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Public presentation (June 2013)

Reducing salt in the diet to protect health: Easy and

effective

Associate Professor Nick WilsonDepartment of Public Health

University of Otago, Wellington, New Zealand

nick.wilson@otago.ac.nz

uow.otago.ac.nz/BODE3-info.html

ContentsContents

Why salt is an important health problem?

What can be done – at a personal level?

What can be done by government – and is it a good use of government funds?

Salt vs sodiumSalt vs sodium

Salt is sodium chloride (NaCl)

Sodium is an element which occurs naturally and is used by the body

1g of sodium = 2.5g of salt(1 teaspoon = 6g)

Salt: Historically importantSalt: Historically important

Once critical for food preservation – but we now have fridges, freezers and canning

Image: Carlos Porto / freedigitalimages.net

Too much salt in the dietToo much salt in the diet

Raises blood pressure increased risk of heart attacks and stroke

Possibly around a third of heart disease could be prevented if the salt risk factor was eliminated

Charity Registration No. 1098818

Not just heart attacks & strokes:Not just heart attacks & strokes:

Osteoporosis

Stomach Cancer

Kidney Disease

Too much salt in the dietToo much salt in the diet

Major study “Global Burden of Disease 2010” ranked the risk factor “diet too high in salt” as 11th most important risk factor for health loss globally

In NZ – also ranked 11th (ahead of diet low in fibre, diet low in vegetables, diet high in red meat)

How much for adults?How much for adults?

• NZ/Australia recommendations: <2300 mg day sodium (just under 6 g of salt)

• That’s just one teaspoon’s worth!

• But 80% or more is hidden in processed foods (not added at the table or cooking)

Top sources in NZ

• Bread• Processed meats• Sauces

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Nutrition survey data

Personal action

• Beware of excuses: “but my blood pressure is okay” – as salt makes BP rise with age

• Focus on reducing the big 3: bread, processed meat, sauces

• Minimise in cooking (phasing down & you may not notice)

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Simple swapsSimple swaps

Ham or cheese sandwich

Egg or tuna sandwich

CrispsPlain popcorn

Biscuits Dried Fruit

Swap: For:

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Eat more fruit & vegetables – the potassium reduces the risk of stroke

Societal level action

• Successful campaigns in the UK, Japan & especially Finland

• NZ – some progress by bread manufacturers (with Heart Foundation) but salt levels still fairly high

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Societal level action needed

• Upper limits on salt in bread, processed meats, sauces

• Better labelling – is coming• Could consider junk food taxes

(help with obesity as well)?

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Improved food labelsImproved food labels

Simpler, easier to understand eg,:

Good use of government resources?

• Yes – 13 international studies all indicate this (esp. laws on upper limits); 8 studies: costs saved.

• Health system savings – fewer heart attacks and strokes

• Consumer acceptability – don’t notice a 10%/year reduction

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Rationale for government role

• Society expects safe food (government bans bacterial contamination of food)

• The taxpayer-funded health system pays for the heart attacks and strokes

• Economic cost to society when workers die of heart attacks

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Conclusions

• Excess dietary salt – an important problem (rank=11th)

• Easy options for personal action• Government action makes sense

eg, upper limits & better labelling• This would improve health &

probably save health dollars19

Acknowledgements

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Thanks to Heather Kizito, Stroke FoundationSome online materials from “Consensus Action on Salt & Health” (UK)

Email: nick.wilson@otago.ac.nz