Study: Less Salt, More Potassium for a Healthier Heart

Cara Murez and Ernie Mundell wrote . . . . . . . . .

You might want to put the salt shaker down and pick up a banana.

Having less sodium and more potassium in your diet is linked to lower risk of heart disease, according to a new study involving more than 10,000 adults.

Prior observational studies had led to confusion about whether reducing current levels of salt in the diet might backfire, raising cardiovascular disease (CVD) risk, noted first study author Yuan Ma. He’s a research scientist in epidemiology at the Harvard T. H. Chan School of Public Health.

The new data should put those fears to rest.

“Our study combined high-quality individual participant data from six cohort studies where sodium was measured by the currently most reliable method, namely, multiple 24-hour urine samples,” he explained in a Harvard news release. “Our results should help clarify sodium’s role in CVD — that lower consumption is associated with lower risk of CVD in most populations, including in the U.S.”

The findings were presented Sunday at the annual online meeting of the American Heart Association, and also published simultaneously in the New England Journal of Medicine.

Sodium is one of the components of table salt and naturally occurs in some foods. However, much higher amounts are also frequently added to commercially processed, packaged and prepared foods.

Potassium naturally occurs in fruits (such as bananas), leafy greens, beans, nuts, dairy and starchy vegetables. It has an opposite effect to sodium, helping to relax blood vessels and increase sodium excretion while decreasing blood pressure, the researchers explained.

In the new study, Ma conducted a pooled analysis of data from six major studies: The Health Professionals Follow-up Study, the Nurses’ Health Study, the Nurses’ Health Study II, the Prevention of REnal and Vascular ENd-stage Disease study, and the Trials of Hypertension Prevention Follow-up studies.

They analyzed the individual sodium and potassium excretion data, plus the incidence of heart disease, including coronary heart disease (which includes heart attacks) and stroke.

The data came from multiple 24-hour urine samples, which researchers said is the most reliable method for assessing a person’s sodium intake. Those samples were taken from more than 10,000 generally healthy adults with a study follow-up of cardiovascular events for an average of nearly nine years.

After documenting 571 strokes, heart attacks and other heart “events” in the data, Ma’s team concluded that higher salt intake was significantly associated with higher heart risk in a dose-response manner with a daily sodium intake that ranged from about 2,000 milligrams (mg) in some people to more than 6,000 mg in others.

The current U.S. Dietary Guidelines for Americans recommends adults limit sodium intake to less than 2,300 mg per day — that’s equal to about 1 teaspoon of table salt.

The new study found, however, that for every 1,000 mg per day increase in sodium excretion, a person’s risk for heart disease rose by 18%.

Conversely, for every 1,000 mg per day rise in potassium excretion, the risk of heart disease was 18% lower.

Therefore, a higher sodium-to-potassium ratio was significantly associated with increased cardiovascular risk, the team concluded.

“This study underscores the importance of using a reliable biomarker to measure habitual sodium intake and assess its relationship with cardiovascular risk,” said Frank Hu, the Fredrick J. Stare Professor of Nutrition and Epidemiology, chair of Department of Nutrition at Harvard Chan School and senior author of the paper. “The findings provide further support for public health strategies including regulations, food labeling, and promoting healthy dietary patterns to reduce sodium intake and increase potassium intake.”

Sharon Zarabi is a registered dietitian and program director of Northwell Health’s Katz Institute for Women’s Health in New York City. Reading over the new findings, she said the new study offers gold-standard evidence of the harms of too much salt in the diet.

“This just puts the proof in the pudding — what better evidence would you need when you can actually visualize the outcomes of a high sodium diet?,” she said.

The urine tests used in the new research are available to everyone, she added. “These are easy tests we can do in any office and by showing numbers, metrics and data to our patient on an individual level, we may be better equipped to change behavior,” Zarabi said.

People don’t even have to sacrifice on foods’ taste, she added. “We can still enhance the flavor of our food with low sodium alternatives, herbs and spices,” Zarabi noted.

The U.S. Food and Drug Administration has already asked the food industry to gradually reduce sodium in commercially produced foods over the next two and a half years.

Source: HealthDay

FDA Reduces Recommended Salt Levels in Americans’ Food

Robin Foster, Robert Preidt and Steven Reinberg wrote . . . . . . . . .

The U.S. Food and Drug Administration announced Wednesday that it is lowering the recommended levels of sodium in processed, packaged and prepared foods.

The goal of the new, voluntary guideline is to help reduce Americans’ average sodium intake from 3,400 milligrams (mg) to 3,000 mg per day — roughly a 12% reduction — over the next 2.5 years.

“It’s really a pivotal day for the health of our nation as the FDA is announcing a critical step in our efforts to reduce the burden of diet-related chronic disease and advance health equity,” acting FDA Commissioner Dr. Janet Woodcock said during a media briefing announcing the new guideline.

“We as a nation face a growing epidemic of diet-related chronic diseases such as cardiovascular disease, obesity and diabetes, which disproportionately impact racial and ethnic minority groups,” Woodcock added.

“As a result, thousands of lives are lost and billions of dollars spent in health care costs each year for these preventable illnesses. We also know that limiting certain nutrients such as sodium in our diet can play a huge role in helping to prevent diseases such as hypertension [high blood pressure], cardiovascular disease and renal [kidney] disease,” Woodcock said.

U.S. Health and Human Services Secretary Xavier Becerra said the new guideline, although not mandatory, should help all Americans become more healthy.

“These new recommendations and target by the FDA take this a step closer to improving health outcomes for all Americans,” he said during the media briefing. “It keeps Americans on track to stay healthier as we move forward. [The] human and economic costs [of] diet-related diseases are staggering. And hundreds of thousands of Americans are learning that the hard way, as they contract these chronic diseases, and they face the consequences of poor nutrition. So, it’s time for us to do much better.”

Despite the lowering of recommended sodium levels in processed and packaged products, it still does not meet U.S. Dietary Guidelines for Americans’ recommended limit of 2,300 mg per day for those aged 14 and older, the FDA noted. Roughly 70% of added sodium in American diets comes from packaged, processed and restaurant foods, the agency noted.

The American Heart Association (AHA) applauded the FDA’s move, but said the agency needs to go further in the future.

“These targets will be an important driver to reduce sodium consumption, which can have significant health benefits and lead to lower medical costs,” the association said in a statement. “Lowering sodium levels in the food supply would reduce risk of hypertension, heart disease, stroke, heart attack and death in addition to saving billions of dollars in health care costs over the next decade. Many members of the food and restaurant industry have begun to reduce sodium in their products. We strongly encourage the industry as a whole to adopt these targets and build upon existing efforts to reduce sodium in their products and meals.”

Still, “lowering sodium intake to 3,000 mg per day is not enough. Lowering sodium further — to 2,300 mg — could prevent an estimated 450,000 cases of cardiovascular disease, gain 2 million quality-adjusted life years and save approximately $40 billion in health care costs over a 20-year period,” the AHA said.

“We urge the FDA to follow today’s action with additional targets to further lower the amount of sodium in the food supply and help people in America attain an appropriate sodium intake,” the association stated.

One nutritionist concurred.

“It is a first step, but we need to take a stronger stance,” said Sharon Zarabi, a registered dietician and program director for Northwell Health’s Katz Institute for Women’s Health in New York City and Westchester, N.Y.

“Most people believe they eat a low-sodium diet because they avoid use of the salt shaker. Little do they know that most of the sodium is lurking in every packaged food we consume. It serves as a flavor enhancer and preservative to increase shelf life. The effects are multifold, impacting our blood pressure, increasing our risk for cardiovascular disease, stroke, cancer, and increasing inflammation. Ever wonder why you feel so swollen after Chinese takeout or a bag of popcorn?” Zarabi said.

The FDA’s new guidance covers 163 categories of processed, packaged and prepared foods.

Woodcock pointed out that “research shows that people consume 50% more sodium than recommended. This includes our youngest and most vulnerable populations, with more than 95% of children aged 2 to 13 years old exceeding recommended limits of sodium for their age groups.”

She noted in an FDA news release: “A number of companies in the food industry have already made changes to sodium content in their products, which is encouraging, but additional support across all types of foods to help consumers meet recommended sodium limits is needed.”

Source: HealthDay

Salt Sensitivity May Increase Risk of High Blood Pressure

Thor Christensen wrote . . . . . . . . .

People who are salt-sensitive may have an increased risk of developing high blood pressure, according to a study that points to the need for better genetic testing for sodium sensitivity.

Scientists already knew high salt sensitivity is more common among people with high blood pressure, which is a leading preventable risk factor for cardiovascular disease. But researchers wanted to investigate whether salt sensitivity caused hypertension or happened as result of it.

The new study, published in the American Heart Association journal Hypertension, determined the salt-sensitivity level of 1,604 Chinese adults by putting them on a seven-day low-salt diet, followed by a seven-day high-salt diet. After following the participants for an average of 7.4 years, researchers found that people with high sodium sensitivity were 43% more likely to develop high blood pressure than those with moderate sensitivity.

The findings suggest sodium sensitivity is a cause, not a consequence, of high blood pressure, said study author Dr. Jiang He.

“This really supports the idea that we need to pay more attention to reducing salt intake in the general population,” said He, professor of epidemiology and director of the Translational Science Institute at Tulane University in New Orleans.

In addition to helping prevent high blood pressure, cutting back on salt has an added benefit, according to past studies: It reduces stiff arteries, a condition associated with heart attack and stroke.

The new research was part of the Genetic Epidemiology Network of Salt Sensitivity, or GenSalt study, which included genetic testing. Researchers said it was the largest diet-feeding study to test blood pressure sodium sensitivity and resistance.

However, the genetic aspect of the study was “very challenging,” He said.

“We were not successful in identifying either genetic variants or other biomarkers for salt sensitivity. We clearly need more research in this area to identify simple ways to identify people who are salt-sensitive.”

The findings were also limited by the study being conducted solely in Chinese adults. A much larger study is needed in the U.S. that includes a diverse group of people who may be more sensitive to salt, He said.

“It’s an important study that took the difficult, unusual step of tracking blood pressure for years, which gives more credence to their findings. It’s a good first step,” said Dr. Gordon Harold Williams, who was not involved in the research.

The second step – developing genetic tests to find out which salt-sensitive people have increased risk for high blood pressure – will be more difficult, said Williams, who heads the Hormonal Mechanisms of Cardiovascular Injury Laboratory at Harvard’s Brigham and Women’s Hospital in Boston.

“It would be fairly easy to do this study if you did it with your eye color. But there are so many different mechanisms that can lead to salt sensitivity of blood pressure, so many environmental factors that can influence what a particular gene variance does in a given individual,” said Williams, also a professor at Harvard Medical School.

But Williams holds out hope that with enough research, scientists soon will be able to test people for higher salt-sensitivity risks just as they routinely test for genetic variations to guide cancer diagnosis and treatment.

“I think this study and this topic will energize people,” he said. “Hopefully, on the horizon, we will have personalized medicine for this, too.”

Source: American Heart Association

Company Reformulates Salt So You Use Less of It

Chris Albrecht wrote . . . . . . . . .

It’s not until you start reading food labels that you realize just how much salt is in what we eat. It’s everywhere!

MicroSalt aims to reduce the amount of salt we consume by changing up salt delivery itself, and the company is running an equity crowdfunding campaign to help expand its market presence. MicroSalt’s crowdfunding prospectus describes its product as:

…a particle coated with nano-sized salt crystals that range in size from 0.2 um (microns) to 0.6 um. The carrier (usually maltodextrin) simply acts as a vehicle molecule to deliver the small salt crystals. These salt crystals naturally attach to the carrier through electrostatic forces. When consumed, MicroSalt® dissolves almost immediately due to the extremely small size of its crystals, which is what allows for that authentic, salty flavor.

MicroSalt says that its product can deliver the same amount of flavor using 50 percent less sodium compared to table salt. MicroSalt has created its own line of potato chips using this technology called SaltMe!, but its main business is to sell its salt as an ingredient to other packaged foods companies.

The company says that MicroSalt is better than other reduced sodium products on the market because current alternatives use potassium chloride. But potassium chloride isn’t the same salt and has a different flavor. MicroSalt still uses salt, just in a different form.

MicroSalt’s approach to reducing salt use is similar to DouxMatok’s method for reducing sugar consumption. DouxMatok makes a “more efficient” sugar by binding it to silica, the result of which is better diffusion on our tongues so you can use up to 40 percent less sugar in whatever you’re making.

You can buy SaltMe chips online, where they cost roughly US$20 for a six-pack of, 5 oz. bags (they are also available in 71 stores across the Northeaster U.S. and Texas).

The company says it is already developing an 80 percent less salt version of its product.

Source: The Spoon

‘Healthy’ Plant Based Meals in U.K. Restaurants Drowning in Salt

New research by Action on Salt (based at Queen Mary University of London and Bart’s Hospital) have exposed the shocking reality of many ‘healthy’ sounding plant based and vegan meals[1] being served at UK restaurants, fast food and coffee chains.

To mark Salt Awareness Week (9th-15th March 2020), the group of experts are urging the Secretary of State for Health, Matt Hancock to implement more robust salt reduction targets – with proper enforcement – in order to create a fair and level playing field across both the retail AND eating out sectors.

Data from a recent public opinion poll to accompany the survey highlights one of the main reasons why people consume plant-based food is that they are perceived to be healthier[2]. However, this survey (the largest of its kind) of 290 plant-based and vegan meals collected from a total of 45 restaurant, takeaway, fast food and coffee chains, reveals the shocking truth about their salt and saturated fat content, and the dismal lack of nutritional information available. If food or drinks are high in saturated fat, salt or sugar (HFSS), they are not classified as ‘healthy’[3].

Restaurant Plant Based and Vegan Meals

A staggering three out of five plant-based restaurant meals surveyed with nutrition information (96/151) contain 3g or more salt – that’s half of an adult’s maximum daily intake of salt. Worse still, 19 of these provide 6g or more salt – that’s an adult’s ENTIRE maximum daily limit in just one meal!

Examples of Salty Meals:

  • Papa John’s Vegan American Hot Medium Pizza, 9.28g salt – more salt than 7 McDonald’s Hamburgers
  • Loch Fyne Spiced Roasted Cauliflower & Squash Goan Curry 8.65g salt – saltier than 19 anchovies
  • Bella Italia Vegan Cheese Pizza 8.1g salt – saltier than 23 bags of ready salted crisps
  • Chiquitos Vegarrito 7.89g salt
  • Slug and Lettuce Louisiana Chick’n Vegan Meat-less Burger 7.6g salt

If these restaurant chains were to display colour-coded nutrition information on their menus like packaged food in supermarkets, more than four out of five (127/151) plant-based meals would have a red label for high salt content (i.e. >1.8g salt in a meal)[7].

Interestingly, the variation in salt content of similar meals served at different restaurants is surprising and shows that salt isn’t needed for flavour – with some restaurants offering tasty dishes that have seven times less salt than their competitors, clearly demonstrating that these meals can easily be made with much less salt.

Fast Food & Coffee Chains Plant Based and Vegan Meals

A whopping two thirds of plant-based meals (82/128) available in fast food and coffee chains would get a red label for being high in salt (>1.8g salt per portion) – along with nearly two in five (29/128) meals containing 3g or more salt i.e. half of an adult’s maximum daily intake of salt.

Examples of Salty meals:

  • Wasabi Pumpkin Katsu Curry Yakisoba 10.3g salt – saltier than 8 McDonald’s Hamburgers
  • Wasabi Veg Tanmen Soup 9.7g salt –saltier than 21 anchovy fillets
  • EAT 3 Bean, Smoked Chili and Tomato 5g salt – saltier than 14 bags of ready salted crisps
  • Abokado THIS Vegan Katsu Curry (with sauce) 4.6g salt
  • Cojean Vegetable Gyoza Miso Soup 4.3g salt

Saturated Fat in Plant Based and Vegan Meals

AND it’s not just salty food being served up by UK restaurants, fast food and coffee chains – over half of all restaurant meals surveyed would qualify for a red label (>6g/portion) for saturated fat, and more than one in five dishes provide more than half of an adult’s maximum daily intake for saturated fat[8]. One of the worst offenders is Harvester’s The Purist Burger (served with triple cooked chips), containing 54.2g saturated fat in a meal, nearly 3 times a woman’s maximum daily intake!

Salt Targets

Public Health England’s 2017 salt reduction targets include targets for the eating out sector and are intended to guide salt reduction in the meals we eat in restaurants, cafes and fast food outlets[9]. However, of all the meals surveyed, only half (56%) have a salt reduction target in place, and of those, only 53 (32%) have failed, despite the high levels of salt reported in many of these dishes. This clearly demonstrates that the targets not comprehensive, ambitious or fit for purpose. The Government announced their commitment to reducing salt in their Prevention Green Paper last year, and are currently negotiating new targets for the food industry to achieve by 2023. The Secretary of State for Health Matt Hancock must now be brave and bring these out of home targets in line with the rest of the food industry, with clear consistent monitoring across the whole industry.

When asked if they would support government taking action to ensure that the out of home sector reduces salt levels in their dishes and is transparent about the nutritional content of their meals on menus, 73% of the public said yes2.

Source: Action on Salt

Read also:

Salt content of vegan and plant-based meals served in the out of home sector . . . . .