Nobody is talking about salt. And I just don't understand it....

My nutrition and health coaching clients know that I'm constantly looking for small, simple changes that will pay high dividends in terms of energy, vitality, health and longevity. And this one is an absolute no-brainer:  

YOU NEED TO WATCH YOUR SALT INTAKE!

What do I mean by "watch your salt intake"?

1. Start tracking how much salt you are consuming every day;
2. Learn how much you should be consuming; and
3. Make sure you are consuming the right amount.

This one simple (but not necessarily easy!) health tip could literally - LITERALLY! - save your life. Or save you from the trauma of experiencing a catastrophic health crisis in the best years of your life.

And no, I'm not being unnecessarily melodramatic. 

Here's why:

Lots of health bloggers and internet "health gurus" will tell you that it is OK to eat the "good" kinds of salt like Himalayan pink salt or celtic salt. They even say it is healthy for you because of the extra trace minerals it contains. Well dahlinks I'm calling every one of them out!

Humans evolved in an environment of salt-scarcity. Only 0.25-0.5g/day is necessary to maintain health. Abundance of dietary salt is a relatively recent phenomenon, and our bodies haven't evolved to be able to cope with high levels of salt intake.

And salt is EVERYWHERE in the modern western diet.

It's the sodium in salt that can lead to problems when consumed in excess. You see, when we eat more salt (sodium) than our kidneys can effectively process and excrete, our body retains fluid to dilute it. This means increased blood volume which in turn places more pressure on our heart and blood vessels. Over time this can lead to hypertension, arterial stiffness, heart attack or stroke. It can also damage our kidneys, reduce our bone density, and is even linked to increased risk of stomach cancer.

Eating too much salt contributed to 2.3 million deaths from heart attacks, strokes and other heart-related diseases throughout the world in 2010, representing 15 percent of all deaths due to these causes, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

The Australian National Health and Medical Research Council has set an Upper Limit for sodium of 2,300mg per day. Each gram of salt contains approximately 400mg sodium. So that's equivalent to around 6 grams - or one teaspoon - of salt per day. This is the amount above which adverse health impacts can be expected.

However, to minimise stroke and heart disease risk, our National Health & Medical Research Council (NHMRC) has set a Suggested Dietary Target of 1,600mg of sodium a day. That is less than a teaspoon of salt.

And here's the truly frightening thing: The majority of Australians (and all westerners) are consuming way too much salt, in amounts that are known to cause harm.  In the most recent Australian Health Survey, every single Australian over 3 years of age who was surveyed was consuming salt in amounts well in excess of the NHMRC recommendation. That means that almost every Australian is consuming levels of salt that places them at risk - of hypertension or it's sequelae: heart attack or stroke.

The most common effect of excess salt intake is elevated blood pressure (aka hypertension), which is in turn one of the biggest risk factors for heart attack and stroke. And hypertension is a silent condition. Sadly, for many people, the first indication they will have that they have been suffering from high blood pressure is when they suffer a heart attack. Seriously! The same thing goes for stroke.

In fact, more Australian deaths can be traced back to high blood pressure than any other single risk factor. Don't take my word for it. Those are the views of Heart Foundation CEO A.Prof John Kelly, shared in this article.

So cutting down your salt/sodium intake to the levels recommended by the NHMRC could - literally - save your life.

But we don't even realise that we are consuming dangerous amounts of salt.

That's because firstly, 70-80% of the salt in our diet is "hidden" in processed foods - food products that are made from cheap ingredients that would be bland and unappetising without loads of salt. Salt is even in foods we don't expect to have high levels of salt like breads, breakfast cereals, tinned beans, cakes and biscuits. And even though our public health experts are well aware of the huge price Australians pay for the high levels of salt hidden in processed foods, they have to contend with the food industry putting its considerable resources and influence to work to lobby against worthy public health initiatives like WASH. Here in Australia the processed food industry is using every tactic in its playbook to slow progress on salt reduction (I've listed a few references on this below if you would like to learn more!).

And secondly, our palates have been habituated to chronically high levels of salt - we just can't trust our taste buds to warn us when we are eating a meal with too much salt. And when we try to cut back on salt, dishes with low salt levels can taste bland an unappetising to us. 

It blows my mind that not only are the dangers of our current levels of salt consumption not common knowledge, but that so many of the "wellness guru" and health blogger set actually encourage people to eat salt! They say things like: "himalayan salt/celtic sea salt etc is the good salt. It's the stuff you get at the supermarket that you should avoid." 

But that "healthy" pink himalayan salt the "wellness gurus" love so much? It contains the same amount of sodium as ordinary table salt. They play up the fact that this salt has "additional minerals". Yes, there are indeed additional trace minerals but not in sufficient amounts to provide any meaningful health benefit (unless you want to consume kilos of the stuff). And worse, some of those additional trace minerals are ones we would never knowingly choose to ingest like radium, uranium, and polonium. It just got it's BS "health halo" from very clever marketing. Here's a link to a spectral analysis showing what is in Himalayan Salt: https://themeadow.com/pages/minerals-in-himalayan-pink-salt-spectral-analysis 

The iodised salt that you get at the supermarket is actually a better choice than the supposedly "healthy", "natural" salts - because it has iodine added to it. I will be writing about iodine in the coming months, but for now just know that it is a mineral that people can be deficient in, and deficiency can have devastating impacts on children and babies in the womb.

Oh, and before you come at me citing studies peddled in the media casting doubt on the health benefits of salt reduction, and defending the health benefits of pink salt, hold fire, keep an open mind and block out some time to dig below the surface and follow the money...

Remember, 80% of the salt in our diets is hidden in processed foods. That's to make them more palatable and also to help preserve them. So the food industry has a huge vested interest in playing down the health risks of salt in our diet. And they do this by investing heavily in casting doubt on the body of scientific evidence.

The Salt Institute is the salt industry's PR body. This body has sought to promote studies that show a "J curve" relationship between salt and cardiovascular outcomes. Let's just say these studies have a LOT of flaws...

Don't fall for it dahlinks. The tactics used by the food industry have been likened to the tactics used by the tobacco industry. They are trying to cast doubt on the science in order to be able to continue to profit from sale of products that are damaging to population health. And that's not cool. 

Consistently reducing your salt intake could actually save your life. Or the lives of the people you love. Don't believe me? Here are a couple of powerful facts:

• Japan implemented a salt-reduction program in the late-1950’s in response to the identified link between its high salt consumption and high rate of stroke mortality. Population BP fell in parallel with average salt consumption, and stroke mortality fell by 80%.
• And in the 1970’s Finland introduced a salt-reduction program utilizing media education programs, and securing food industry cooperation. Average salt intake dropped from 14g/day in 1972 to less than 9g/day in 2002, with an associated decrease in BP of 10mmHg (systolic and diastolic), reduction in stroke and CVD mortality of 75-80%, and an increase in life-expectancy of 5-6 years.

Wouldn't it be amazing if our Government stopped bowing to pressure from the processed food industry and legislatively required them to make the same sodium reductions for processed foods sold in Australia that they have implemented in other countries? Imagine how many Australian lives could be saved. And how many people would be spared the trauma of a catastrophic health crisis.

But until our Government starts putting Australian lives ahead of the profits of multinational corporations, it is up to us to take steps to reduce our salt intake.

So here are my tips for reducing the salt in your diet:

1. The easiest way to cut back on our salt intake is to cut back as far as you can on processed foods.

Remember, 70-80% of our salt intake comes in the form of processed foods. Even in foods we don't expect to have high levels of salt like breads, breakfast cereals, tinned beans, cakes and biscuits.The food industry relies heavily on salt to make their manufactured commodified food products palatable to us. So making some simple swaps to whole, unprocessed foods is a no brainer for anyone needing to cut their intake.

2. Read the labels at the supermarket and choose low salt options.

Remember, salt is very often hidden where we would least expect to find it - so check all the labels at the supermarket. We need to teach these food companies that they can't play fast and loose with our health and our lives. And the best way to do that is to vote with our dollars! Don't reward these companies for hiding salt in our food! If you are tech minded, you might like to try the FoodSwitch App created by Bupa Australia and The George Institute for Global Health. It's specifically designed for Australia and enables you to make healthier choices at the supermarket. And check out this handy guide from the Unpack the Salt Initiative.

3. Recognise that our palates have been habituated (aka "trained") to tolerate high amounts of salt.

This means that when we cut right back on salt our food can taste bland. But we need to realise that it's not because our food is bland, it's because our tastebuds are used to high levels of salt. Our palates do adjust over time - but only if we stick to our lower salt way of eating.

4. Be patient! Your palate WILL adjust in time.

And to help it along, experiment with adding herbs and spices to your meals like rosemary, parsley, thyme, dill, chilli, garlic, and even a squeeze or two of lemon or lime.

5. Ignore the salt-loving "wellness gurus" who spruik about "healthy" "natural" salts

All of the different kinds of salt contain the same amount of sodium, and have the same impact on our health. And if anyone in the medical or allied health field tries to tell you there are "good" kinds of salt that are "healthy" for you, run far far away from them! 

6. Don't take your salt-reduction efforts to extremes

It can be REALLY hard to reduce our salt intake. But there are always one or two very disciplined people who take sensible advice to extremes. Don't cut salt completely out of your diet. A small amount of salt is necessary to maintain health. Hyponatraemia is the name for the condition that occurs when there is not enough salt in the body. It tends to happen to marathon runners who drink too much water (which is why runners generally favour electrolyte drinks) and it's absolutely life-threatening. Stick to the NHMRC recommendation of 1,600mg of sodium (approximately a teaspoon of salt) a day!

REFERENCES:

NHMRC https://www.nrv.gov.au/nutrients/sodium

National Health and Medical Research Council and New Zealand Ministry of Health, 2006, Nutrient Reference Values for Australia and New Zealand, <https://www.nrv.gov.au/nutrients/sodium>

Australian Bureau of Statistics, 2014, Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12, 'Sodium', cat. no. 4364.0.55.007 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.007Main+Features7152011-12

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Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001;344:3-10.

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