High salt intake increases blood pressure, which can lead to heart disease, while high potassium intake can help relax blood vessels and excrete the sodium and decrease blood pressure.
By Job Osazuwa
Table salt is an added ingredient to most foods. It is used for curing meat, masking off-flavours, retaining moisture, and enhancing flavours.
Nutrition & Public Health specialist and Director, Nutrition Services and Education, State Primary Health Care Development Board, Osun State, James Oloyede, defines salt as a mineral composed primarily of sodium chloride used in food for both preservation and flavour.
He said both sodium and chloride ions are needed in small quantities in the body. While salt is involved in regulating the water content (fluid balance) of the body, sodium is used for electrical signalling in the nervous system.
Many people believe that without satisfactory quantity of salt in a food the meal could be classified as tasteless, hence, the need to add more and more. Some persons habitually crave salty, savoury foods and salty snacks.
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However, it has become worrisome to many specialists as salt is increasingly and typically consumed in very high amounts in different parts of the world including Nigeria. Well, dieticians advise that it is pertinent for everyone to restrict his or her daily intake of salt to no more than a teaspoon’s per day or no more than 2, 300 milligrams for most adults, according to global dietary guidelines.
Even if you don’t develop high blood pressure from eating too much salt, you may still be damaging your blood vessels, heart, kidneys and brain, experts have warned.
You might be wondering whether you are consuming too much salt or not. The more salt you eat, the higher your blood pressure and high blood pressure dramatically increases your risk of heart diseases and stroke. Also, excessive levels of it in your body, overtime, can increase your risk of osteoporosis – a disease characterised by low bone mass and deterioration of bone tissue, as well as other chronic conditions.
It has been revealed that more than 90 per cent of children and 89 per cent of adults consume more sodium than is recommended in the new global 2015-202 Dietary Guidelines. Indeed, nearly all Nigerians, regardless of age, race or gender, consume more salt than is recommended for a healthy diet, said a Lagos-based general practitioner, Dr. Dominic Ibe. According to him, many people have been wallowing in a sheer ignorance on the level of salt intake, thereby, exposing their health to grave and many dangers.
He said despite long-standing advice to cut down on salt, Nigerians’ consumption of salt has stayed mostly the same during the past decade, revealing that the trend was not unconnected with the fact that more than three-quarters of the salt (sodium) that people eat comes from processed or packaged foods and restaurant food.
“If we must witness a drastic reduction of salt consumption in Nigerian population, restaurants and food manufacturers would need to cut the amount of salt they put in food. This might simply be the most powerful public health tool or campaign that is needed for reducing salt for Nigerians. You must agree with us that most people now patronise food vendors than foods cooked at homes. People, including women, are always busy working into late hours and wouldn’t have the time to start cooking when they get home. Therefore, restaurants’ foods become the likely available option,” Ibe said.
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Nutritionists, researchers have reviewed available evidence from different studies and found that high levels of salt consumption have harmful effects on a number of organs and tissues, even in people who are “salt-resistant,” which means their salt intake does not affect their blood pressure. They advise that you will still enjoy your food so much more if you cut your salt intake to acceptable dietary guidelines.
In 2013, a Turkish study showed that lower levels of salt were linked to better brain ability in adults with high blood pressure.
Another research on too much consumption of salt conducted on mice in 2017 revealed: “We translate that in humans to activities of daily living, and that’s what we would call severe cognitive impairment or dementia,” says Costantino Iadecola, a professor of neurology and neuroscience at Weill Cornell Medical College in New York City and the study’s lead researcher.
Experts have also raised the alarm that frequent urination, whether during the day or at night, is a key sign of excessive salt intake. But others have countered the submission saying that it could also be a symptom of a number of other conditions, from an overactive bladder or urinary tract infection to Type 2 diabetes.
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High salt consumption levels can lead to reduced function of the endothelium, which is the inner lining of blood vessels. Endothelial cells are involved in a number of processes, including blood clotting
and immune function. High salt levels can also increase artery stiffness, another research revealed.
A study conducted by an associate professor in Kinesiology and Applied Physiology at the University of Delaware, United States of America, David Edwards and others in 2015 reveals: “High dietary salt can also lead to left ventricular hypertrophy or enlargement of the muscle tissue that makes up the wall of the heart’s main pumping chamber. As the walls of the chamber grow thicker, they become less compliant and eventually are unable to pump as forcefully as a healthy heart.”
Edwards’ colleague and chair of the Department of Kinesiology and Applied Physiology at the university, Prof. William Farquhar, said, “chronically elevated dietary sodium may ‘sensitise’ sympathetic neurons in the brain, causing a greater response to a variety of stimuli, including skeletal muscle contraction.
“Again, even if blood pressure isn’t increased, chronically increased sympathetic outflow may have harmful effects on target organs.”
On determining or being watchful over the quantity of salt one consumes, a senior clinical nutritionist at New York University Medical Centre in New York City, USA, Samantha Heller noted that reducing salt consumption can be confusing for consumers because many foods high in salt don’t necessarily taste salty. It is advised that one of the easiest ways to reduce our salt intake is to eat more home-cooked foods using less-processed products.
Corroborating Heller’s position on cutting down of salt intake, Ibe suggested that one of the ways Nigerians can cut the salt in their diet is by reading food labels and deliberately choosing foods low in salt.
“Looking at the label for content of salt is a powerful way of controlling high salt intake. In addition, people can adopt a healthy eating plan, such as the one recommended in dietary guidelines. Also, people can adopt the dietary approaches to stop hypertension, which is an eating plan that is simple and heart healthy. It’s high in fruits, vegetables, fibre, potassium and low-fat dairy products,” he said.
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“Also, excess of salt in your diet can lead to swollen ankles. Swollen ankles can be caused by water retention as a result of eating too much salt. But ensure you run the appropriate tests and get it evaluated by a doctor. However, other conditions can give rise to swollen ankles. If you suffer from frequent mild headaches and have no idea what is causing them, you might have to reduce your salt intake. An overload of salt in the diet can lead to dehydration-induced headache symptoms,” Ibe enlightened.
On the implication of too much salt in the body, Oloyede said studies had shown that when sodium is consumed regularly on excess basis, the kidneys have trouble keeping up with the need to excrete excess sodium in the bloodstream.
He said: “As sodium accumulates, it gets stored in the blood; increases water retention and blood volume in a bid to dilute the sodium. This increases the pressure on the heart, which has to work harder to pump the blood, thereby increasing pressure on the arteries. This invariably leads to stiffening of blood vessels over time, leading to high blood pressure, heart attack, and stroke, including heart failure.
“In population with high consumption of salt, high blood pressure is a leading cause of cardiovascular disease accounting for two-thirds of all strokes and half of heart disease. In China, high blood pressure is the leading cause of preventable death, responsible for more than one million deaths a year.
“Interference with Endothelium: high-sodium diets could interfere with the proper functioning of the endothelium (cells that line the interior surface of blood vessels and lymphatic vessels, forming an interface between circulating blood or lymph in the lumen and the rest of the vessel wall). It causes inflammation and stiffening, hence damage to heart, aorta, and kidneys without necessarily increasing blood pressure.
Research shows that higher intake of salt, sodium, or salty foods are linked to an increase in stomach cancer. The World Cancer Research Fund and American Institute for Cancer Research concluded that salt, as well as salted and salty foods are a “probable cause of stomach cancer.”
The higher the salt intake the more the quantity of calcium that your body loses, via urination. If calcium is in short supply in the blood, it can be leached out of the bones. So, a diet high in sodium could have an additional unwanted effect – the bone-thinning disease known as osteoporosis. Studies have shown that reducing salt intake causes a positive calcium balance, suggesting that reducing salt intake could slow the loss of calcium from bone that occurs with aging.
He said: “Sodium and potassium have opposite effects on heart health. High salt intake increases blood pressure, which can lead to heart disease, while high potassium intake can help relax blood vessels and excrete the sodium and decrease blood pressure. Our bodies need far more potassium than sodium each day, but unfortunately the converse is the case.
“People who eat high sodium, low potassium diets have a higher risk of dying a heart attack or from any cause. Some studies have found out that people with the highest sodium intakes had a 20 per cent higher risk of death from any cause than people with the lowest sodium intakes. People with the highest potassium intakes had a 20 per cent lower risk of dying than people with the lowest intakes.
“People with the highest ratio of sodium to potassium in their diets had doubled the risk of dying of a heart attack than people with the lowest ratio, and they had a 50 per cent higher risk of death from any cause,” the expert explained.
People at high risk
Oloyede said the people with high risk of developing health problems related to salt consumption are those over age 50; people who have high or slightly elevated blood pressure; diabetes patients and African Americans (US).
Tips to lowering salt intake
To lower the risk from excess salt intake, Oloyede recommended an increase intake of diet rich in potassium. “Eat more fresh vegetables and fruits, which are naturally high in potassium and low in sodium. Eat less bread, cheese, and processed meat, as these and other processed foods are high in sodium and low in potassium.
Cardiologists (heart experts) recommend getting less than 2, 300 milligrams (mg) of salt or sodium each day, unless the consumer has high blood pressure or if he or she is at risk (those already with hypertension, diabetes or kidney disease). Then, the recommendation is that you eat 1,500 milligrams of salt a day. That’s less than a teaspoon from all your meals and snacks,” he said.
Avoid adding salt to foods at the table: Break the habit of automatically reaching for your salt shaker. Table salt is about 40 per cent sodium. It is more dangerous to add salt to already cooked foods.
Read the labels on salt/sodium content when shopping for foods or snacks: Look for lower-sodium cereals, crackers, pasta sauces, canned vegetables, or any foods with low-salt options. At restaurants, ask about salt added to food. Many chefs will skip or cut back on salt if you ask.
Eat fewer processed and packaged foods: Packaged, processed foods account for most of the sodium in people’s diets. If you prepare your own food, there is a higher chance to that you can control what is in it. If your restaurant posts the nutrition facts for its dishes, check how much sodium is in a serving. There may be lower-sodium options on the menu then opt for the latter.