The Times (London, UK)
October 24, 2005


Salt is our national weakness, but where do the risks begin?

By Anjana Ahuja

Stay away from the white stuff. Once you start, you'll be hooked. It
will ruin your life and may eventually kill you. And children, in
particular, must be saved from its seductive grip.

This was the message issued recently by scientists, in an effort to
persuade the nation to reduce its salt intake. Table salt, or sodium
chloride, raises blood pressure. High blood pressure (hypertension),
although symptomless, is a known risk factor for stroke and coronary
heart disease. Britons consume 9.5g of salt per day, and we should aim
to eat less than 6g (0.2oz), equivalent to a teaspoon. The Government
estimates that cutting salt intake by a third would, on average, lead
to a 13 per cent drop in the incidence of stroke and 10 per cent fewer
cases of heart disease. That could save around 35,000 lives.

Dr Susan Jebb, head of nutrition and health research for the Medical
Research Council nutrition centre in Cambridge, wrote the MRC's report
on salt, which was launched at a press conference in London earlier
this month. It supports the Government's message that cutting salt
intake can reduce blood pressure and improve the health of the nation:
"Among independent scientists, there is a clear consensus on the
evidence of the link between health and blood pressure, " Jebb
declared. At the press conference, Jebb, who has young children,
confessed to giving up crisps and becoming fastidious about reading
food labels.

Jebb, who was joined by Paul Lincoln, the National Heart Forum, and
Professor Peter Aggett, the University of Central Lancashire and a
government adviser on salt, was tackling one of the most contentious
disputes in public health: the link between salt and sickness. Salt
has long tumbled from its historic pedestal as an expensive delicacy
and our consumption of it is now a matter of national concern. While
the evidence that high blood pressure is a factor for stroke and heart
attacks is firm, the corresponding evidence that cutting salt reduces
blood pressure enough to ward off a heart attack is more equivocal. On
one side, salt producers -- worried about their product becoming as
stigmatised as tobacco -- reject the suggestion that the path to a
hospital bed is sprinkled with salt. On the other, public health
watchdogs maintain that any reduction in the nation's blood pressure,
however small, is worth striving for.

Last year, when the Government launched a u4 million advertising
campaign to curb national salt intake, the UK-based Salt
Manufacturers' Association claimed that it was based on questionable
evidence, and that alcohol and obesity were equivalent risk factors
for high blood pressure.

Professor Graham MacGregor, chairman of the lobby group Consensus
Action on Salt and Health, and a consultant at St George's Hospital,
London, countered this by saying that "if successful it will result in
the biggest improvement in public health since the introduction of
clean water and drains into the UK in the late 19th century".

Salt is 40 per cent sodium and 60 per cent chloride; it is the sodium
that poses a health issue. The human body requires a tiny amount to
help nerves and muscles to function; the element also regulates fluid
in the body. A daily intake of 1g of salt is enough to meet this
biological need (the 6g recommendation, while still high, is seen as
an achievable objective). Nonetheless, Britons get through nearly 10g
a day, and a fifth of men -- keen consumers of processed meat products
-- consume more than 15g daily. Crisps, one of the saltiest foodstuffs
at around 1g a bag, are a national weakness.

In most people, excess sodium is flushed out by the kidneys and
excreted in urine. But for those whose kidneys cannot cope, the extra
sodium trapped in the body draws out water from the body's tissues.
The heart works harder to pump the extra fluid, and blood pressure
rises. One in three Britons suffers from hypertension, defined as a
blood pressure that is persistently above 140/90 mmHg.

Researchers have worked hard to isolate and quantify the link between
sodium and disease. A recent survey of 23,000 people in Norfolk
suggested that those with the saltiest diets were twice as likely to
develop hypertension as those on the least salty diets.

In public health terms, the question is whether cutting salt reduces
blood pressure, and whether those reductions lead to a measurable
reduction in disease. The trend is clear -- the lower the salt intake
of a population, the lower the average blood pressure will be.

The salt lobby's argument is that the benefits gained by salt
reduction are so small as to be of questional clinical relevance. The
Salt Manufacturers' Association states: "Scientific research shows
that lower sodium diets have a miniscule long-term effect on the blood
pressure of healthy individuals (my italics)."

Almost everyone else, though -- the Food Standards Agency (the
Government's food watchdog), plus the majority of doctors, scientists
and nutritionists -- recommend the precautionary principle. As the MRC
report summarises: "Since individuals will not be aware of whether or
not they are salt-sensitive, and since there are no advantages to a
high salt intake, it follows that the greatest benefits will be
achieved by encouraging the whole population to decrease the average
intake of salt."

Since 60-75 per cent of salt in our diets comes from bought staples
such as bread, cereals, soups, processed meats, cheeses and biscuits,
the risk of consuming too little salt seems remote. Salt that occurs
naturally in foods -- such as milk -- accounts for 15 per cent. That
leaves only another 10-15 per cent that is added during cooking or at
the table.

The Department of Health now has the food industry in its sights. Last
year, it "named and shamed" food companies for failing to cut salt in
foods such as bread and cereals (it is added for flavour, texture and
as a preservative). Shortly afterwards, the Food and Drink Federation
announced that salt in sliced bread would be cut by 5 per cent (one
slice contains about 0.5g), and salt in cereals would be cut by 9 per
cent (a bowl of corn flakes contains about 1g). MacGregor has
denounced such changes as "fiddling at the edges". The two warring
sides have reached an impasse -- while campaigners clamour for steeper
cuts, manufacturers protest that unpalatable low-salt foods will force
British consumers to buy salt-laden imports.

Manufacturers are being urged to clean up their act in other ways,
such as providing large-print, front-of-packaging information, and
replacing "sodium" content with "salt" content -- many consumers are
unaware that "sodium" values must be multiplied by 2.5 to calculate
salt content.

Lo-Salt, which replaces the sodium in salt with potassium, is better
for health. We are, though, being encouraged to re-educate our
tastebuds so that we crave neither salt nor salt substitutes,
prompting an increased consumer demand for low-salt products.

Doctors advise giving up crisps, eating less cereal, bread, bacon and
pizza, fewer ready-made desserts, and eating smaller portions of salty
foods such as cheeses and hams.

The FSA has devised a "salt-o-meter", which lists the salt contents of
common foods. (You can order a salt-o-meter, which is free, by ringing
0845 6060667).


Piperine, the alkaloid that gives black pepper its pungency, offers a
variety of health benefits. It's thought to enhance the absorption of
nutrients from food -- making the gut wall more permeable, and also
lengthening the finger-like projections of the bowel wall, increasing
the surface area available for absorption. Piperine is also one of a
group of spices which reduces the effect of proteins linked to
hypersensitivity and inflammation, and possibly even asthma. And
research on mice suggests it may help in reducing the DNA damage in
lung cancer.

The Salt Manufacturers' Association is at


Hooked on the white stuff

How to reduce your child's intake

The apple hunters

Psoriasis: relief that comes from an unexpected source?

Going back to basics


Click here to browse our range of Health and self help books, at Books


Time Out
For activity holidays or pure relaxation, search our travel classified
ads for your next break
Health Insurance
Use our Life Assurance finder to compare over 100 policies and find
the best one for you
Times Online brings you the best of public sector jobs, as advertised
in The Times and The Sunday Times



Entry to the game has now closed. Follow the link above to check your
teams score and make transfers in the race for cash prizes
The world-famous Times crosswords online, plus unique access to our
archive and special offers to members -- JOIN NOW

Contact our advertising team for advertising and sponsorship in Times
Online, The Times and The Sunday Times.

Copyright 2005 Times Newspapers Ltd.
This service is provided on Times Newspapers' standard Terms and
Conditions. Please read our Privacy Policy .
To inquire about a licence to reproduce material from The Times, visit
the Syndication website.