Sodium reduction
“A gradual reduction in salt intake across the whole population, as recommended by the WHO, is achievable, affordable, and cost-effective,” he adds. “An example of a good substitute to regular table salt would be a low-sodium, high-potassium salt. While sodium raises blood pressure, potassium lowers it.”
Take it with a grain of salt Walton’s recent work has looked closely at the balance between sodium and potassium in a healthy diet. Both minerals are vital to the healthy functioning of the human body, so the current argument is not about entirely replacing one with the other, rather achieving the right balance between the two. Given the high and widespread use of sodium-based salt, however, this could be the key area where substituting with potassium-based salts may have the biggest impact on health. “My research has shown that sodium intake is above the recommended [guidelines] and potassium intake is below recommendations,” she remarks. “Following food-based dietary guidelines will help to balance this by increasing consumption of fresh foods including fruit and vegetables, milk and yoghurt, and fresh rather than processed meats.”
The ratio of sodium (Na) to potassium (K) intake is an important predictor of hypertension, so Walton investigated the Na:K ratio in adults with data from the Irish National Adult Nutrition Survey (2008–2010), which collected spot urine samples and dietary data in a nationally representative sample of Irish adults. The findings showed sodium intake exceeded target maximum population goals for all gender and age groups.
“Reducing salt intake at population level from low nutrient dense foods is in keeping with public health advice linked mainly to hypertension and CVD),” says Walton. “Substituting sodium for potassium in salt will increase potassium levels whilst decreasing sodium levels. It is certainly one strategy, but a reduction in low nutrient dense foods in parallel with an increase in high nutrient dense foods – including fruit and vegetables – is also necessary.”
No substitute for a healthy diet Potassium-based salt certainly seems to be one of the most useful weapons in the battle against excess sodium intake, but it cannot win the war all by itself. This is partly because reworking the global supply chain to bring potassium-based salt to supermarket shelves at the same price as traditional table salt will require time, effort and the willingness of the food industry to make such a big change. In the meantime, Walton and other researchers suggest that a healthy diet should contain plenty of potassium-rich foods. Bananas, avocados, dried and
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fresh fruits, leafy greens, potatoes, milk, yoghurt and fresh meat can all help people to achieve a lower Na:K ratio. On the other hand, breads, cured and processed meats, butters and fat spreads have the opposite effect.
The WHO, meanwhile, is calling on countries to implement its ‘best buys’ for sodium reduction – reformulating foods to contain less salt; establishing public food procurement policies to limit salt or sodium rich foods in public institutions such as hospitals, schools, workplaces and nursing homes; using front-of-package labelling that helps consumers select products lower in sodium; and engaging in behaviour change communication through mass media campaigns to reduce salt or sodium consumption. It is also calling on food manufacturers to implement the WHO benchmarks for sodium content in food.
“My research has shown that sodium intake is above the recommended [guidelines] and potassium intake is below recommendations.”
“I think that consumers are aware of the sodium message,” says Walton. “They may not be as aware of the potassium message, but most people are already aware of the message to consume at least five-a-day of fruit and vegetables. Behaviour change is extremely complex, and awareness and education [form] only one aspect of it.” “Awareness is extremely important,” she adds. “So clear labelling is definitely important, but awareness doesn’t always lead to behaviour change.” Building a healthier world is no simple task, but the latest research has at least confirmed the tools that we can use to address the risk of CVD and cognitive decline through dietary changes. ●
Research has shown high levels of dietary potassium is linked with improved cognitive function.
10.8g
The estimated global average intake of salt per day.
WHO 71
Evan Lorne/
Shutterstock.com
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