x Abu Dhabi, UAESunday 23 July 2017

Worth its weight in salt?

New research questions the existing advice on salt restriction and its effect on our health. We investigate further.

New research indicate that cutting salt fromour diets may not, in fact, improve our health after all.
New research indicate that cutting salt fromour diets may not, in fact, improve our health after all.

It's news that could literally shake up the way we eat. Salt, according to a new study from British scientists, may not be the bad guy of the dining table after all.

Ever since links between high salt levels and blood pressure problems were first identified in the 1940s, dieticians and medical professionals have advised people to control and, where possible, curb their intake of salt. According to the World Health Organisation (WHO), high salt intake is the cause of around one-third of hypertension cases across the world.

So the new revelation that it may not be bad for us after all will come as a great relief to most of us who've grown conditioned to having it in our food.

It's not easy to reduce the impact of salt in your diet. Even if you were to leave the shaker well alone, salt is still used on a global scale as a flavouring in most of the processed meals, bread and restaurant-served dishes we eat.

That's especially true in the UAE, where the daily salt intake is, on average, two to three grams above the WHO recommended safe level. There's no doubting that the populace loves its salt - one recent study also showed that 40 per cent of men will habitually sprinkle it over their food before tucking in.

The latest report comes from a Cochrane group of researchers from the University of Bristol, Florida Atlantic University, the University of East Anglia and the London School of Hygiene and Tropical Medicine, led by Professor Rod Taylor from the University of Exeter. It involved a review of 6,257 people and concluded by suggesting that there was no clear evidence of benefit - in terms of preventing cardiovascular disease and heart problems - from telling folk to cut their salt intake.

It's not the first time the commonly held view that we should always strive to reduce our salt intake has been questioned. In 2006, health news reports on whether salt was really worth worrying over followed a study of almost 7,000 people with no previous history of hypertension (high blood pressure), published in the American Journal of Medicine. It also suggested that those who consumed the least amount of sodium were 37 per cent more likely to die of cardiovascular disease that those with the highest intakes.

Back then, the study authors argued that if your blood pressure scores were normal then a very low-sodium diet could - conversely - do more damage than good by raising blood levels of a hormone called renin, which in turn could trigger hypertension.

But such studies are usually far outweighed by the weight of research and professional opinion which emphasises the need for people to limit their salt levels. Almost as soon as the Cochrane findings appeared - in the American Journal of Hypertension - and were reported as showing that salt was no bad thing, health campaigners vigorously criticised them. With headlines such as "Salt is safe to eat" on the front page of the UK newspaper the Daily Express - even in a week when the demise of Britain's biggest-selling newspaper, the News of the World, was dominating the national media - this story was bound to cause a stir.

"This is a completely inappropriate conclusion," Katharine Jenner, of the Consensus Action on Salt and Health (CASH) told The National. "It's a very disappointing message based on a small review of just a handful of studies." Of more concern to Jenner and a number of leading scientists who cast doubt on the findings were the choice of studies re-examined by the Cochrane group. "The research they examined was not originally designed to test for the effects of salt-reduction interventions on cardiovascular disease," she argues.

Taylor, the lead study author, has defended the findings but emphasised that the existing health warnings should not change. "Our results do not mean that asking people to reduce their intake of salt is not a good thing - people should continue to strive to do this. We do show, as have others, that advice to reduce salt does lead to reductions in blood pressure.

"But in people with normal blood pressure such reductions are small and in those with mild to moderate high blood pressure, are not as great as the effect achieved by using medication," adds Taylor. "The likely explanation for this is that it is very difficult for individuals to stick to a low-salt diet for many years. It's likely that people in the studies we looked at followed the initial advice to reduce salt - but didn't stick at it, which contributed to the lack of health benefit.

"We believe our results suggest that individual-based advice to reduce salt intake on its own is not as effective as we might hope.

"Instead, population-based strategies such as the use of food labelling/traffic light systems on food packaging and continued policies of salt reduction in processed food need to be used."

In short, telling people to cut down on salt intake isn't as effective as getting major food suppliers to reduce the input of salt in food at its source. That's something both Taylor and organisations such as CASH can agree on - but it contrasts sharply with the way this study has been reported by some. Currently, adults in the UAE are advised to eat no more than 6g of salt a day - or one teaspoon - but it's estimated they average 9g a day, and that about 77 per cent of an adult's salt intake comes from processed foods and restaurant fare.

Some simple shifts from the food producers could have a major positive impact on the health of people in the UAE, though. "In the UK just reducing the amount of salt a person had by 1g per day would save around 6,000 lives a year and £1.5 billion (Dh8.9bn) in lost revenue through healthcare and absence from work," concludes Jenner.