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Posts Tagged salt

How much salt is in our food? Amanda Johnson Apr 19

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A new study just published this week (16 April) by Canadian researchers has looked at the salt content of different foods in countries around the world, including New Zealand.

It’s an interesting paper! You’d think, for example, that if you ordered a burger from Burger King, McDonald’s, or KFC; or even a Subway sandwich, or a Domino’s pizza, that you’d get the exact same product from a particular company, with the same nutritional content, wherever you were in the world. Not so! In fact a McDonalds Big Mac provides 30% more salt in New Zealand than it does in the UK or France, and a Subway Club Sandwich provides more than twice as much salt in New Zealand than it does in France.

Overall, results show that New Zealand is comparable with Australia in terms of the amount of salt provided by the fast foods tested, but we have more salt in our fast food products than France and the UK, and less than the USA and Canada.

This study has attracted a bit of attention, both in New Zealand and internationally. The New Zealand Herald covered the story yesterday, and an article in Food News also mentioned the study. In addition, Fox News covered the story, along with ABC in Australia.

Salt is found in lots of foods — not only those tested in this study. In fact it has been estimated that only 15% of the salt we consume comes from the salt shaker — with a further 10% being provided naturally by foods. The rest comes from manufactured foods.

It’s important to avoid excess intakes of salt as this can lead to high blood pressure and increased risk of cardiovascular disease. It has been estimated that reducing our salt intake a third, from around 9g a day to 6g a day, could save over 900 Kiwi lives a year.

Dietitians New Zealand last year published a fact sheet on salt and health, which gives some nice tips on how to eat less salt, and the Heart Foundation in New Zealand has some great ideas on their website too, in relation to salt reduction.

Many food manufacturers are removing salt from their foods — but this study suggests that more could be done to reduce the salt content of some fast foods — as lower salt choices are being offered in different countries — with some countries (particularly France) offering foods with significantly lower salt levels. Clearly product formulation is not an issue.

In the meantime, I think following the advice of Dietitians New Zealand and the NZ Heart Foundation is a good starting point for anyone wanting to reduce their intake of salt.

The salt debate continues Amanda Johnson Aug 02

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A new comment just published in The Lancet resurrects the salt debate yet again, following the publication of the controversial Cochrane report on salt last month (6 July).

The plain language summary of the Cochrane report stated,

’Cutting down on the amount of salt has no clear benefits in terms of likelihood of dying or experiencing cardiovascular disease.’

In their Lancet commentary, Feng He and Graham MacGregor say that,

’In our view, Taylor and colleagues’ Cochrane review, and the accompanying press release reflect poorly on the reputation of The Cochrane Library and the authors. The press release and the paper have seriously misled the press and thereby the public.’

They go on to say,

’The totality of the evidence, including epidemiological studies, animal studies, randomised trials, and now outcome studies all show the substantial benefits in reducing the average intake of salt.’

The Cochrane review, published last month, was followed by media headlines around the world such as that in the UK paper The Daily Mail, which said, Cutting back on salt ‘does not make you healthier’ (despite nanny state warnings) and The Daily Express which said, ’Now salt is safe to eat’

Significant debate was prompted among the scientific community around the world and the New Zealand Science Media Centre collated response from leading experts in the field.

Professor Robert Walker, Head of Department, School of Medicine, University of Otago, said that,

’In the context of general good health, it is not appropriate to go out and reload the salt shaker. Dietary reduction in salt for those at risk of cardiovascular disease should still be encouraged and placed in the same context as exercise, healthy diet and smoking cessation.’

And Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool, commented

’This is a disappointing and inconclusive meta-analysis, with mixed data and small numbers of events. It is fronted by a potentially misleading press release from the American Journal of Hypertension.’

The salt debate is likely to continue, both within the scientific literature and within the media (an article in The Press just last week looked at how much salt was too much).

In the meantime, the best advice is to just follow a few basic practical tips for a healthy diet: focus on fresh foods; use alternative flavourings in foods; and if you are buying processed foods then check out the food labels and go for the lower sodium options. Take a look at the Dietitians New Zealand recent fact sheet on salt for more information and advice.

Is too much salt really bad for your health? Amanda Johnson May 09

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According to the Herald on Sunday this week ’Salt is not dangerous at more than a pinch’

This headline is based on a paper, published last week in the Journal of the American Medical Association (JAMA), which has been stirring up a fair bit of interest.

The research study followed 3681 participants for a mean of 7.9 years to assess whether 24-hour urinary sodium excretion predicted blood pressure and health outcomes. The authors reported that systolic blood pressure, but not diastolic pressure, changed over time and that this aligned with changes in sodium excretion. The association did not, however, translate into a higher risk of hypertension or cardiovascular disease (CVD) complications. In fact, lower sodium excretion was associated with higher CVD mortality.

So — does his mean we should all stop worrying about how much salt we eat?

In yesterday’s Herald on Sunday, Tony Astle, Masterchef guest judge and owner of Auckland’s fine dining restaurant Antoine’s, is reported as saying he had long ignored advice about salt: ’salt is flavour and your body needs it,’ he said.

And Tony Astle isn’t the only chef with this view; last year Masterchef winner Brett McGregor was reported to have said, ’Make sure you know your products – and use salt! Use more salt than you’ve ever used before.”

But what does the science really say?

Well, there is certainly good evidence from many studies that excess intake of salt is linked to high blood pressure and increased risk of cardiovascular disease.

And the JAMA paper has attracted criticism from experts in this field. For example, Professor Graham McGregor said in a Heartwire article last week that:

‘this is a ’badly written paper,” and there are “severe methodological problems” with it, most notably with urine collection in the group that had the lowest salt intake, MacGregor notes, adding that “JAMA has published a lot of controversial papers about salt. I really don’t think this is worth paying attention to. They are trying to create a stir. This is clever, but it’s harmful in my view. It’s like saying we don’t think cigarettes are harmful so we shouldn’t do anything about smoking,” he adds.

“The overall evidence [in favor of salt reduction] is overwhelming,” MacGregor asserts. “That isn’t to say we wouldn’t change our mind if we had really good evidence, but I don’t think this is it. This will not divert us from reducing salt intake worldwide. At a high-level meeting of the World Health Organization, salt reduction has been recommended as the next thing after tobacco reduction because it’s so cost-effective to implement and so easy to do.’

Yes, salt does provide flavour and we do need it — but too much is not good for our health. As the Herald on Sunday article goes on to report, current intakes of salt are much higher than we actually need and there is some sensible advice from Delvina Gorton from the New Zealand Heart Foundation to cut down on processed foods with a high salt content. For more information and advice from the NZHF, check out their fact sheet on salt.

Although salt does add flavour to food, so do many other ingredients. Have a look at this Heart Foundation fact sheet on alternative flavouring suggestions.

The latest nutritional recommendations for New Zealand advise us to aim to reduce our intake of salt to 4g per day — this is significantly below the 9g a day that we are currently, on average, consuming.

There is certainly plenty of confusion about salt and sodium in New Zealand. A consumer survey commissioned by NZFSA published by MAF earlier this year found that there was a lack of clear understanding of the relationship between sodium and salt, with only 36% of those surveyed correctly determining that salt contains sodium. Almost as many (32%) thought salt and sodium are exactly the same, while a quarter did not know, and 6% thought sodium contained salt.

So, overall, I don’t think the JAMA study provides us with evidence to start pouring the salt over our food. And amid the current confusion around salt and sodium, for those who have high blood pressure, the standard advice still applies: keep to a healthy weight, avoid too much alcohol, and keep the salt intake to a minimum. There is also good evidence from the DASH (dietary approaches to stop hypertension) trials that in addition to having a low salt (or low sodium) diet, there are additional benefits to having a diet rich in potassium, calcium and magnesium – with fruits, vegetables, and low-fat dairy, along with whole grains.

The HEARTsafe programme , facilitated by the New Zealand Heart Foundation, is certainly a positive initiative as well. This initiative aims to reduce the sodium content of manufactured foods and involves food manufacturers, food industry associations, and health and nutrition experts. Given that three quarters of our salt intake comes from manufactured foods this is certainly a programme that we should all welcome.

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