The Role of Salt in High Blood Pressure: Revealing the Global Health Crisis

The World Health Organization released its first-ever report on the devastating global impact of high blood pressure, along with recommendations on the ways to win the race against this silent killer. According to the paper, 4 out of 5 hypertensive individuals do not receive proper treatment; yet, 76 million fatalities might be prevented between 2023 and 2050 if nations were to increase coverage.

In the world, 1 in 3 individuals suffer with hypertension. Stroke, heart attack, heart failure, renal damage, and several other health issues are caused by this prevalent and fatal illness. One of the biggest global challenges to public health and development is the prevalence of poor diets. The overproduction and overconsumption of foods and drinks with an unhealthy nutritional composition, mostly industrially prepared food, must be curbed immediately. The biggest concerns are poor intake of whole grains, legumes, vegetables, and fruits, and excessive consumption of salt, sweets, and harmful fats, especially trans and saturated fatty acids. Too much sodium in the blood is called hypernatremia. Processed foods contribute significantly to diet salt intake in many high-income nations and increasingly in low- and middle-income countries.

One of the things contributing to the global rise in noncommunicable diseases is a high consumption of salt. In the twenty-first century, NCDs constitute the main cause of premature death. Two of the primary NCDs that are frequently linked to salt are cardiovascular disease and stroke. Diseases related to chronic conditions (NCDs) cause 12 million premature deaths annually and an estimated $500 billion in economic losses in low- and middle-income countries, where 85% of all premature deaths from chronic diseases occur.

There is overwhelming scientific evidence that a high-salt diet causes elevated blood pressure. In countries where salt intake was reduced by 1 gram per person per day, deaths from stroke and heart attack were reduced by more than 7%. Salt, also known as sodium chloride, is about 40% sodium and 60% chloride. It flavors food and is used as a binder and stabilizer.

Eastern Mediterranean Region data indicates that most of nations have an average daily salt intake of about 10 grams per person, which is more than double the WHO recommendation.

In the United States, hypertension affects nine out of ten men and women at some time in their lives. This epidemic places a huge burden on the healthcare system and economy.

Cardiovascular disease

The Institute of Medicine found that while reducing down on salt decreases blood pressure, there is conflicting data about a lower risk of cardiovascular illnesses. This conclusion was reached after reviewing research on sodium. Nonetheless, it is evident that one of the main causes of CVD is excessive blood pressure. It is the cause of half of heart disease cases and two thirds of all stroke cases. In China, high blood pressure is the leading cause of preventable death, responsible for more than one million deaths a year.

Chronic kidney disease

High blood pressure is a significant risk factor for both cardiovascular disease and chronic kidney disease. These two conditions share many risk variables. Due to a decreased ability to eliminate sodium, which can raise blood pressure, salt sensitivity is said to be more common in CKD patients.

Osteoporosis

The amount of calcium that your body loses via urination increases with the amount of salt you eat. If calcium is in short supply in the blood, it can leach out of bones.

Cancer

Research shows that a higher intake of salt, sodium, or salty foods is linked to an increase in stomach cancer.

Recommended Amounts

The U.S. Dietary Reference Intakes state that there is not enough evidence to establish a Recommended Dietary Allowance or a toxic level for sodium . Because of this, a Tolerable Upper intake Level has not been established; a UL is the maximum daily intake unlikely to cause harmful effects on health.

Is table salt less healthy than “natural” salts?

Either seawater evaporation or salt mining are used to extract salt. All salts are composed of sodium chloride, with very little variation in terms of nutrients. Little quantities of minerals are present in less processed salts, but not in sufficient numbers to provide a noticeable nutritional advantage. For taste, different salts are selected.

Table salt, which is most often used, is taken out of subterranean salt deposits. In the process of severely processing it to eliminate contaminants, trace minerals may also be removed.

2021 update: FDA releases voluntary sodium-reduction goals

The U.S. Food & Drug Administration released new voluntary guidance on October 13, 2021, encouraging the food industry to gradually reduce sodium in commercially processed, packaged, and prepared foods over the next two and a half years—with the aim of helping Americans reduce their average levels of sodium from 3,400 to 3,000 mg/day.

Sodium and salt converter

Convert the sodium listed on food products into grams of salt and vice versa.

Sodium to salt conversion

E.g., 5 g salt = 2000 mg sodium = 87 mmol sodium = 87 mEq sodium

The WHO Regional Offices have developed nutrient profile models that countries can use as a tool to implement the marketing recommendations. In 2011, world leaders committed to reducing people’s exposure to unhealthy diets through a Political Declaration of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs. The WHO guidelines on sodium provide thresholds for healthy intake and outline measures for improving diets to prevent noncommunicable diseases. These guidelines guide countries in designing new policies and strengthening existing ones to reduce the impact on children of the marketing of unhealthy food.

The United Kingdom and Finland have spearheaded effective initiatives to reduce salt intake.

In Finland, a government-led program of education, salt-labeling legislation, and pressure on the food industry has led to a thirty percent drop in salt intake, from 12,000 milligrams a day to around 9,000 milligrams today.

The world is not on track to meet its global goal of reducing sodium intake by 30% by 2025, according to a first-of-its-kind World Health Organization report on the subject.

The development, implementation, monitoring and evaluation of sodium reduction policies should be government-led and safeguarded against possible conflicts of interest.

 

Links

https://www.fda.gov/food/food-additives-petitions/sodium-reduction

https://www.who.int/news/item/19-09-2023-first-who-report-details-devastating-impact-of-hypertension-and-ways-to-stop-it

https://www.who.int/news-room/fact-sheets/detail/salt-reduction

https://www.emro.who.int/noncommunicable-diseases/highlights/reducing-salt-improves-health.html

https://www.hsph.harvard.edu/nutritionsource/salt-and-sodium/sodium-public-health-concerns/

https://www.hsph.harvard.edu/nutritionsource/salt-and-sodium/#:~:text=Recommended%20Amounts&text=For%20men%20and%20women%2014,is%201%2C500%20milligrams%20a%20day

https://www.who.int/news/item/09-03-2023-massive-efforts-needed-to-reduce-salt-intake-and-protect-lives

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