A recent large study has tied reduced salt consumption to a dramatic drop in deaths from heart disease and stroke.
Scientists analyzed medical data on thousands of participants in the Health Survey for England, following them from 2003 to 2011 to determine the effect of governmental efforts to reduce salt consumption. Blood pressure and sodium levels were measured in random samples of participants. The researchers found a drop in dietary salt consumption of 15 percent over the study period, which was associated with a remarkable 40 percent fewer deaths from heart disease and 42 percent fewer deaths from stroke, according to a paper published April 15, 2014 in the online journal BMJ Open.
“These are important findings and a great validation for those of us in the hypertension community who have urged our patients to restrict salt intake,” says Randy Zusman, MD, Director of the Division of Hypertension at the MGH Heart Center. “Hypertension, or high blood pressure, is the major cause of stroke in the world, and stroke is a primary cause of mental and physical incapacitation. Controlling salt consumption is essential if you want to protect your brain from injury.
“About five percent of adults with hypertension are salt sensitive, with a reaction to salt consumption that can move their blood pressure up or down by more than 10 points. But even in those hypertensive individuals who are not salt sensitive, too much salt causes problems by negating the effects of blood pressure medications.”
WHAT YOU CAN DO
Consider these possible strategies for reducing your salt intake and lowering your stroke risk:
- Work to lower your blood pressure through lifestyle modifications and anti-hypertensive medications.
- Use a commercial salt substitute with your doctor’s okay. Formulated using potassium chloride, they are generally considered safe for individuals who do not have kidney disease.
- Replace salt with other seasonings, such as vinegar, lemon juice, or herbs.
- Try engaging in regular meditation or yoga to induce the relaxation response, which lowers blood pressure.
An essential nutrient
Salt, or sodium chloride, is not all bad: It’s a nutrient that is required for the proper functioning of the cells in the body and brain. Both too little of this nutrient and too much can result in health problems, since salt is involved in many biological processes. Salt is essential for promoting proper nerve and muscle function, for regulating blood pressure, for maintaining optimal fluid levels in cells and for sustaining cellular integrity. Too little salt impairs chemical processes that support energy production, enzyme functioning, hormone production, and protein transport. Since salt cannot be produced by the body, it must be consumed in the diet.
“A healthy individual under 40 years of age without hypertension or kidney disease can consume 2,300 mgs of salt daily without ill effects,” says Dr. Zusman. “About 1,500 mgs per day is recommended for older individuals, those who are salt sensitive, or those with hypertension or health problems such as kidney disease, edema, or heart failure,
“Unfortunately, it’s very easy to go over your salt limit, especially if you don’t pay attention to what you are eating. Many American adults regularly consume from 6,000 to 9,000 mgs a day. Just one large dill pickle, for example, can contain as much as 5,000 mgs of sodium.”
Because salt is so common in the American diet, consumers must raise their awareness of the salt content of the foods they select, Dr. Zusman says. Many common foods contain surprising amounts of added salt. As a general rule, food products with salt listed among the first five ingredients on the label should be avoided.
“Get in the habit of reading the labels on all the products you buy at the grocery store, and select low-salt items,” he says. “Choose fresh or frozen instead of canned vegetables and fruits. Rather than buy prepared foods, make your own meals at home, where you can control the salt content. Many processed foods are loaded with extra salt, as are most low-fat foods, which contain added salt to boost flavor. Avoid salty snacks, such as pretzels, potato chips, and nuts. When you eat at restaurants, choose low-salt menu items. For example, have a salad with an oil-and-vinegar dressing on the side, order your vegetables steamed or grilled, and choose baked, grilled, or broiled meat or chicken. Try to avoid sauces and breading. Choose fresh fruit for a satisfying dessert.”
Make the change to a low-salt regimen by cutting normal amounts in half and then gradually cutting further.
“You may feel like you’re sacrificing for a few weeks, but then your low-salt diet feels normal and you may even find that you no longer like high-salt foods,” says Dr. Zusman. See What You Can Do for other options.