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Action on Salt

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Iodine deficiency has substantial effects on growth and development and is the most common cause of preventable mental impairment worldwide. Mild deficiency impairs cognition in children, and moderate to severe iodine deficiency in a population reduces IQ by 10 – 15 points. Globally it is thought that 20 million children are born every year at risk of brain damage due to iodine deficiency. Iodine supplementation before pregnancy may prevent these adverse effect on the intellectual development of infants and children.

It is thought that around 45% of the population of continental Europe continues to show evidence of iodine deficiency despite a lot of work aimed at increasing intake. The main measure put in place to increase iodine intake is through iodisation of salt.

The current recommendation for salt iodisation is that it should be fortified at a level of 20-40ppm. This is based on the assumption that the average salt intake at a population level is 10g per day. The World Health Organisation however recommends that this level will no longer be valid due to public health policies working to reduce population salt intake to 5g per day. They therefore recommend that iodine levels be adjusted in order to take this into account.
CASH acknowledges that iodine deficiency is a potentially serious problem in the UK, particularly in teenage girls and in unplanned pregnancies. However, we are concerned about the public health implication of using iodized table salt as the solution.

In the UK we are currently consuming far too much salt; an average of 8.6g/day compared to the maximum recommendation of 6g/day. Our current high salt intake is responsible for many thousands of deaths and disability from strokes, heart attacks, heart failure and kidney disease each year. The UK is currently leading the world with salt reduction which is crucial if we are to reduce the number of premature cardiovascular deaths worldwide.
There is currently significant progress being made to reduce the salt intake of the UK population, with the food industry voluntarily reducing the amount of unnecessary salt that they add to processed foods. There is also work to increase consumer awareness about the issues surrounding salt and to encourage people to reduce the amount of salt they add in their cooking or at the table.

Using table salt as a vehicle for carrying iodine is, in our view, not sensible as it requires us to put something that is potentially good into something that is known to be bad for our health. We feel that, given the high intake of salt we have in the UK and the progress that is being made, making salt beneficial to our diet is a conflict in public health. If people are aware of their need to increase iodine consumption we do not want them to think that increasing their intake of table salt is the answer. More than anything this is a confusing message for consumers.

Further difficulty comes when deciding to what extent salt should be iodised. Clearly when we are working towards reducing our salt intake to less than 6g per day by 2015 (5g worldwide) this lower amount needs to be taken into account rather than the current high intakes.

The WHO reports that alternative delivery methods of iodine include bread, water, milk, and possibly edible oil and wheat fl our. We feel that these alternative options are preferable and should be investigated by the Department of Health. Iodized bread has been successfully implemented in Australia and Holland. In this case iodised salt has been used in the bread.

References

Vanderpump MPJ, Lazarus JH, Smyth PP, Laurberg P, Holder RL, Boelaert K, Franklyn JA. Iodine status of UK schoolgirls: a cross-sectional survey. The Lancet. 2011. 377 (9782) 2007-2012

World Health Organisation: Salt as a vehicle for fortification. A report from a WHO expert consultation. 2007.

Sea salt and rock salt

Gourmet rock and sea salts have been popularised by TV chefs who sprinkle them liberally on their culinary creations. Due to their premium image and the misleading  claims of manufacturers declaring that their product is ‘natural’, contains ‘essential minerals’, and is a ‘tastier and healthier alternative’ to table salt, there is a popular belief that these salts are better for us. A recent Which? survey reveals that more than one in four Which? (28%) members think rock and sea salts are healthier than table salt. It is understood that many people are switching to more expensive and premium forms of salt, such as sea salt and rock salt, because they believe that they are healthier than table salt. In fact one survey has shown that 61% of consumers believe that sea salt is lower in sodium than table salt. Garlic salt and celery salt are also popular alternatives to standard table salt. Companies and chefs often highlight the fact that sea salt has been used in a food with the implication that it makes it a tastier and more natural product.

Do not be deceived! Salt is salt. No matter how expensive salt is, whether it comes in crystals or grains, from the sea or from the Himalayas, a new CASH survey has found they all contain an equally high sodium chloride content as table and cooking salt. Sodium and chloride combine to form salt (NaCl), it is this combination of minerals which puts up our blood pressure, leading to strokes, heart failure and heart disease. Aside from certain alternatives to sodium salts such as Potassium salt (see below), all salts are equally damaging to our health, don’t be fooled by the claims made by salt manufacturers.

Garlic salt and celery salt are also popular alternatives to standard table salt. These products are made predominantly of table, rock or sea salt combined with small amounts of dried garlic or celery. The salt component is still sodium chloride so these too should be limited as with rock and sea salt.
‘Posh’ salt health claims should be taken with a grain of salt! ‘Posh’ salt health claims should be taken with a grain of salt! Click here to view the CASH survey


Click here for an article from Food Navigator about sea salt

Click here for a downloadable factsheet on salt substitutes [PDF 249KB] 

Potassium salt

Salts which contain a combination of sodium and potassium chloride are now widely available in the UK. The most widely available and used product is Lo Salt.
Potassium salts have up to 70% less sodium than standard table salt so do not carry the same high risks as sodium based salts. Potassium salts may even have a beneficial effect on your blood pressure because potassium is an antagonist of sodium.

Potassium salts can be used in the same way as standard table salt and many people feel they do replace their need for salt. However, other people have reported a metallic after taste and therefore choose not to use them. Another problem with using potassium salts is that, although you have less sodium, you still have salty tasting foods and therefore your preferences for salt is not changed.
People with kidney disease or diabetes should seek medical advice before using potassium salts, as an increase in potassium intake may not be advisable.

Taste-test study

A study from Ireland demonstrated that lasagne produced with reduced salt levels and potassium salt scored higher for taste than the ‘normal’ salt version. The lower salt lasagna had nearly 30% less salt than the normal lasagne, without affecting the overall taste and saltiness of the finished product

Click here for the paper in the Journal of Foodservice

Iodised Salt

CASH acknowledges that iodine deficiency is a potentially serious problem in the UK, particularly in teenage girls and in unplanned pregnancies. However, we are concerned about the public health implication of using iodized table salt as the solution.

Using table salt as a vehicle for carrying iodine is, in our view, not sensible as it requires us to put something that is potentially good into something that is known to be bad for our health. We feel that, given the high intake of salt we have in the UK and the progress that is being made, making salt beneficial to our diet is a conflict in public health. If people are aware of their need to increase iodine consumption we do not want them to think that increasing their intake of table salt is the answer. More than anything this is a confusing message for consumers. 

Click here for more information

Adjusting to lower salt foods

Reducing the amount of salt in your food (without the use of salty tasting substitutes) is the preferable way that you can improve your health, although it can take awhile as foods may initially taste bland. However, within two or three weeks you will become accustomed to the taste of lower salt foods. During this time the salt taste receptors in the mouth become much more sensitive to salt and you will begin to detect a salty taste in anything which you previously ate. Using other sources of flavour, such as herbs, spices, black pepper, vinegar, lemon juice and chilli can improve completely the taste of food to make the transition even easier for you. Once the salt taste receptors have adjusted, you will find that high salt foods will taste unpleasant. The same applies to fatty and sugary foods.

Salt reduction in processed foods

There is a currently a huge amount of pressure on the food industry to reduce the salt content of the processed foods that they sell. A lot of research is going into finding ways that salt can be reduced in foods without affecting any of the sensory characteristics such as taste and texture. The solutions to date range from simply using potassium salt to using micro fine salt crystals which, even when a small amount is used, can give an intense salty flavour. Flavour enhancers have also been explored as a way of increasing salty taste so that the salt level can be reduced.


How you can help

Although there has been significant progress in reducing the salt content of processed foods, There is a lot more that can be done. The food industry claims that none of their customers ever tell them they want foods with less salt. Unless consumers demand it, they are less likely to make changes and the changes they do make will be done slowly. You can help by adding your voice. Why not write to your local supermarket about them about the very high salt and fat content of nearly all of the processed foods that they sell. Tell them that you need processed foods that contain far less salt and fat. 

 


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