A salty advice

Dr. Tony Leachon, the current president of the Philippine College of Physicians (PCP), recently e-mailed me an article-commentary on the unfavorable effects of a high salt diet. The PCP, which is composed of around 6,000 specialists in internal medicine practicing all around the country, is actively involved in a healthy-lifestyle advocacy to help prevent common medical problems.

Written by Prof. Aaron E. Carroll, a consultant at the Indiana University School of Medicine,  the article cited a study published recently in The New England Journal of Medicine reconfirming how a high level of dietary salt intake can cut short one’s life.

The study monitored more than 100,000 people in 18 countries and the authors came up with the conclusion that people who consumed more salt generally had a higher risk of high blood pressure, heart failure and other cardiovascular problems compared to populations with moderate salt intake.

Millions of lives

Needless to say, if we’re looking at the population level, we’re talking about millions of lives who are at risk for the complications of excessive salt in the diet. Ironically, these people don’t even realize the peril they expose themselves to.

The unfortunate ones who succumb to a fatal cardiovascular complication don’t even know what hit them because they were generally symptomless all the time that their blood pressures had been shooting past the ceiling. Their initial clinical presentation could be a heart attack and stroke and many may not survive their first event.

Professor Carroll also detailed another data analysis in the same journal which showed that people who consumed more than 7 grams of sodium per day—the average consumption of most Filipinos—had a significantly higher risk of death than people who consumed 3-6 grams per day. Again, as has been shown in previous studies, those consuming high levels of sodium, which is the main element in salt, had more heart attacks, heart failures and strokes.

I’m sure the average layman knows this fact already about what too much salt can do to one’s health, but there’s simply a huge translational gap between what one knows and what one should actually practice. Health-promoting behavior entails so much effort, discipline and a firm conviction to constantly follow what one must do, think, eat and avoid.

Just to give one an idea, a 3-gram consumption of sodium per day is about the equivalent of three tablespoons of soy sauce. But what one must realize, too, is that some canned or preserved food preparations could already contain this much sodium since salt is still the most common food preservative used.

So if one wishes to control his or her sodium intake, one should eat canned foods in moderation. One should be also conscious of the amount of sodium in various food items. One regular slice of some pizzas, for example, may already contain 1 gram of sodium. Strictly speaking, as Professor Carroll pointed out, a healthy sodium intake should be not more than 1.5 grams per day.

 Other means

We hope our food manufacturers and food establishments would take heart and voluntarily reduce the salt they use in manufacturing or preparing their products. There are other means to enhance the taste of food without loading it with sodium.

Some experts would even recommend a very low sodium diet of less than 1 gram per day. I also recommend this for patients with heart failure because they tend to retain a lot of sodium, making them edematous or swollen, but for the average individual without heart failure, a very low salt intake might be a little too much to impose.

As patients would usually tell us, “what’s the the sense of living if one can no longer enjoy what one eats!” Well, the old adage still applies—we can still enjoy life but everything must be done in healthy moderation.