographic areas, partnered with UNICEF in a global effort to eliminate iodine deficiency disorders (IDD). In just 10 years, starting in 1990, the percentage of the world population consuming iodized salt went from 20 percent to 70 percent. Kiwanis ultimately provided nearly $105 million to protect children from preventable mental and physical disabilities.
“There is no reward greater in life than helping children, and seeing them live healthy, vibrant lives. Our clubs and members understand the importance of helping children in their communities, and in communities around the world, and have proudly contributed to protecting more than 80 million children from the devastating effects of iodine deficiency,” said Stan D. Soderstrom, executive director of Kiwanis International, during a Kiwanis sponsored presentation at the 2018 World Salt Symposium in Park City, Utah.
Iodine deficiency was a problem in the United States as well, until American salt producers started adding iodine to table salt more than a century ago. Today, about 70 percent of the table salt sold in the United States is iodized. In fact, salt has been and remains the primary source for iodine in the American diet. The effect of this public health initiative has been to virtually eliminate the incidence of thyroid related illness, including goiters. “Iodized salt has been one of the greatest and most economical public health successes and it continues to help raise healthy, smart children,” said Lori Roman, President of the Salt Institute, which hosted the 2018 World Salt Symposium.
(BPT) - You can find them on the side of most every product at your local grocery store. They are plain and kind of boring but nutrition labels were designed to contain vitally important information for good health and wise food choices. These labels tell you the number of servings in a container, how many calories per serving, and what amounts of vitamins and essential nutrients (like sodium) they contain.
However, they don’t just give you the raw data, they also tell you what percentage of your daily allowance of needed nutrients you are getting. When it comes to sodium, however, that may be a problem. The daily allowances are based on the 2015-2020 Dietary Guidelines, with guidance from the Institute of Medicine (IOM), now known as the Health and Medicine Division (HMD) of the National Academies of Sciences, Engineering, and Medicine (the National Academies).
The current FDA Dietary Guidelines call for a maximum daily sodium allowance of 2,300 mg, well below what the average American eats, which is about 3,400 mg per day of sodium. But, when the IOM studied this issue and released their report in 2013, “Sodium Intake in Populations: Assessment of Evidence,” they found no evidence to lower the daily allowance below 2,300 mg per day and some indication that doing so would be harmful. The level set by the FDA not only represents a significant population-wide sodium reduction effort, it also ignores the latest evidence.
An increasing amount of research is contradicting the FDA’s sodium guidelines. A 2014 study, published in the New England Journal of Medicine found that the healthy range for sodium consumption was between 3,000 and 6,000 mg per day and eating less than 3,000 mg per day may increase the risk of death or cardiovascular incidents. And a 2011 study published in the Journal of the American Medical Association found that low-sodium diets were more likely to result in death from cardiovascular disease.
Low-salt diets can lead to insulin resistance, congestive heart failure, cardiovascular events, iodine deficiency, loss of cognition, low birth weights, and higher rates of death. Dr. Michael Alderman, editor of the American Journal of Hypertension and former president of the American Society of Hypertension, has repeatedly cited his concern that a population-wide sodium reduction campaign could have unintended consequences.
Very few countries in the world meet the government recommendations. A study of almost 20,000 people in 33 countries shows the normal range of consumption around the world is 2,800 to 4,800 mg/day. This is consistent regardless of where people get their food, either from home-cooked meals, prepackaged meals or restaurants.
The new nutrition labels were supposed to go into place this year, but now the FDA has indefinitely delayed their implementation. Hopefully this will allow them time to adjust the sodium limits to more accurately reflect the evidence as well as how real people eat and the safe range of sodium consumption.
Everyone agrees that we need salt to live and that it is an essential nutrient, but getting the right amount is important.
(BPT) - The news lately is full of articles about salt and health. Everyone seems to be getting either too much salt or not enough. So which is it? Part of the problem is with how we study the connection. Fortunately, researchers on both sides of the issue are starting to agree on how best to proceed and may soon have a better answer for all of us. That answer may be that for most of us, there is no need to eat less salt than we do now.
The European Heart Journal recently published a report by researchers from the World Heart Federation, the European Society of Hypertension and the European Public Health Association that clarified that eating more than 5 grams of sodium per day increases the risk of heart disease, but there was little evidence that eating less than 2 grams per day had any health benefits. They recommended a safe range of between 3 and 5 grams of daily sodium. The good news is that the average American eats about 3.4 grams of sodium per day, an amount that has stayed the same for the last 50 years.
Of course more research is needed, but also better research. In the past, many studies only looked at the effect of salt on blood pressure. Today more doctors and scientists are looking at the effect salt has on your total health. The researchers agreed that your overall diet is more important to your health than a single nutrient. It’s true that a low-salt diet can lower your blood pressure slightly, but it can also place stress on other parts of your body, and that can increase the risk of bad outcomes like diabetes.
Another way research into salt and health is being improved is in the way the results are collected. In the past, people whose salt levels were being studied provided only one urine sample, but your salt levels vary throughout the day and from day to day.
A much more accurate way to study salt in people is to collect multiple urine samples over many days, not an easy task, but one that the researchers recognized produces much more accurate results. Fortunately, there is a captive group of people that scientists are studying to measure their salt intake exactly: Russian cosmonauts living in a closed environment as part of the “Mars” project. This research is already yielding some surprising results, such as more salt makes you less thirsty.
Everyone agrees that we need salt to live and that it is an essential nutrient, but getting the right amount is important. The fact is that a small percentage of people are salt sensitive and are affected by salt more than others. These individuals may benefit from less salt, but the rest of us may be put at risk from that same low-salt diet. Every person has different health needs and should follow the advice of their doctor. Placing the entire country on a low-salt diet, as some have suggested, may do more harm than good.
(BPT) - A typical soup and sandwich lunch can seem like a healthy meal. However, the bread, cold cuts and soup can be packed with something that can have a negative impact on your overall wellness: salt.
“Even meals that seem healthy, like a turkey sandwich with a side of cottage cheese, can have high levels of salt. It may not even taste salty," says John Meigs, Jr., MD, president of the American Academy of Family Physicians.
Meigs says one of the biggest mistakes people make is to assume if they aren't adding salt with a salt shaker, their sodium levels are under control. The truth: The Centers for Disease Control and Prevention estimates Americans get 77 percent of their salt from processed foods and restaurant meals, compared to 6 percent from the salt shaker at the table and 5 percent added during home cooking.
According to the CDC, the top 10 foods that contribute to a significant amount of the salt Americans consume are:
1. Breads and rolls
2. Cold cuts and cured meat (e.g., deli or packaged ham or turkey)
4. Fresh and processed poultry
6. Sandwiches such as cheeseburgers
8. Pasta dishes (not including macaroni and cheese)
9. Meat-mixed dishes such as meatloaf and tomato sauce
10. Snacks such as chips, pretzels and popcorn
Some salt is necessary for the body to function properly, but too much can contribute to high blood pressure, heart disease and stroke. The CDC says most people should limit total salt intake to 2,300 milligrams a day or less.
"There are 2,300 milligrams of sodium — the chemical name for salt — in a single teaspoon of table salt," Meigs notes. "It's a real challenge to reduce salt intake, even for people who are highly motivated to do so."
Meigs offers some easy strategies to lower hidden salt intake and take control of your nutrition:
Know your numbers
Talk with a doctor about your blood pressure, cholesterol levels, family health history and ways to prevent health problems before they start. Visit familydoctor.org to learn more.
Read nutrition labels
It takes mere seconds to read nutrition labels to see which items are high in sodium. Sometimes this information is even printed on the front of the package.
Keep in mind, different brands of the same foods often contain varying levels of salt. For example, a slice of white bread can range anywhere from 80 to 230 milligrams of salt. Salt levels in a can of chicken noodle soup can range from 100 to 900 milligrams per serving.
Be a smart diner
Dining out can still be a healthy treat with a little proactive effort. If nutrition information isn’t included on the menu, do some homework in advance by visiting the restaurant’s website. You may be surprised to find that items billed as “light or healthy fare” are often high in salt.
Opt for whole foods
Whether eating out or dining in, filling your plate with whole foods — items in their natural state or close to it — will help you lower your sodium levels. Non-processed fresh foods that are high in fiber are ideal, for example, fresh fruits, vegetables, lean meat and whole grains.
Prepare food at home
It's easier to regulate salt consumption by preparing meals at home. Not only can you select healthy ingredients and pack your plate with whole foods, you can control the salt you add to dishes by manipulating recipes and including flavor-enhancing alternatives like fresh herbs.
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