Public health efforts to cut sodium in diets ‘justified’ after research links salt intake to premature death

Jul 12 2022 – A study reveals that consumers who always add salt to their food have a 28% higher risk of early death compared to those who never or rarely add salt. Sonia Pombo, campaign manager for Action on Salt, says the findings represent another nail in the head in making salt reduction policies mandatory.

The research is “the first of its kind to evaluate the relationship between adding salt to foods and early death,” according to lead researcher Dr. Lou Kee, Professor and Distinguished Chair, Tulane University (USA).

nutrition He talks to Pompeo and scientists from both studies about the impact of these findings and how they might shape policy and public health.

“There is compelling evidence linking excessive salt intake to high blood pressure, which is the single largest risk factor for stroke and cardiovascular disease,” Pompeo stresses.

“Reducing salt intake reduces blood pressure in nearly everyone – men and women of all ages, ethnic groups, and socioeconomic status – and will therefore improve population health outcomes.”

Linking salt to death?
The new research revealing the link between salt and early death, published in the European Heart Journal, followed 501,379 people for nine years. This longitudinal study included more than half (52%) of the women, and the average age of the participants was approximately 56.5 years.

It found that compared to those who never or rarely added salt to their food, those who always added salt to their food had a 28% increased risk of premature death, which the study defines as death 75 years ago.

The investigation also found that women and men who always added salt to their foods lost 1.5 and 2.3 years of life expectancy, respectively.

The study provides new evidence to support recommendations for modifying eating behaviors to improve health. Even a small reduction in sodium intake, by adding little or no salt to the food at the table, is likely to result in significant health benefits, especially when achieved in the general population,” Qi highlights.

Chinese heart-healthy diet efficacy testStudies have found that lowering salt intake lowers blood pressure while adding salt to the table, and reduces life span.
The results were published following a separate study by a team of researchers at Peking University, which revealed that a diet of heart-healthy Chinese (CHH) foods lowers blood pressure.

Published in the Journal of the American Heart Association Circulation, a Peking University study exploring the effect on Chinese cuisine found that the CHH regimen cuts sodium in half, from 6000 mg per day to 3,000 mg per day, reduces fat intake and doubles dietary fiber. It also increases protein, carbohydrates and potassium.

It divided 265 subjects with hypertension into two groups and found that taking CHH for 35 days reduced systolic blood pressure (SBP) by an average of 10 mm Hg and lowered diastolic blood pressure (DBP) by an average of 3.8 mm Hg. .

“The heart-healthy Chinese diet had a net effect of lowering systolic blood pressure,” explains Yangfeng Wu, Professor of Epidemiology of Science in Clinical Research, Peking University. “The effect was consistent with antihypertensive drugs and should give both patients and clinicians confidence in a healthy diet to prevent and treat high blood pressure and related cardiovascular disease.”

The diet was developed to match the regional cuisines of Shandong, Huaiyang, Cantonese, and Sichuan.

Healthy Western diets such as DASH and Mediterranean have been developed and proven to help lower blood pressure. However, to date, a proven heart-healthy diet to match traditional Chinese cuisine has not been developed,” Wu adds.

public health intervention
High blood pressure has long been associated with stroke and other cardiovascular diseases.

Commenting on the impact of the CHH diet, American Heart Association volunteer expert Lawrence Abell says: “The results of this trial are really impressive and provide a roadmap for healthy eating for people who consume a variety of Chinese cuisines.”

Significant public health efforts are warranted to ‘scale up’ across China in order to achieve population-wide reductions in blood pressure.

According to Pompeo, encouraging people to use less salt in cooking is beneficial, but with salt already added to most foods (up to 75%), “the best policies to reduce salt intake for the population are to encourage food companies to reformulate foods containing Less salt.”

Focus on fruits and vegetablessGovernment regulations may help as Dr. Wu points out that education alone is not enough to change people’s lifestyles.
Both studies found that eating plenty of fruits and vegetables may be a key ingredient in reducing early death and lowering blood pressure.

Humans need sodium from salt to maintain their health; However, excess salt intake may be harmful, says Qi. “Our data suggest that a high intake of potassium-rich vegetables and fruits may attenuate the inverse relationships between salt supplementation and death.”

Furthermore, Wu notes that CHH’s principles are easy to follow and can be easily adapted to suit any type of cuisine. “Essentially, the salt for cooking should be reduced to 5 grams per day as much as possible without losing too much flavor,” he explains.

“Second, use all possible ways to increase the flavor of food, such as onions, peppers, ginger, etc. Salt substitutes can also be used to help keep the flavor of food unchanged too much. Third, increase fruits, vegetables, whole grains, high-fiber foods, nuts, beans and reduce fat intake, Especially those that contain saturated fats.

Wu’s study also found that the CHH diet is achievable at a modest price point. The study indicated that supplementing with CHH, on average, costs an additional US$0.60 per day per person.

Eliminate the salt, but not all of it
Although these two studies reveal that reducing salt appears to be of paramount importance for both individual and general health, they also note that there is no need to eliminate salt completely.

“Adding salt to foods at the table is a common eating behavior that is directly related to an individual’s long-term preference for salty-tasting foods and habitual salt intake,” says Qi. The problem, he says, is that “in the Western diet, adding salt at the table accounts for 6-20% of total salt intake.”Action On Salt points out that the “Achilles heel” of UK salt reduction production is in its voluntary nature.

Both studies agree that reducing salt and even using salt substitutes are good ways to reduce sodium intake. Products promoting low- or low-sodium claims have increased 8.3% since the mid-2000s, and Innova Market Insights has noted a continued launch of low-sodium cooking solutions.

Furthermore, recent studies have shown that, over time, taste buds can easily adapt to the flavor profiles of a low-sodium diet. The World Health Organization set standards for salt last year as part of its initiative to reduce sodium levels by 30% across 60 different food categories by 2025. behavior

Pompeo stresses that an important component of a successful salt reduction strategy from a policy perspective is public awareness campaigns.

“Campaigns help drive reformulation work to meet consumer demand. They should focus on the effects of salt on health and salt levels in supermarket and restaurant foods. A successful campaign should also be launched every year to maintain awareness and understanding.”

Currently, Wu explains, salt plays a major role in flavor. To reduce salt for health, it often means that there is a need to tolerate a diet or foods that taste bad. Thus, reducing salt only through health education had little effect.”

“Although eating a lot of salt is unhealthy, it is also not necessary to practice abstinence. In fact, the World Health Organization has recommended an intake of less than 5 g of salt (2000 mg sodium) per day for adults.

CHH cut sodium intake by half, to less than 3,000 mg. “This is still above the recommended target but the effect we achieved was satisfactory and the food taste was kept good enough to study subjects like them.”

Intervention may be required
Although individuals must ultimately monitor their salt intake, some believe that the system is fraudulent against the consumer. Groups like Action On Salt have consistently decried the inefficiency of food labeling systems, recently revealing that over 55 percent of their purported “healthy” snacks were full of sodium.

Other organizations, such as the European Food Safety Authority, are looking to establish mandatory labeling practices that highlight the high fat, salt and sugar content of packaged foods. For its part, the US Food and Drug Administration recently overhauled 10 years of dietary guidelines in order to reduce the amount of salt consumed in school meals.

Pompeo notes that “reducing salt has been a feature of UK food policy for two decades, and is universally accepted as a cost-effective strategy to improve public health”.

“In 2004, the Food Standards Agency developed a salt reduction program and called on food manufacturers to gradually and unobtrusively reduce the amount of salt added to processed foods.”

“At the height of its success, the salt reduction model saw UK food companies reduce the salt content of foods by 30-50%,” she adds. “By 2011, the population’s salt intake had decreased by 15%, accompanied by lower average blood pressure and deaths from stroke and heart disease.”

“But the Achilles’ heel was its voluntary nature. Under the Food Standards Agency, salt reduction flourished, but change in the hands of Parliament gave the food industry full rein on the police itself. As a result, no major reductions in salt intake have been made for the population since 2011.”

“In its current form, the UK’s salt reduction program is no longer fit for purpose. What we need now are mandatory, comprehensive salt reduction targets that require all businesses to work towards the same standards. We have seen examples of successful mandatory salt reduction policies around the world. , such as South Africa. The same approach must now be put in place in the UK.”

Written by William Bradford Nichols, with additional reporting by Andrea Caddis

This feature is provided by food ingredientssister site, nutrition.

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