Wish and Cook — Oct. 12, 2020, 10:52 a.m.

I'm 99.2% sure you are eating too much salt

Did you know that there's a higher salt intake worldwide than the World Health Organization (WHO) recommends?

The recommendation and the consumption

Salt is composed with sodium and chlorine. In a large study including 187 countries it was found that 99.2% of the adult population consumed more sodium than the WHO's recommended (2g of sodium per day) (1). The vast majority (88.3%) of the adult population consumed more than 3g of sodium per day (2).

Our preference for the salty taste

Highly processed foods are palatable and satisfy human taste for salty and sweet foods (3). In the developed world, obesity is partially caused by the invention of foods that are hyper-appealing — foods high in salt, glutamate, sugar and fat. In modern environments taste-driven decisions of what to eat must be checked, as our sense of taste may lead us to eat highly palatable foods that are high in calories but low in nutrients, an action that when is repeated often will bring some health problems.

Despite their convenience, palatability, longer shelf life, improved food safety, endless choice and affordability for consumers (4), the frequent consumption (more than once a month) of certain fast foods by young teenagers may be associated with an increased preference for salt taste (5). The problem with these high levels of sodium consumption at a young age is two-fold. Firstly, it sets children up for developing high blood pressure during childhood and adulthood. Secondly, children might get used to eat high levels of salt and expect a certain level of saltiness in their foods. This potentially leads to unhealthy food choices during child and adulthood. Humans have a high tendency to like salty tasting foods, which, from an evolutionary point of view, would result in humans preferring foods with sodium, needed for survival. The addition of salt to food changes the complete sensory profile, beyond making food tastes saltier as well as less bitter. Such suppression of bitter taste can increase perceived sweetness of particular foods.

Consequences of high salt intake

Excessive salt consumption has been associated with side effects such as increased blood pressure (6,7) and an increased risk of fatal cardiovascular events (8).

What are the salt vehicles?

The main salt vehicle is the salt added in the cooking process. Also, breads, toasts, soups, processed meats, soft drinks, ready-made meals, packaged sauces and broths, savory snacks, some preserves have generally high salt content (9).

Why we like to use salt?

Salt is a relatively cheap and widely used ingredient such in processed foods. The salt limits microbial growth by lowering the water activity. Besides that, texture and juiciness of foods are improved because of the interaction between salt and protein, as well as the elasticity given by gluten in bakery products. Moreover, the salt gives not only saltiness but also suppresses bitterness, resulting in a generally liked flavour profile. That's why only a small portion of the daily intake of salt comes from natural sources in a western diet.

How to reduce salt?

Quality information: you need to have access to quality information. Developing literacy and autonomy for healthy choices are two of the WHO initiatives to reduce salt intake, important to allow people to know how to reduce it.

Monitoring food availability: monitor the food you have available at home, knowing which are the main salt vehicles.

Learn how to read labels: the label has salt information related to content. WHO is working to provide in the near future a better way to show a label capable of showing clearly salt content and identifying products with low salt content.

Reduce the classical take away foods: the takeaway food can have a high salt content, with pizza being on the top of the list (9.45g per portion), followed by chinese meals (8.07g per portion), kebabs (6.21g per portion) and Indian meals (4.73g per portion) (10).

Improve the use of herbs: the use of herbs in cooking can be a healthy and pleasant way to reduce salt intake. Herbs have some beneficial properties that could protect our health such as from diabetes and cardiovascular diseases (11-13) and improve our imunity. Herbs are rich in fiber, vitamins (A, C and complex B) and minerals (calcium, phosphrum, sodium, potassium and iron) (14). Unfortunately, not everyone knows how to use them in the kitchen and some people are not used to the flavours of the different type of herbs. It would be interesting to follow and try different recipes that allow us to experiment and discover different flavours that we could find interesting. Herbs are often used in salads, soups, meat, fish, infusions and so one. (15). Those are used mainly fresh but you can find recipes to use them dry or in powder.

Find recipes with low salt content

To help you to find recipes with low salt content click here.

How industry can help us to reduce salt intake?

Monitoring and evaluating the involvement of food industry and all food chain is another objective from WHO. For example, in Portugal there was an incentive to pastries and bakeries to limit the salt content in breads until 1g per 100g of bread (16). Lower cost in formulation, positive effects on organoleptic properties of food products, effects on food quality during shelf-life, and microbiological food safety, make sodium chloride a notable candidate and an indispensable part of formulation of various products. Although low-sodium formulation of each product possesses a unique set of challenges, review of literature shows an abundance of successful experiences for products of many categories. Studying various commodities in Western diets, recent studies emphasize that breads, processed meats, cheeses, sauces, and spreads have salt content considerably higher than reasonable benchmarks, suggesting reformulation for such high sodium categories.

1. World Health Organization. Guideline: Sodium intake for adults and children. World Health Organization (2012)
2. Mozaffarian, Dariush, et al. "Global sodium consumption and death from cardiovascular causes." New England Journal of Medicine 371.7 (2014): 624-634
3. Breslin PA. An evolutionary perspective on food and human taste. Curr Biol. (2013);23(9):R409-R418
4. Augustin MA, Riley M, Stockmann R, et al. Role of food processing in food and nutrition security. Trends Food Sci Technol 2016
5. Kim, G. H., and H. M. Lee. "Frequent consumption of certain fast foods may be associated with an enhanced preference for salt taste." Journal of Human Nutrition and Dietetics 22.5 (2009): 475-480.
6. World Health Organization. Effect of reduced sodium intake on blood pressure and potential adverse effects in children. Geneva World Health Organization (2012)
7. World Health Organization. Effect of reduced sodium intake on blood pressure, renal function, blood lipids and other potential adverse effects. Geneva World Health Organization (2012)
8. World Health Organization. Effect of reduced sodium intake on cardiovascular disease, coronary heart disease, and stroke. Geneva World Health Organization (2012)
9. Lopes C, Torres D, Oliveira A, Severo M, Alarcao V, Guiomar S, et al. Inquerito Alimentar Nacional e de Atividade Fisica, IAN-AF 2015-2016: Relatoorio de resultados. Universidade do Porto (2017): 978- 989-746-181-1.
10. JAWOROWSKA, Agnieszka, et al. Determination of salt content in hot takeaway meals in the United Kingdom. Appetite (2012): 59.2: 517-522.
11. Kaefer, C.M. and J.A. Milner, The role of herbs and spices in cancer prevention. J Nutr Biochem (2008):19(6): p. 347-61.
12. Iriti, M., et al., Neuroprotective herbs and foods from different traditional medicines and diets. Molecules, (2010):15(5): p. 3517-55.
13. Jungbauer, A. and S. Medjakovic, Anti-inflammatory properties of culinary herbs and spices that ameliorate the effects of metabolic syndrome. Maturitas, (2012):71(3): p. 227-39.20-
14. U.S. Department of Agriculture - Agricultural Research Service, USDA National Nutrient Database for Standard Reference, in Release 23. (2010): Washington DC.
15. Vanessa Candeias; Emilia Nunes, C.M., Manuela Cabral, Pedro Ribeiro da Silva, Sal, in Principios para uma Alimentacao Saudavel, Direcao Geral da Saude, Editor.Lisboa.(2005)
16. Portugal. Ministerio da Saude. Direcao-Geral da Saude. Alimentacao Saudavel | Desafios e Estrategias 2018 Lisboa: Direcao-Geral da Saude (2018).