Working in the Low-Salt Mines

We're finally catching up with reality, at least in one arena. In the past week I've read two local newspaper articles, one article in the Annals of Internal Medicine and an accompanying editorial in the same monthly journal from the American College of Physicians, all on our need to decrease our salt intake.

Those of us who've spent much of our medical careers dealing with the treatment and the consequences of high blood pressure, medically termed  hypertension, have been on a low-salt kick for years. Both of my parents and, eventually my older brother had hypertension, so I watched my blood pressure for years and, when it went up to high normal, cut way back on my salt intake. I also started to lose weight and to exercise more.

So two days ago I read an article titled "Shaking the Salt Habit." That was written for our Fort Collins paper and was followed by one today, from the Associated Press, titled "Too Much Salt: Report urges FDA to force rollback. Then there were the two medical pieces which came out in the April 20th edition of the  Annals. The editorial encapsulated the concept: "We Can reduce Dietary Sodium, Save Money, and Save Lives.

The bottom line is the American diet contains roughly twice as much salt as is optimal for health, nearly 4,000 milligrams vs. the maximum recommended of 2,300 mg. for young, healthy adults, and the 1,400 to 1,500 mg. that is the suggested maximum for people with high blood pressure, for African-Americans and for anyone older than 40. Much of the excess comes from processed foods.

Other countries have already made progress along the lines of cutting average salt intake (salt, of course, is sodium chloride, but I'm used to using either term). The UK started in 2003, and cut salt intake by an average of 9.5% The Annals article suggests if we were able to do the same, gradually perhaps so people didn't think the taste of food was inferior and started salting things at the table, we'd save lots of lives.

The consequences of hypertension include heart attacks, strokes and kidney failure. That less than ten percent decrease in our dietary salt could prevent over a half million strokes and just under a half million heart attacks in our 40 to 80-year old group. That would save over $32 billion dollars in medical costs.

The UK plans further cuts in salt intake, up to a 40% decrease by 2012. Japan, Finland, Ireland, Australia and Canada plus other countries are also implementing similar programs.

We don't cook with salt for ourselves, decrease the amounts specified in recipes when we cook for others, don't add salt at the table and tend to avoid processed foods. I wondered if we were getting enough iodine, added to most or all salt you purchase, but the salt that goes into processed foods, according to the articles I read, doesn't have idoine anyways. Plus our senior vitamins have the RDA (recommended daily allowance) for iodine anyway. So I quit worrying that we'd develop thyroid problems.

The bottom line is we Americans need to wean ourselves off our excess salt habit and doing so will both improve health and save a healthy chunk of change.

18 Responses to “Working in the Low-Salt Mines”

  1. Terri says:

    I think we need to distinguish between processed sodium and salt, especially sea salt. I've seen doctors forbid people to use salt of any kind. We do need some salt. I think the emphasis should be to avoid processed foods containing sodium. Then we're free to use sea salt in our cooking or at the table in moderation.

  2. Peter Springberg says:

    Terri, sea salt does contain some other minerals, but my basic point still holds true. We do need sodium, but the typical American diet has roughly twice as much as is optimal, even for young adults without hypertension (and nearly three times as much as a sixty-nine-year old man with hypertension, like me, should ingest). Sea salt, contains, according to my research, roughly 85% sodium chloride, so the sodium content is about 30.6% as opposed to table salt's 39.32%. I generally agree with your comment as to avoiding processed foods, at least those with high sodium content, and with adding salt, if at all, in moderation otherwise. That's probably reasonable if you're young, have normal blood pressure (and no family history of hypertension) and if you really mean it when you use the word moderation. We sometimes use no salt or small amounts of table salt, sea salt or kosher salt in cooking and don't add any salt at the table. I certainly wouldn't "forbid" people from using salt, but think as a nation and as individuals, we clearly need to decrease our sodium intake.

  3. Hypertension is very common among old men and women these days.`..

  4. Peter Springberg says:

    At my age (69), I'd use the term older rather than old. Hypertension is a major health issue and its complications are legion. I think we all should have our blood pressure (BP) checked at intervals and was pleased to see that our local drug store lets us check our own BP, without charge, utilizing an automated process . You should be aware that your BP fluctuates and a single reading may not be representative of your usual BP. If you are able to measure/check your own BP and find a mildly elevated reading, be sure to repeat the measurement and, if it's repeatedly high, make an appointment to see your own physician. On the other hand, if you have a markedly elevated BP, I'd suggest you should see a medical professional as soon as possible.

  5. hypertension is a common disease among the older age men and women.'-*

  6. Peter Springberg says:

    I've already responded to a similar comment sent late last month. Please see my 13 July remarks on this subject.

  7. Adam Brooks says:

    hypertension can be minimized by taking some food supplements like fish oil and CoQ10-~:

  8. Peter Springberg says:

    Numerous studies have concluded that fish oil consumption lowers blood pressure, but a few have found no effect and others have been inconclusive. Researchers at the Harvard Medical School evaluated the results of 31 placebo-controlled trials involving 1356 subjects. They found that fish oil supplementation (mean dose of 5.6 grams/day) lowers systolic blood pressure (first [highest] reading of blood pressure measurement) by an average of 3.4 mm Hg and diastolic pressure (second [lowest] reading) by an average of 2.0 mm Hg. The effect is highly dose-dependent. Both eicosapentaenoic and docosahexaenoic acids (the main components of fish oils) are effective in blood pressure reduction with docosahexaenoic acid being slightly superior.
    Dr.Norman Kaplan's book, "Clinical Hypertension," mentions a 2002 study showing a minimal lowering of blood pressure by fish oil in reviewing 22 double-blind trials, with a greater effect in older and hypertensive patients. Since
    even a small decrease in blood pressure can be helpful, I do take a fish oil supplement daily.
    I don't take CoQ10; the National Library of Medicine mentions it may have an effect on blood pressure, but says well--controlled, long-term studies are needed to confirm this.

  9. Melanie Long says:

    when i went to college, i chose a medical career because it is high paying job -,,

  10. Peter Springberg says:

    I spent almost all my active medical practice time (except for three years in a academic position with a private practice on the side) in the United States Air Force. So I made a third or a fourth as much as some friends in full-time private practice did. But I think the opportunities to help others are the real reward in medicine. I hope you'll find that our too.


  11. almost everyone in our family have hypertension, this disease is very common among older people :*-

  12. Great article over again! Thumbs up!

  13. Amos says:

    Good post! I will be also likely to write a blog post about it... thanks a lot

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