Just how much salt should you be eating?

Nicole Jennings, spokesperson for Pharma Dynamics, says South Africa has the highest prevalence of hypertension in Southern Africa – estimated to be at 35%.

“About 90% of patients [with hypertension] are not adequately controlled. This includes patients who are undiagnosed, patients diagnosed but not treated, and patients who are treated, but not adequately so.”

Prof Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA), says that uncontrolled hypertension puts patients at an increased risk of heart attack, stroke, heart failure, pulmonary hypertension, and kidney disease, which places an enormous burden on SA’s healthcare resources.

Image: Supplied

“There is a strong correlation between increased dietary sodium (salt) intake and elevated blood pressure. The South African and International Hypertension Guidelines recommend a reduced dietary sodium intake, together with a healthy diet and medication, as part of the treatment protocol for hypertension. The World Health Organisation (WHO) recommends no more than 5mg per person of salt per day, however many foods exceed that and the WHO estimates that the actual global dietary salt intake is almost double this, which is of concern,” remarks Naidoo.

According to Jennings, thousands of lives could be saved each year if salt consumption was curbed to help prevent hypertension in the first place.

The appeal comes in the wake of Heart Awareness Month this September, driven by Pharma Dynamics and the HSFSA, to make the public aware of the real dangers associated with excessive salt consumption.

Jennings says eating too much salt can lead to hypertension (high blood pressure), which is a major risk factor for heart disease and stroke. “Processed and packaged foods are responsible for most of the salt in our diet. Since people aren’t adding salt to these products themselves, they don’t realise how much salt they contain and the harm that it’s causing.”

Image: supplied

Prof Naidoo reminds us that excessive salt consumption is known to drive hypertension. “Blood pressure that exceeds 140/90 is dangerous. We often advise the public to read food labels and to check for sodium levels, but in the rushed society we live in, many don’t take the time to do so and, when they do, it can be confusing,” she says.

In an effort to help the public to eat less salt, Pharma Dynamics and the HSFSA have launched a digital pocket guide that contains salt charts for various food groups, such as:

• grains and bakes
• savoury snacks
• spreads and dips
• dairy
• herbs and spices
• condiments
• meat and proteins, as well as
• popular ready-made meals.

The salt charts forms part of the popular Cooking from the Heart wellness and healthy recipe programme, which aims to get the nation eating smart for their hearts.

Jennings says most people already know that chips and roasted nuts are high in salt, but it’s the “hidden salts” in processed food that consumers aren’t aware of.

“The salt charts address this issue and serve as a visual online tool, which can be downloaded and saved to mobile phones to make heart-healthy food choices easier when shopping.”

The salt charts indicate which foods to avoid or limit based on the sodium (or salt content). Some of these include:

• cheese, flavoured cream cheese and cottage cheese,
• tinned foods, especially those preserved in brine,
• stock powders or cubes, soup powders or tinned soups,
• marinades or marinade powders,
• olives and pickles,
• processed meat, such as polony or baloney, ham, salami, turkey, sausages, viennas
• take-outs, like burgers, fish and chips, crumbed chicken, pizzas and Chinese takeaway
• seasoning salts, like barbeque or chicken spice, and salty spreads, including margarine, butter and meat spreads,
• cured meat and fish,
• instant noodles with flavouring,
• Worcestershire sauce and soy sauce,
• crisps, salted biscuits and crackers, as well as ready-made popcorn.

How exactly does salt intake influence blood pressure?

Jennings says there are a multitude of studies that show how limiting one’s salt intake positively impacts blood pressure.

“Clinical studies have shown time and time again that too much salt imbalances the Renin-Angiotensin-Aldosterone System (RAAS) – a hormone system essential for regulating blood pressure and fluid balance in the body. When the RAAS doesn’t function properly, it leads to sodium and water retention that increases vascular resistance and blood pressure, increasing the risk of CVD.”

Salt, which is also referred to as “sodium chloride”, consist of 40% sodium and 60% chloride. One teaspoon of salt is approximately 5 grams and therefore contains 2 grams (2 000 mg) of sodium.

A randomised clinical trial of hypertensive patients consuming 2,9 g of salt daily, following the DASH (Dietary Approaches to Stop Hypertension) diet, had a profound effect in lowering blood pressure in just 30 days.

The DASH diet, which is high in lean protein, fruit, vegetables, beans, nuts, whole grains and low-fat dairy, is also low in salt and sugar, and is recommended for a healthy heart.

Jennings says dietary interventions, including sodium reduction, are extremely important in the management of hypertension. “Further research shows that reducing blood pressure by just 10/5 mmHg is associated with a decline in:

• all cardiovascular disease events by 20 %
• all-cause mortality by 10–15 %
• coronary events (heart attack) by 20 %
• stroke by 35 %
• heart failure by 40 %.

“Ultimately, it’s up to each one of us to stay on top of our blood pressure and to keep it where it needs to be by exercising and following a healthy eating plan. Knowing what food contains more or less salt, will help us to understand what is helping or harming the health of our hearts,” concludes Jennings.

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