Stroke Reduction Advice – Take It Without a Pinch of Salt
Dietary risk comes primarily from processed foods that contain high levels of sugar, saturated fat and salt. People are aware of messages to lower saturated fat intake. Much has been said to highlight the contributory role that excess sugar consumption combined with low levels of physical exercise plays in the development of obesity (see our Outlook on Obesity series).
In comparison, public perception is relatively low concerning the impact of high levels of salt; it increases the risk of kidney failure, cardiovascular disease, heart failure and stroke. About 80% of the salt we eat is in processed food stuffs, takeaway and fast food, microwave and ready meals. However, potentially damaging levels can lurk in common food staples, such as bread.
Salt raises the sodium content of the blood to dangerous levels. This disrupts the capacity of the kidneys to filter blood and remove unwanted fluid. The presence of excess fluid means the heart must pump harder, pushing up the blood pressure. This damages the delicate blood vessels of the kidneys and thickens the walls of the arteries that channel blood around the body, to the brain and the heart.
Although the contribution of excess salt to stroke risk can’t be overlooked, conversely there is evidence that reducing daily intake below three grams actually increases clinical events in at-risk groups. However, it is estimated that a reduction of just one gram of salt per day per person may prevent around 4,000 premature deaths in the UK each year.
As a result, a daily adult intake of no more than six grams was recommended almost two decades ago. Proposals to limit the level of salt put into food by manufacturers were drawn up at that time but in the years since then UK food industry has remained free to operate under voluntary controls. Some observers cite the shift in responsibility from policymakers to the food industry as a reason the drive to lower individuals’ salt consumption has stalled.
Around the world, the number of working-age people having strokes increased by 25% in the decade preceding 2010. Despite UK incidence and survival rates improving over a similar period, 150,000 events occur each year. The recent data on hospital admissions suggests a worsening trend in younger people, but the increase could also indicate that the physical signs of a possible stroke are now more readily identified.
As awareness grows and more people visit hospital with symptoms, even trivial stroke events can be confirmed with advanced scanning techniques. Critical Illness claims could also increase if the requirement for persisting neurological deficit is waived. While a drop in fatalities is good news, a larger burden of care will evolve if more people with severe stroke survive where previously they did not.
Ultimately, the onus is on consumers to make healthy buying choices at the supermarket. But food labels that describe amounts of salt in terms of grams per portion are not easily understood. A lack of consensus only causes further confusion on how manufacturers should describe the ingredients in less healthy products. Understandably, people have difficulty in controlling the amount of salt they eat.
It would surely be simpler, and have greater positive impact on public health, if processed food contained less salt. Until it does, we can assume that salt - together with sugar and saturated fat - will continue to form an unhealthy trinity that contributes to the future poor health of nations.