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WHAT'S NEW IN NUTRITION RESEARCH

SALT - should you cut down?

Most doctors and nutritionists recommend a low salt diet if you have high blood pressure; but, the most effective dietary treatment for hypertension is weight loss, increased intake of fruit and vegetables and reduced fat dairy products.

What if your blood pressure is normal - are there any benefits in being on a low salt diet? A meta-analysis of 56 trials in 1996 by Midgley et al (JAMA) concluded that "dietary sodium restriction for older hypertensive individuals might be considered, but the evidence in the normotensive population does not support current recommendations for universal dietary sodium restriction". Another meta-analysis of eleven trials with over 3,500 subjects was published in 2002 in the BMJ. The authors concluded that sodium restriction resulted in minimal blood pressure changes (not more than one mm of mercury) and there was no effect on any cardiovascular events or death.

These analyses suggest that salt restriction is mainly important in people with high blood pressure to help stop their medication. However, this does not mean that the recommended dietary intake (RDI) for sodium (2500mg) can be safely ignored by people with normal blood pressure. Excessive sodium intake has also been linked with other health conditions apart from raised blood pressure. They include any condition exacerbated by water retention. See our Fact sheet.

Did you know that:

1. A food label that claims the food is "low salt" must have less than
   120mg sodium/100g.
2. A jam sandwich has only 30% less salt than a vegemite sandwich because most of the salt comes from the bread.
3. Onion/Celery/Garlic salts are not low sodium substitutes.
4. If you get rid of the salt shaker from your table and stop adding salt to cooking, this will only cut salt intake by about 15% for most people because the bulk of our salt intake comes from processed foods, especially bread.
5. A bowl of cornflakes has about the same salt as a small packet of plain chips.
6. Some sweet biscuits contain as much or more salt than savoury biscuits.
7. Of the fatty spreads, mayonnaise has the most salt (240mg/100g), followed by margarine (140mg), butter (130mg), dairy blends (110mg) and cream cheese (85mg/100g).
8. Ricotta, cottage, mozzarella and Swiss cheeses are lower in salt than most other cheeses; processed cheeses contain much more salt than regular cheeses.
9. Since less than 20% of our salt intake comes from the salt we add directly to our food, it is OK to sprinkle a little iodised salt on nutritious foods to help us eat them
10. Instead of cooking with salt, just put a little on your food afterwards. This way you will get the taste, but use less salt because the salt is on the surface of the food instead of cooked into it.

11. There is emerging evidence that iodine intake has dropped in the Australian population because of reduced use of salt in cooking and at the table (particularly iodised salt); also most salt used in processed foods is uniodised (iodine is needed for normal functioning of the thyroid gland and associated hormones which regulate metabolic rate and promote growth and development throughout the body including the brain).

So, if you have a normal blood pressure, it is OK to sprinkle a little iodised salt on nutritious foods like fish, vegetables and legumes if it helps increase your intake of such foods by making them more palatable.

For more information read our 2002 edition SALT fact sheet (co-authored by the Better Health Channel)

Recipe of the month: Fruit Cake

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