The Pan American Health Organization/World Health Organization (PAHO/WHO) is joining the call for “Less salt, please!” during this year’s World Salt Awareness Week. The March 11–17 campaign urges everyone to help reduce dietary salt, with a focus this year on chefs, caterers, and others who prepare food for consumption outside the home.
“Restaurants and caterers often add excessive salt to foods because they think that’s what customers want,” notes Branka Legetic, who leads PAHO/WHO’s salt reduction efforts. “But people can in fact change their tastes for salt over time. If you gradually consume less salt, you will gradually want less salt. The same is true of sugar. Chefs and caterers can help consumers choose this better path.”
Salt is an essential part of the human diet, but most people consume more than they realize and more than is healthy. Consuming excess salt contributes to high blood pressure, a major risk factor for heart attacks and strokes, as well as other health problems, including kidney disease, osteoporosis, obesity and Alzheimer’s. High blood pressure is the focus of this year’s World Health Day (April 7), and reducing dietary salt will also be one of the key recommendations of that campaign.
PAHO/WHO recommends that adults consume less than 5 grams of salt per day. In the Americas, salt intake averages 12g/day in Argentina, 11 g/day in Brazil, and 8.5–9 g/day in Canada, Chile and the United States.
Most of the excess salt people consume comes not from the salt shaker but from processed foods such as bread, snack foods, “instant” meals, processed meats and condiments. Restaurant foods are also major contributors, hence the focus this year on chefs and caterers.
PAHO/WHO nutrition expert Enrique Jacoby notes that choosing “low-salt” versions of processed foods is not always the best solution, because processed foods tend to be less healthy than fresh foods for other reasons.
“Foods that come in a bag or a box—what we call ultra-processed foods—are things that people should be avoiding anyway,” says Jacoby. “Low-salt versions of processed foods are full of empty calories, low on micronutrients, and often formulated and marketed to make people over-consume. In contrast, real, fresh foods provide real nutrition, satisfy hunger and are naturally low in salt. The best advice is to eat real foods like those your grandmother ate.”
Cost-effectiveness studies have shown that reducing salt consumption at the population level can cut the prevalence of related chronic diseases at a cost of between 4 and 32 U.S. cents per person per year. A Canadian study of 18 Latin American countries estimated that reducing sodium intake by 10 percent each year could prevent 593,000 cardiovascular events and save some 54,000 lives.
Salt reduction efforts are under way in countries including Argentina, Brazil, Canada, Chile, Costa Rica, Cuba, Mexico, Suriname, Uruguay, and the United States. They include efforts ranging from mass media and educational campaigns to collaboration with food makers to improve nutrition labels and reformulate products to contain less salt.
PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.
Interview with Dr. Branka Legetic on World Salt Awareness Week
Cardiovascular disease prevention through dietary salt reduction
Pan American Journal of Public Health: special issue on cardiovascular disease prevention and dietary salt reduction. Vol. 32 No. 4, October 2012
Countries of the Americas are taking action to reduce salt consumption and save lives
Policy Statement: Preventing cardiovascular disease in the Americas by reducing dietary salt intake population-wide http://new.paho.org/hq/index.php?option=com_content&view=article&id=2022&Itemid=1766&lang=en
Quiz: Test your salt awareness
True or false?
1. Most people consume too much salt.
True. In developed countries, levels of salt intake today are 40 times higher than what our human ancestors consumed during several million years of evolution. Thanks to globalization, high salt consumption is taking hold in developing countries as well.
2. Populations that consume too much salt have higher blood pressure.
True. Epidemiological studies show that salt intake is directly related to blood pressure; communities with higher salt intake have a higher mean population blood pressure.
3. If I stop adding salt to my food, I don’t need to worry.
False. Most excess dietary salt comes from processed foods (especially those sold in bags or boxes). In most developed countries, about 80% of salt consumed is added to foods at the manufacturing stage, where consumers have no control over how much salt is added.
4. Salt is main source of sodium.
True. Table salt is 40% sodium and 60% chloride. PAHO/WHO recommends consumption of less than 5 g/day of salt, equivalent to 2 g/day of sodium.
5. Reduced-salt products are “healthier” products.
True and False. Reduced-salt products are preferable to higher-salt versions, but processed food products are less healthy than fresh, whole foods for many reasons in addition to salt content.
6. If people consume less salt, they will not get enough iodine.
False. Policies for salt iodization and salt reduction are compatible. Close collaboration between salt iodization and salt reduction programs can ensure that their aims are congruent.
7. Salt substitutes are healthier than regular table salt.
Unknown. Many salt su
bstitutes use potassium chloride, and most people need more potassium in their diets. However, there is insufficient scientific evidence so far to recommend widespread consumption of salt substitutes.