With a pinch of salt

With a pinch of salt

If you're confused about salt, I'm not surprised. There's been a steady back-and-forth on claims that reducing dietary sodium (which represents 40% of the salt molecule) is crucial to our well-being, countered by claims that following this advice can sometimes be a health hazard.
While some studies have concluded that only people with hypertension on high-salt diets need to reduce salt intake, the overwhelming strength of scientific findings bolsters advice from major health organisations that most of us should cut back on sodium for the sake of our health. Excess sodium is responsible for most cases of hypertension, and hypertension is a leading risk factor for heart attacks, strokes and kidney failure.
Because salt added to our foods by processors and restaurants, not that from our salt shakers, is the main source of sodium in our diets, protecting the health of the most vulnerable requires a society-wide reduction in sodium.

Going overboard

The recommended daily intake for healthy adults - 2,300 milligrams of sodium a day, or the amount in about 1 1/8 teaspoons of salt - will be reflected in the new nutrition facts label. Currently, the average person consumes more than 3,400 milligrams a day, an amount often found in a single restaurant meal. A lunch of soup and a sandwich can easily add up to a day's worth of sodium.
However, an expert team reported last year in The New England Journal of Medicine that an average reduction of just 400 milligrams of sodium a day could save 28,000 lives and $7 billion in health care costs a year.
Around 75 countries have adopted or advocated salt-lowering goals, and wherever this is happening, rates of hypertension and deaths from cardiovascular disease are declining. Indians consume 119% more salt per day than the World Health Organisation's prescribed limits.
To be sure, sodium is an essential nutrient, as is chloride that makes up the rest of the salt molecule. We evolved from ocean-dwellers, and human tissues still swim in a salty sea.
Our kidneys are fine-tuned machines for keeping blood levels of sodium within a physiologically healthy range; when there's too much sodium on board, the kidneys dump it into urine for excretion, and when more is needed, they reabsorb it from urine and pump it back into the blood.
Unfortunately, faced with a chronic excess of sodium to deal with, the kidneys can get worn out; sodium levels in the blood then rise along with water needed to dilute it, resulting in increased pressure on blood vessels and excess fluid surrounding body tissues.
So why, you may wonder, is there any controversy? Shabby science, resulting in claims that is it unsafe to reduce sodium intake below 1,500 milligrams a day, is one reason, according to Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest, a health advocacy organisation in Washington, DC.

Smart servings

"Very few people consume so little sodium, and most of those who do are sick to begin with, so they eat less and consume less sodium," she explained. "It's a phony issue." But when a study is published that runs counter to prevailing beliefs, it tends to get undue media coverage. "The media like 'man bites dog' stories, and studies with surprising results make headlines," Liebman said.
Also feeding the debate is resistance from the food and restaurant industries, which fear that consumers will reject a change in recipes. However, two developments indicate no negative effect on sales or consumer choice when salt is reduced.
"Consumers are sometimes wary of low-sodium products, thinking they will lack flavour," Liebman observed. But when sodium is reduced gradually and without fanfare, they hardly notice it.
That, in fact, is the key to cutting back on salt generally: Do it a little at a time to give taste buds a chance to adjust. While I still like some salt, highly salted foods I once enjoyed, like corned beef, cured olives and smoked fish, are now unpleasantly salty to me.
A culinary trick worth trying is to prepare foods without adding salt, then sprinkle some on at serving time. You'll get a bigger bang for that salt buck while consuming less sodium. Some producers of chips rely on this tactic - consumers taste only the salt on the surface, which to my taste is more than enough on chips labelled "low sodium."
Likewise, when buying canned or packaged soups, select ones labelled low-sodium and, if desired, add some salt at the table. Better yet, enhance the flavours of low-sodium soups with herbs, peppers, garlic and other salt-free seasonings. Also helpful, for reasons beyond sodium reduction, is to eat more fruits and fresh vegetables. They are naturally low in sodium and many are high in potassium, which helps to lower blood pressure.
Often, most of the salt in a restaurant dish comes from the sauce or dressing; ask for it served on the side and use only a small amount on the food. For dishes cooked to order, ask for them prepared without salt; you can always add some at the table, if desired.

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