Melanie McLean | Cut salt for healthy life | Commentary

There is probably a reason our grandparents and great-grandparents used to say good people are “the salt of the earth” and reliable people are “worth their salt”.

Salt is vital to life, and what better way of highlighting its significance than through Salt Awareness Week, being observed May 15 to 21 under the theme ‘Ditch the Salt’.

The words ‘salt’ and ‘sodium’ are often used interchangeably, but they are not the same. Salt is a crystal-like compound that is abundant in nature. This is what we add to our food when we reach for the salt shaker, and it consists of 40 per cent sodium and 60 per cent chloride. Sodium is a mineral that naturally occurs in a variety of foods such as celery, beetroot, meat, milk and milk products. It is even in our drinking water, though the amount varies depending on the source.

THE GOOD AND THE BAD

Sodium plays a critical role in several human bodily functions. It regulates blood volume, blood pressure, osmotic equilibrium (water balance), and pH levels in our bodies. Our musculoskeletal and nervous systems require a small amount of sodium for muscles to contract and nerve impulses to be conducted throughout the body.

Sodium has a wide variety of uses, such as for curing meat, baking, thickening, retaining moisture, enhancing flavour, and as a food preservative. Sodium has become such a staple in our diet that we eat a lot of it, partly fueled by the fact that when salty foods are regularly on the menu, our taste buds develop a preference for them. And of course, when we eat at one of our favorite fast-food restaurants, we are very likely to consume foods that contain ‘bucketloads’ of sodium.

Research has shown that excessive consumption of sodium is a major risk factor for developing hypertension, or high blood pressure, also known as the ‘silent killer’, because its symptoms are not always obvious. Hypertension increases the risk of heart failure, stroke, heart attack, kidney disease and blindness — all of which contribute to millions of premature deaths and life-years lost to disability globally. It is one of the major risk factors for heart disease, the leading cause of death worldwide.

HOW MUCH IS TOO MUCH?

The World Health Organization (WHO) and the American Heart Association recommend that ideally, one should aim to eat less than 2000 milligrams/day (which is equivalent to one teaspoon of salt), especially persons living with hypertension. This includes salt already contained in foods as well as added salt. Most people, globally, consume nearly twice the recommended amount. Reducing salt intake lowers blood pressure and the risk of fatal or disabling heart attacks and strokes.

In the first phase of last year’s salt study commissioned by the Ministry of Health and Wellness, it was found that two-thirds of Jamaicans consume about 3.6 grams of sodium per day, much more than the recommended two grams/day (Ferguson et al2022).

This is a worrying trend. It is therefore not surprising that the 2016-2017 Jamaica Health and Lifestyle Survey III found that one in three Jamaicans was hypertensive; and even more concerning is that two-thirds have abnormally elevated blood pressure, or prehypertension. To reduce the many premature deaths caused by hypertension and cardiovascular disease, it is imperative that urgent public health interventions be implemented.

REDUCING SODIUM CONSUMPTION

The WHO and Pan American Health Organization recommend that governments and stakeholders adopt population-level strategies to effectively reduce the amount of salt that people consume.

Even though it may seem like the only way to add flavor to meals is with a big pinch of salt, there are so many other ways to ensure your food packs a flavourful punch. Even cutting back sodium intake by 1,000 mg/day can improve blood pressure and overall heart health.

Here are some quick tips:

• Read the nutrition facts label: Food labels on packaged foods help us to know the amount of sodium we consume. Compare and choose foods to get less than 100 per cent DV (daily value). Also, watch for ingredients with the words ‘soda’, ‘sodium’ or ‘Na’ in their name.

• Choose low-sodium or no-salt-added nuts, seeds and snacks.

• Ensure your diet includes plenty of fruits and vegetables, which are an important source of potassium, which lowers blood pressure. These include bananas, orange juice, cantaloupe, spinach, avocado, and sweet potatoes.

• Try to prepare your own food when you can.

• When eating out, ask that your meal be prepared without salt, and request that sauces and salad dressings be served on the side. Also, ask if nutrition information is available, and then choose options that are lower in sodium.

• Try to limit the use of mixes (packet soups, sauces, pasta mixes, cake mixes, flavored rice, instant noodles, and instant cereals, etc).

• Use fresh or natural foods, seasonings, spices and herbs instead of salt to flavor food when you are cooking. Some examples are thyme, scallions, paprika, lime juice, vanilla, onion, no-salt spice blends, mustard, vinegar. Avoid canned/processed food.

• Choose fresh meats, poultry and seafood, rather than processed varieties. Also, check the package on fresh meats and poultry to see if salt water, or saline, has been added.

• Many canned foods are packaged in brine. Rinse these foods to reduce the salt.

• Smoked, cured or processed meats, chicken and fish are very high in sodium. Salted meats and fish should be soaked overnight and boiled using fresh water to remove as much of the salt as possible.

• Sauces like soy sauce, ketchup and jerk sauce/seasoning have added salt. Avoid using them too often, or try reduced sodium sauces. Use vinegar and healthy oils for salads.

Let us all celebrate home cooking, the meals we grew up with, and the recipes we’ve tried and loved.

Dr. Melaine McLean is a Jamaica-born, New York-based public health practitioner and paediatrician. Send feedback to [email protected].

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