How to be salt savvy

A study suggests that salt may not be so harmful for us, but let's shake up the evidence before tucking in.

Fast food and processed food are all high in sodium. Rosanne Olson / Workbook Stock
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Salt, the most common format of the mineral sodium, is never going to win any popularity awards from conventional doctors – and that's a bit of shame because it does have its uses. "Without any sodium, the water in the body would evaporate very fast and lead to dehydration," explains Emilie Hartmann, a registered dietician at the EHL Dubai Mall Medical Centre. "Sodium is also involved in the vital transmission of electrical impulses to the heart, muscles, organs – and it's an essential mineral, working together with potassium and chloride to maintain the balance of fluids [water and blood] in the body." Well, who knew?

In truth, the beneficial properties of sodium – at low levels – have been familiar to medics for generations. But recently, a number of reports from academic studies have hinted that it may be time to rethink the whole issue of salt in our diet, perhaps to even question the established link between the amount of salt people eat and their likelihood of developing heart-health problems such as hypertension.

It makes for interesting reading, especially in the UAE where the daily intake of sodium significantly exceeds the recommended 2,300 milligrams (equal to about six grams of salt a day) and the negative side to salt is well known.

"People living here eat out quite often in fast-food restaurants and consume many processed or ready-made foods, so their diet is inevitably high in salt," explains Hartmann. "This puts them at higher risk to have high blood pressure – and we already know that hypertension is a very common health problem here."

But a review of seven separate studies by the Cochrane Library, published in the American Journal of Hypertension, (which tracked 6,500 people for up to six years) has shown that people who cut down on salt were just as likely to have a heart attack or stroke as those who didn't.

This study followed on from the findings of a paper published in the scientific journal Nature, which cited genetics as being much more likely to trigger blood pressure problems than salt consumption. But against the wealth of established evidence that salt is bad for us, these revelations have been subjected to a great deal of scrutiny.

Experts who've questioned the findings point to the fact that it only identifies "trends", not direct correlations between a much larger group of "guinea pigs". The American Heart Association, for example, pointed out that to evaluate the actual amount of damage caused by a diet that's high in sodium, you would need to follow subjects for a lot longer than six years.

Even the lead author of the study, Dr Rod Taylor, from the University of Exeter in the UK, stressed that people should continue to eat less salt and should be more aware of the "hidden" salt content in many everyday meals and snacks.

Until larger, longer-term trials are carried out, the opinion among the vast majority of health professionals is to keep your sodium intake low and to take any contrary revelations with, well, a large pinch of salt.

"We evolved to exist on less than 1-2g of salt a day, but we are currently eating closer to 9g of salt a day, more for men," warns Katherine Jenner of Consensus Action on Salt and Health, an advocacy group based in London. If this is the case, then it may be an idea for those of us needing to cut down on the salt to identify the key sources and to possibly cut them out one by one. "Some studies have suggested there are adverse reactions to an immediate big drop in salt intakes," says Jenner. "But a longer-term modest reduction in salt intake won't cause a significant shock to the body."

In the meantime, it may pay to get familiar with where the salt bombs lay in your diet.

A few things to consider as you sprinkle some salt sense into your life

Safer options

"There are no safe sources of salt in our diet – unlike, say, naturally occurring sugars," says Katherine Jenner from Consensus Action on Salt and Health. "But sodium naturally occurs in low levels in vegetables such as spinach and celery, and also in animal products such as red meat and dairy, especially milk. In unprocessed foods, the levels are generally low enough not to worry about."

Hidden dangers

"Tomato sauce and paste, cheese, olives, pickles, soy sauce, mustard and ketchup all have very high salt content," warns Emilie Hartmann. "Interestingly, bread and breakfast cereals also contain a large amount of sodium."

Sports salts

The product blurb for sports and energy drinks claims to "replenish lost salts" after exercise. "In this case, salts generally means all mineral salts; magnesium, calcium, potassium – as well as sodium," says Jenner. "Check the label to see if yours is high in sodium [above 0.5g sodium per 100ml]. Unless you are drinking them every day, they should not be a large contributor. Make sure you're drinking plenty of water, and keep an eye on your blood pressure."

Balancing act

According to studies from the journal Hypertension, your heart health could benefit from an increase in your potassium intake as you attempt to lower your sodium consumption. Bananas are among the best natural sources of potassium. Beans, lentils and dried fruit also make for ideal low-salt, high-potassium snacks.

Be 'appy

Find out if you're extra sensitive to the hypertension-inducing effects of sodium by checking your own blood pressure. The iPhone app "iBP" will do this for you for several consecutive days. As you cut back on salt, see how your BP score reacts, and talk to your doctor about sensitivity if it drops significantly.