Quick Read – Health Tips to reduce dietary salt intake
RECOMMENDED SALT INTAKE
The recommended intake of salt per day is 1 teaspoon which is 2.3g sodium/day as per the World Health Organization, especially for those with risk factors like Hypertension. Sodium constitutes 38-39% of common salt, and 1 teaspoon has around 6g of common salt. However recent studies and research have shown that 3-5g of sodium (1.5 to 2 teaspoons salt/day or 8-12g salt) is needed for best protection against cardiovascular disease.
However, the average intake of salt has been seen to be >14g/day (around 3 teaspoons or more) in most diets. The optimum amount of salt helps our body to retain water and maintain blood pressure, along with the effective functioning of nerves and muscles. However, consistently supplying an increased load of salt to the body over the years can have adverse impacts on our health.
EFFECT OF INCREASED SALT LOAD ON THE BODY
Increased sodium from salt in the diet, affects the body’s regulation of potassium, calcium, and magnesium.
Potassium is vital to maintaining fluid balance, nerve and muscle functioning by the body. In the kidneys, sodium and potassium are absorbed together by a cotransport mechanism. Therefore, if there is a high salt load, the kidneys excrete more sodium thereby leading to more potassium loss also. Low potassium in the body can lead to weakness, fatigue, tingling sensations, muscle aches, and stiffness, as well as affected digestion and mood. Low potassium and high sodium lead to an increase in blood pressure over a period of time, with increased load on the heart as well as kidneys. This contributes to the risk of developing Hypertension, Stroke, Heart failure and decline in Kidney function, especially with age.
Calcium is a vital mineral for healthy bones and teeth. Calcium also regulates many processes in the body like those of enzymes and hormones, as well as nerve signaling and muscle contraction. Magnesium also has an important role in maintaining bone health, nerve and muscle function, along with improving immunity. Magnesium also helps produce energy and regulate blood sugar. High salt intake and increased sodium in the urine also lead to increased loss of calcium and magnesium in urine and a drop in their body levels.
Therefore, high salt intake adds to the risk of developing Osteoporosis (low bone mass) with age. Further, muscle cramps, fatigue, decreased appetite, indigestion, and tingling can also be symptoms of calcium or magnesium deficiency, the former being more prominently affected. More calcium in the urine can also increase the risk of Kidney stones.
In patients suffering from Arthritis, high salt in the diet can increase joint swelling and discomfort in Osteoarthritis, and trigger flare-up episodes in Rheumatoid arthritis. High salt load in the body is also associated with a decline in cognitive function, increasing the risk of Dementia.
CONTROLLING DIETARY SALT INTAKE
High salt intake in diet happens mainly for two reasons.
Firstly, it happens for cultural and taste reasons where high salt is part of traditional ‘tasty’ food preparation in many cultures and regions. High salt can also help in putting together a quick meal in busy day to day life helping in faster cooking of vegetables, faster thickening of gravy/sauces, less need for garnishing with good taste.
The second reason is increased intake and dependence on processed, preserved and packaged foods, which are high on salt. In fact, packaged foods are not only high on salt (saline-sodium chloride) but also contain many other sources of sodium like sodium benzoate, sodium bicarbonate (baking soda), sodium chloride (salt), sodium nitrite, and monosodium glutamate (MSG).
Frozen meats and cold cuts, canned seafood, soup powders/noodles in packets, processed cheese, instant puddings, dressings, sauces, chips, biscuits, pickles and fast food items like pizzas, tortillas, wraps, and buns are all high on sodium. Dependence on such foods is a bane of modern living today. Children eating increased processed, junk and packaged foods with high salt intake are at an even greater risk of its health impact later in life.
The best way to cut down salt is to follow the 5-POINT GUIDELINE below:
Measuring salt used in cooking
Start with measuring how many total teaspoons of salt are used in cooking daily and divide it by the number of people consuming that food. Try and bring the salt quantity down gradually over 3 months to 1.5 to 2 teaspoons of salt/person/day. Abrupt reductions will be unacceptable taste-wise, while gradual reduction will help taste buds adjust effectively.
Note that rock salt/pink salt has the same amount of sodium as regular table salt. Due to coarser crystals, 1 teaspoon has less amounts of such salts and thereby 15-20% less sodium as compared to the amount of regular table salt in a teaspoon. However, the proportionate difference in taste will also be there. The main advantage of natural (Himalayan) pink salt is that it has many other minerals that are good for the body like Magnesium, Potassium, Calcium and other trace minerals.
Using alternate taste-enhancing substances
As you lower the salt in cooking, introduce other effective and healthy substances that can be added to food to enhance taste: onion, garlic, ginger, olives, vinegar (apple cider-salt free), cumin, lemon, bell peppers/paprika, cilantro, mustard, fennel, celery, and pepper. It is important not to increase the chili/hot spices quotient of food to make up for taste loss due to low salt.
Increase Potassium, Calcium, and Magnesium in the diet
This is easily achieved by increasing the intake of green vegetables, legumes, fruits, nuts, resins and whole grains in the diet. Low-fat milk, yogurt and tofu (paneer) are good dairy sources for Calcium.
Restrict and Reduce processed, packaged and preserved foods
Freshly cooked meals are much lower in salt content than packaged and processed foods. Also if inevitably buying packaged or preserved items, look at the sodium content on the label shown as the amount in milligrams (mg) and the Percent Daily Value (%DV) of sodium in one serving of the food which should ideally be less than 2.4g. (Low DV=5% DV or less of sodium/serving and High DV = 20% DV or more of sodium/serving). Select low DV or low sodium item brands as much as possible.
Washing canned/frozen meats, seafood, and vegetables well, before consumption can also reduce salt intake.
Water intake
It is a common misconception that taking high amounts of water with a high-salt diet will help flush out excess salt from the body. In fact, this can lead to an increase in blood pressure, water retention, and swelling.
Another misconception is that boiling water removes excess salt from drinking water. Boiling can actually increase salt concentration of drinking water, as the boiling point of salt is much above that of water.
A salty tinge in the taste of drinking water can be felt if salt levels cross 180-200mg sodium/liter of water. Civic regulators constantly monitor salt levels in drinking and tap water, and household Reverse Osmosis filters (RO) filters are effective in removing most of the salt from tap water. Water intake should be at the normal recommendation of 1.5-2 liters/day.
Further Reading-
High Blood Pressure (BP) – Risks and Solutions for Hypertension
Incorporating the DASH diet to reduce BP, BMI and Cardiovascular risk
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