“The cure for anything is salt,” says a character in Karen Blixen’s short story The Deluge at Norderney. “Sweat, tears, or the sea.” But while there’s a lot to commend a long run, a little cry or a pensive look at the wide blue ocean, everyday life has got a lot saltier since Blixen’s era – and salt is no longer the cure-all it once was. So what should we be doing about it?
First things first: the World Health Organization recommends capping your salt intake at 5g a day, and keeping it even lower if possible. That’s because, according to a large body of evidence, ingesting a lot of it is linked to high blood pressure, which in turn is a risk factor for heart disease and stroke. (Salt is technically sodium chloride; it’s the sodium that seems to lead to most of its ill-effects, which is why American brands tend to tout their reduced-sodium options.)
“It’s basically a long-term, chronic form of poison,” says Graham MacGregor, a professor of cardiovascular medicine and president of the British Hypertension Society. “Blood pressure is a huge factor in health as you age, and we’re seeing evidence that excess salt elevates it over the course of your lifetime.” More recently, excess salt has also been associated with type 2 diabetes, with people who “always” or “usually” add salt to their meals showing a 39% and 20% higher risk of developing the condition than those who “rarely” or “never” add it. (A quick note here: a few years ago, you might have heard that the case against salt had been overstated, thanks to research published in the Lancet alongside the claim: “There is no convincing evidence that people with moderate or average sodium intake need to reduce their sodium intake for prevention of heart disease and stroke.” The study, however, was criticised for its use of spot urine measurements – which don’t always accurately reflect salt intake – alongside other concerns. Without better replication, it’s definitely not a licence to eat salt.)
So is the answer to put down the shaker? It’s a bit more complicated than that: as the British Heart Foundation notes, 75% of the salt that we eat is added before our food even hits our plates. For most of the 00s, the UK was a world leader in salt reduction, with the Food Standards Agency (FSA) enforcing strict limits on how much could be included in most products. In 2010, however, with the advent of government-introduced “responsibility deals”, the food industry itself took the lead in the process, with limits becoming much more voluntary. Now, even brands that would like to reduce the salt content of their foods are hamstrung by what everyone else is doing: apart from being one of the cheapest forms of flavouring available, salt can also be used to bulk up foods by increasing their water content. “As a colleague of mine said at the time, leaving it up to the manufacturers is like putting Dracula in charge of a blood bank,” says MacGregor. “Some supermarkets want better enforcement, but it has to come from above.”
The answer, then, is that this is one health concern that we should probably be collectively worrying about, since we have so little chance of addressing our salt intake on our own. Yes, if you’re well off – in terms of both your time and finances – you can take steps like cooking most of your meals from scratch, avoiding takeaways and ready meals, and cutting down on how much salt you add to food. Your tastebuds will adjust over time, and you can experiment with other sources of flavour, like spices or citrus, that can actually have beneficial effects – garlic, for instance, seems to lower blood pressure, rather than raise it. You can also up your intake of fruit and vegetables, as there’s recent evidence that the potassium in them has a protective effect against salt. But it’s not an option for everyone.
“At one point, the FSA successfully lowered the amount of salt that could be added to foods, and virtually the whole country’s salt intake went down without anyone really noticing anything had changed,” says MacGregor. “Now, countries like Chile and Argentina are leading the way, and we’ve fallen behind.” You can take the shaker off the table, rinse your beans and pulses, and go for low-sodium foods, but if you really want to lower your salt intake, the best first step might be to write to your MP – after all, there’s only so much damage the odd banana can undo.
