SALT

A major government food campaign is aiming to persuade Britons to limit their salt intake. The Food Standards Agency hopes the 26m people who it says are consuming more salt than is healthy for them will heed its health warnings. High salt consumption can contribute to high blood pressure, which can lead to heart disease and stroke, it says. However, salt manufacturers say the government's £4m campaign is unfairly targeting one of life's essentials. The FSA said every day at least 26m people eat more than the recommended daily limit of 6g of salt.

The food agency said high blood pressure is a cause or contributing factor in 170,000 deaths a year in England. However, studies show that reducing salt in the diet can lower blood pressure within four weeks, helping not only the individual but also the NHS, which spends about £840m on prescriptions for reducing high blood pressure. FSA chairman Sir John Krebs described high blood pressure as a silent killer, as those living with it are three times more likely to develop heart disease and stroke.

But Peter Sherratt, general secretary of the Salt Manufacturers' Association, described the campaign as "spin" because, he said, salt had no impact on blood pressure for people who had not been diagnosed with hypertension. He said, "All the major research over the last 10 or 15 years shows that it doesn't. You're sitting there with something like a cupful of salt inside you and it makes you work. Without it, you would be in deep trouble. It enables your brain to communicate with your hands and feet, your muscles to operate, your heart to pump and it helps you digest your food. Too much salt is not bad for your heart."

Mr Sherratt said there was a possibility that cutting salt out of the diet could actually put some vulnerable people at risk. Japanese people consume four times as much salt as people in the UK, but has the highest average longevity in the world, he claimed. The FSA said that manufacturers also had a role to play by reducing salt in processed foods and better labelling of salt on food products, which would help people change their diet. The public health minister Melanie Johnson wrote to leading food manufacturers in June, asking them to beef up their plans for reducing salt in their products. (Source: BBC News, Sep/04)

Eating smaller amounts of salt every day as a teenager could help to reduce high blood pressure and lower the risk of heart disease and stroke in adulthood, research suggests. Researchers from the University of California used computer modelling to project that reducing daily salt intake by 3g could result in a 44 to 63% reduction in the number of teenagers and young adults with hypertension. This amounts to up to 550,000 fewer cases of hypertension.

By the time the teenagers reach 50, the benefits of cutting levels of salt in their diet will become clear. Rates of coronary heart disease would fall by 7 to 12%, the number of heart attacks by 8 to 14% and the number of strokes by up to 8%. The findings echo calls from NICE to reduce daily salt intake, which were outlined in guidance on preventing cardiovascular disease in June this year. The guidance recommends a reduction in salt intake, aiming for a maximum intake of 6g per day per adult by 2015 and 3g daily by 2025.

Speaking at the time of the guidance launch, Professor Simon Capewell, vice chair of the guidance group and an expert in public health from the University of Liverpool, warned that more and more people were consuming excessively high levels of salt in their diets. He said, “We know that currently across the UK, people are consuming about 8.5g of salt every day, and that's two to three times higher than the level our bodies actually need.”

He added, “If salt levels in food are reduced by 5 to 10% a year, most consumers don't even notice any difference in taste, their taste buds simply adjust. Meanwhile they will benefit from better health and reduced risk of heart disease and stroke.” This latest study, presented earlier this week at the American Heart Association's Scientific Sessions in Chicago, found that even a 1g reduction in salt consumption was enough to lead to a drop in systolic blood pressure of 0.8mm Hg.

Lead researcher Dr Kirsten Bibbins-Domingo, said, “Reducing the amount of salt that is already added to the food that we eat could mean that teenagers live many years free of hypertension. The additional benefit of lowering salt consumption early is that we can hopefully change the expectations of how food should taste ideally to something slightly less salty.” Dr Bibbins-Domingo added, “The hidden places of salt in our diet are in breads and cereals, canned foods and in condiments, and of course in fast foods. Most of the salt that we eat is not from our salt shaker but salt that is already in the food that we eat.” (Source: NICE, Nov/10)

The Public Health Agency (PHA) is urging people to keep a close eye on their salt intake during National Salt Awareness Week, which runs from Monday 21 to Sunday 27 March. The theme for this year’s National Salt Awareness Week is ‘Salt and men’s health’. Research shows that men eat more salt than women and on average have a higher blood pressure than women, particularly at a younger age. Men are also less likely to have their blood pressure checked or to take action to reduce it when it is raised.

Salt puts up our blood pressure, and raised blood pressure (hypertension) is the major factor in strokes, heart failure and heart attacks, the leading causes of death and disability in the UK. High blood pressure often has no symptoms, but if you have it, you are more likely to develop heart disease or have a stroke. Decreasing your average salt intake will reduce incidences of cardiovascular disease which will save thousands of lives every year. There is also increasing evidence of a link between our current high salt intake and stomach cancer, osteoporosis, obesity and kidney disease.

Dr Carolyn Harper, Director of Public Health, PHA, said, “The PHA encourages all consumers to take an active approach to reducing their salt intake, by checking product labels and preparing more of their food at home. Around 75% of the salt we eat is already in the food we buy, so by reading product labels to determine whether a product is high or low in salt, we can significantly reduce our salt intake and improve our health. Often the information on food labels lists sodium, rather than salt content."

She added, "To work out how much salt is in the food, simply multiply by 2.5; so, for example, if the label on baked beans shows that they contain 0.4g sodium per half tin, this means that half a tin of the beans provides 1g of salt. Even though salt is an essential part of our diet, it is important that it is consumed in moderation. Adults should eat no more than 6g of salt a day, and children even less. Reducing the UK’s average daily salt intake for adults to 6g could prevent about 17,500 deaths from heart attacks and strokes a year.” (Source: Public Health Agency, Mar/11)

The benefits of lowering salt intake to save lives and healthcare costs may have been overestimated, researchers believe. Researchers from the University of Leuven in Belgium found no link between high urinary sodium and risk of hypertension, cardiovascular events or death. This suggests models have overvalued the benefit of lowering salt intake in saving lives and health costs at a population level, they argued. Elsewhere, Dutch researchers said low sodium levels in the blood increase the risk of fracture in elderly people.

Recent research predicted that cutting salt intake by around 3g per day could reduce cardiovascular events and healthcare costs. But researchers led by Dr Jan Staessen said such predictions ignored the inconsistency of evidence linking BP to salt intake. Neither did these consider whether the results could be applied to the general population, nor the possible dangers of sudden salt reduction, they said. Researchers used data from 3,681 participants without cardiovascular disease who had urinary sodium and BP measured over eight years. (Source: GP Online, May/11)