When it comes to dietary evils, sugar and fat seem to have grabbed all the attention over recent years. But did you know, there is consistent evidence linking too much salt to a range of health conditions such as hypertension, heart disease, renal disease and certain types of cancers?
Hang on… don’t we need salt? Yes, our bodies need salt to maintain normal fluid and electrolyte balance. But diets are rarely lacking and even when intake is low, the body adapts accordingly. The truth is we’re eating well above what we actually need.
Recommendations versus reality
The recommendation is to limit our intake of foods containing added salt, with adults advised to consume no more than six grams (one teaspoon) of salt daily as the absolute maximum if they want to avoid adverse health. But the statistics, which underestimate actual intake because they exclude salt added during cooking or at the table, show an average daily intake higher than this…
Recommendations Versus Current Sodium Intake (ABS, Australian Health Survey: Nutrition First Results – Food and Nutrients, 2011-12)
Look carefully at these figures. Males aged 14 – 50 are among the worst culprits, consuming about eight grams of salt each day. But even more concerning is the amount kids are eating – nearly all boys and 95% of girls aged 2 – 8 years exceed upper limit recommendations.
This suggests a serious issue. Heart disease kills one Australian every 12 minutes and was responsible for 43,000 deaths in 2013. Childhood blood pressure follows a tracking pattern that continues into later life, which may explain why in 2011-12, 4.6 million adults had hypertension. The Global Burden of Disease estimates that almost 5% of Australian deaths in 2010 were caused by a high sodium diet.
Why are we eating so much salt?
As is usually the case with diet, it’s not necessarily straight forward. While sodium is naturally present in some foods (e.g. milk, eggs, meat and shellfish), around three quarters of the salt we eat comes from processed foods. In Australia, this means cereal and cereal-based products, largely because of the volumes eaten…
Why add salt to processed food? As a preservative, salt prolongs shelf life and enables food to travel long distances. It’s also a cheap way to enhance flavour. Processed foods are also widely available and heavily promoted. The Department of Health and Ageing spent $51.9 million on advertising in 2010-11 across its entire portfolio, compared to an annual spend by Nestle Australia alone of $34 million. We’re now more reliant on convenience food, eating meals not prepared within the home regularly each week, which tend to be higher in salt.
It’s also thought that continuous exposure to salty foods can alter our taste preferences and result in us eating more and more of the stuff, creating a salt habit. And finally, public awareness is lacking. Few Australians read the salt content of food products, only a minority know recommended intake levels and there’s a lack knowledge regarding the adverse health impacts or the amount of salt present in everyday foods.
What are we doing about it?
Australia has agreed to reduce salt intake by 30% by 2025, along with other World Health Organization (WHO) member states. That said, there doesn’t appear to be a comprehensive national approach to support this.
In 2009, the federal government established the Food and Health Dialogue, focusing on voluntary food reformulation to reduce salt. While reduction targets have been agreed with industry across a range of food categories, only a handful of targets have been set and little objective evidence about progress has been provided. More recently, the federal government launched a voluntary Health Star Rating System on packaged food, helping consumers make healthier food choices. And last year, the Victorian government launched its “State of Salt” program aimed at reducing salt intake in Victoria through increased public awareness, support for healthier food supply initiatives and a commitment to work with industry to reformulate food. Neither of these initiatives have been evaluated as yet.
Compare this to Finland, were strong leadership and an integrated approach has lead to a 40% fall in consumption over three decades. Or to the United Kingdom, where public health advocates successfully influenced the Department of Health to establish a national salt target (six grams per day) and who took responsibility for developing strategies to achieve this. By 2012, average population salt intake had fallen to just over eight grams per day, down 15% from 2000 levels.
What should we do about it?
There’s never going to be a ‘one size fits all’ approach to solving the salt problem. But if we’re going to effectively tackle this issue, we need the federal government to provide strong leadership and take accountability as a starting point.