09 March 2014
There is strong evidence that links our current high salt intake to high blood pressure. The solution is simple – reduce your intake and watch the numbers go down.
SALT is a cheap and easily available mineral, but that doesn’t mean we have to douse our foods with it.
The greatest contributor to cardiovascular diseases is hypertension (raised blood pressure), which the medical profession believes is a result of a high sodium diet. In some people, sodium increases blood pressure because it results in excess fluid in the body, creating an added burden on the heart.
There is also increasing evidence of a link between our current high salt intake and stomach cancer, osteoporosis, obesity, kidney stones and kidney disease.
“Most patients say they never add extra salt in their food but they don’t realise it also comes from processed and prepared food. Reducing it costs next to nothing,” says Datin Dr Chia Yook Chin, the president of Malaysian Society of Hypertension (MSH).
The biggest culprits: biscuits, stock cubes, salted fish, salted eggs, bacon anchovies, canned food, especially tuna and sardines, sauces, breads, and the seasoning used in instant noodles.
In conjunction with World Salt Awareness Week 2014 started by World Action On Salt and Health (WASH), the MSH is on a drive to educate the public to cut their salt consumption. They will be organising a series of educational forums in various towns (refer to www.msh.org.my). Themed Switch the Salt!, the campaign runs from March 10-16.
WASH aims is to reduce the salt intake worldwide to the World Health Organisation (WHO) recommended maximum intake of 5g per day by reducing the amount of salt in processed foods as well as salt added during cooking, and while eating.
It has been reported that Malaysians consume 8.7g per day, which is much higher than WHO’s recommendation.
What is salt?
Salt is basically a natural mineral made up of white cube-shaped crystals composed of sodium and chlorine. When you ingest salt, the sodium and the chlorine ions in sodium chloride separate from each other, making the sodium available for your body to use.
Most foods in their natural state contain some sodium, so adding extra salt when cooking is unnecessary.
Dr Chia says, “The tongue can adjust very quickly. If you reduce salt bit by bit, within a month, you won’t feel the difference. For alternatives, you can use herbs and spices such as coriander.”
Once the salt taste receptors have adjusted, you will find that high salt foods will taste unpleasant. The same applies to fatty and sugary foods
If you walk into a store, you’ll notice the various kinds of salt being sold – sea salt, rock salt, potassium salt, iodised salt, etc. And these “designer” salts don’t come cheap.
Gourmet rock and sea salts have been popularised by television chefs who sprinkle them liberally on their culinary creations. Due to their premium image and the misleading claims of manufacturers declaring that their product is “natural”, contains “essential minerals”, and is a “tastier and healthier alternative” to table salt, there is a popular belief that these salts are better for us.
“It’s a myth,” says Dr Chia. “You don’t need to buy a different kind of salt because the sodium content is the same in any salt. Only the chloride component may differ.
Salt is salt. No matter how expensive it is, whether salt comes in crystals or grains, from the sea or from the Himalayas, they all contain an equally high sodium chloride content.
According to the Mayo Clinic, sea salt and table salt have the same basic nutritional value, despite the fact that sea salt is often promoted as being healthier. Sea salt and table salt contain comparable amounts of sodium by weight.
Sea salt is produced through evaporation of ocean water or water from saltwater lakes, usually with little processing. Depending on the water source, this leaves behind certain trace minerals and elements. The minerals add flavour and colour to sea salt, which also comes in a variety of coarseness levels.
Table salt is typically mined from underground salt deposits. Table salt is more heavily processed to eliminate minerals and usually contains an additive to prevent clumping. Most table salt also has added iodine, an essential nutrient that helps maintain a healthy thyroid.
Many people are also unaware that “eating” potassium helps balance the fluids in the body. The more potassium we consume, the more sodium is excreted through urine and out of the body. It helps relax blood vessel walls, which helps lower blood pressure. In fact, many of the natural sources of potassium – fruits, fat-free or low-fat dairy foods and fish, should be part of your diet.
However, Dr Chia points out, “It is true that some people take a lot of salt and do not get hypertension because they are not salt sensitive. And there are also rare cases of diseases where the body has little salt.”
What is more frightening is that those with high blood pressure are getting younger due to poor eating habits, obesity and an unhealthy lifestyle. In the 2011 National Health and Morbidity Survey, 32.7% of patients with hypertension were 18 years and above.
“These detected cases are only a third of our population, and out of these, the overall control rate is only 8%. We don’t know about the others who have not had their blood pressure taken,” says Dr Chia, who is also a professor and senior consultant of primary care medicine.
Statistics (2009) from Universiti Malaya Medical Centre show that 60% of patients with hypertension have diabetes.
The awareness is poor because hypertension is often asymptomatic. In some patients, they will experience a bit of headache, dizziness or a mild stroke. Often it is picked up by chance when one goes to the doctor for a normal flu or cold.
“I had a patient who had never been to a doctor for 30 years because there was no need to – he never fell sick until he had a stroke! I encourage all doctors to measure blood pressure for all patients at least once a year. Hypertension comes slowly, not overnight, and it can be prevented.
“Even though you have a genetic predisposition to hypertension, it can still be prevented. If your blood pressure is slightly high but you continue to smoke, drink and eat unhealthy stuff, then obviously it cannot be prevented. The choice is yours.”
Dr Chia adds that drugs these days are safe, cheap and effective in treating the disease.
“The outcome is very good, so there is little reason not to take the drugs. The doctor will decide if the medicine can be taken off.”
Hypertension doesn’t discriminate by race, although the numbers are slightly higher among the rural Malays.
Her message is simple: Reduce your salt intake, and then make the switch for better health. And, know your blood pressure readings.
Since labelling the sodium content in local foods is not mandatory in Malaysia, consumers do not know how much they’re eating. Dr Chia suggests the authorities legislate the labelling so consumers can make better choices.
In some Western countries, reducing the salt content does not impact the sales of the manufacturer because consumers will slowly adapt to change. Since consumers drive the food industry, we have to choose the correct types of food and make healthy choices.
“We could also create the FoodSwitch apps like they recently did in the United Kingdom to analyse the content of sodium, glucose, etc, in your food.”
FoodSwitch is a revolutionary new smartphone app that helps consumers make healthier food choices. Basically, you scan barcodes of packaged foods with your smartphone or tablet camera to get easy-to-interpret nutritional information for more than 8,000 products, with traffic light-style colour-coded ratings for four key food components (total fat, saturated fat, sugar and salt).
It also searches the database for similar but healthier alternative products, making it easier to switch to healthier food choices.
By Revathi Murugappan