Silent killer, forgotten killer — these are some of the ways that salt is now being described in the media. Why has salt suddenly moved to centre stage in the fight against non-communicable diseases?
Eating fruits and vegetables and avoiding too much fried foods are well known parts of a healthy diet to prevent non-communicable diseases like heart disease, stroke and diabetes. Salt however has been rarely emphasised until recently.
The evidence is growing that high salt intake is a major risk factor for heart disease and stroke, and that by lowering salt intake blood pressure can be reduced. This in turn will reduce the risks of heart disease and stroke.
High salt intake is also linked to other diseases including stomach cancer. Recommendations to reduce salt intake have been adopted across the world, and endorsed by World Health Organisation and other key bodies.
As with many parts of diet, a little bit is OK, but too much is a bad thing. So, yes we do need some salt in our diets, but it's a very small amount (around 1g a day), and most people have at least 8g a day (based on studies in a number of countries) — so we are in no danger of not getting enough. Even for those who are very active and sweating a lot, your needs for salt are low.
Something I've heard a lot is "I don't add salt to food". You may not add it yourself, but many of the foods we all consume are already made with salt. Bread, butter, margarine, noodles, canned meats, crackers and biscuits, sauces (especially soy sauce) and ketchups. The list goes on.
In fact studies in countries like Australia and the US have found that around 85 per cent of individual salt intake is from processed foods, with only a small amount added by people in their cooking and at the table. If you eat any processed foods (and that includes bread and butter), get take-aways or eat at restaurants, then you are likely to be having too much salt — even if you never use any actual salt in the home. Salt is hidden in many of your favourite foods.
Adding salt at the table and in cooking is certainly a problem too.
Another comment I've heard a lot when highlighting the dangers of salt is "but my blood pressure is fine, so I don't worry about salt". Unfortunately, that may not be a good idea. The scientific evidence is that even if your blood pressure is normal a high salt intake is a risk. And don't forget that high salt intake is linked to a number of other diseases also.
If you do have high blood pressure, then reducing salt intake (and losing weight if you are overweight and being more physically active) can really help to control blood pressure. So really everyone needs to be watching their salt intake.
Reducing salt intake is an important strategy to improve health in Fiji. The Ministry of Health and National Food and Nutrition Centre are developing a five-year strategy to work on this issue, and C-POND will shortly be starting a research project to assess the impact of interventions on salt intake. We need concerted efforts by everyone, if the strategy is to be a success.
For consumers that means looking for lower salt options when shopping, cutting down on very salty foods and when eating out looking for foods which are less salty. For manufacturers and food importers that means making available lower salt options.
For food retailers, we need them to ensure we have access to lower salt-processed foods. While efforts have been made in all these areas, much more work is needed.
It has been very disappointing to see in recent weeks a promotion run by our major supermarket chain which includes giveaways of packets of salt, plus a range of other salty snacks. One of my colleagues was unfortunate to have won three packets of salt in a week from this promotion. Killing their customers with kindness!
Changes to the food regulations will soon mean that all processed foods sold in Fiji will have to include the sodium content on them. This will mean that consumers can shop more smartly and find lower sodium options. For example you can buy canned tomatoes with no added salt (but many of the brands here do have salt added). Until the regulation comes in, you can look at the ingredients label — if you see salt or sodium on there, try and find an alternative without. Some foods are generally very high in salt, so eating them less often is the better option.
As Fiji develops a salt reduction strategy you'll hear much more about salt, and hopefully we will see progress in reducing salt/sodium intake.
Hint: What to look for on the label or in the dish
Salt, sodium, monosodium glutamate (MSG), soy sauce, sodium bicarbonate,
Hint: Sodium chloride is the chemical name for salt. Sodium is the part we worry about, so look out for sodium levels in processed foods.
* Wendy Snowdon (PhD) is the co-ordinator of C-POND (Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases), Research Unit, Fiji School of Medicine, CMNHS, FNU. The views expressed are hers and not that of this newspaper.
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