Salt is back in the news. I’m sighing as I write this because salt has been one of the most difficult-to-investigate and complex chapters of our upcoming book (so far). Picking a path through the mountains of conflicting research has left my head reeling. Salt, it seems, is an emotive and contentious subject.
We need salt to live, and a vocal body of scientists believes we should eat more salt, not less. Indeed, low salt consumption has been linked to heart attacks, strokes and death. An equally vocal body of scientists and public health bodies urges us to cut our salt intake. They argue that too much salt leads to high blood pressure (hypertension), a condition that affects twice as many people now as it did 40 years’ ago and is linked to a greater risk of cardiovascular disease and stroke. There you have it … Too little salt is bad for us. And too much salt is bad for us.
A quick look at the WHO stats for ‘death from hypertension’ shows that Africa and Eastern Europe have the highest rates, with Italy (famed for its Med diet) not that far behind. Surprisingly, the lowest rates are claimed by the Japanese – who consume one of the highest salt diets in the world, with an average daily salt intake almost 50% higher than ours. Meanwhile, the UK also has one of the lowest rates of hypertension, despite having one of the highest rates of obesity (another factor in raised blood pressure) and a diet universally acknowledged to be high in salty processed food. No wonder scientists can’t agree. And no wonder we’re confused!
But recent research suggests it might be wise to err on the side of caution. Scientists have discovered that too much salt may shorten our telomeres and contribute to cognitive decline. If you’ve followed our blog you’ll know that shorter telomeres lead to more rapid cellular ageing.
Researchers found that a high salt diet in mice caused changes in the gut that appeared to impair the flow of blood to the brain, leading to impaired cognition. After eight weeks on a high salt diet the mice’ brains showed a 20-30% reduction in blood flow, accompanied by symptoms typical of dementia. These included an inability to recognise objects or to navigate a maze. It wasn’t all bad news: when the mice returned to their usual salt-free diet, their symptoms disappeared.
Experts suggest that a diet rich in fruit and veg could protect us against high blood pressure, but a report from this month’s Hypertension links high salt intake with high blood pressure, irrespective of the healthiness of our diet. Even the lauded Mediterranean diet won’t protect us if we’re dredging our beans and nuts with salt.
Having said that, 75% of the average daily salt intake comes from processed food, where it’s effectively hidden (bread, cereal, ready meals, preserved meat, stock cubes etc). If you eat minimally processed foods and/or cook from scratch, the chances are you’re NOT consuming too much salt and have nothing to worry about.
The WHO advice is to restrict salt to one teaspoon a day (5-6g). But the report quoted above found that only when daily salt intake was increased above 10.7 g did it result in higher blood pressure.
So what to do? If you haven’t had your blood pressure measured recently, ask your doctor to do it. Our blood pressure rises as we age and recent stats suggest that one in four of us has high blood pressure without knowing it.
If you’ve been diagnosed with high blood pressure, a report from the November Journal of the American College of Cardiology has come up with an effective formula for reduction: the DASH diet in combination with a reduced salt intake. Apparently this combo is more effective than taking anti-hypertensive drugs, particularly for those at the highest risk. Read about the research at www.medicalnewstoday.com/articles/320151.php. We wrote about the DASH diet here.
For anyone wanting to reduce their salt consumption, perhaps the easiest things to do (assuming you’ve cut back on processed food) are:
- Cut back on salt-in-cooking by using more spices and herbs
- Switch from table salt to sea salt crystals (you’ll use less and consume a few minerals at the same time)
- Taste before you routinely salt food, or simply keep salt off the table altogether
This week’s dish uses the Lebanese spice mix I wrote about last month (brimming with antioxidant spices, particularly cloves), and which some of you have been asking about. Here’s our first recipe using this magical spice mix and it’s delicious. My daughter calls it Christmas Beans and we’ve been eating it all week. Sometimes on toast, in true English style. Move over, Heinz….
I use cannellini beans but try whatever beans you have in your larder. This recipe is inspired, again, by Salma Hage and she uses pinto beans and cayenne pepper to spice it up. I’ve used dried marjoram (for its huge antioxidant power) instead of cayenne, but do as you please.
LEBANESE BAKED BEANS
- 1 tbsp olive oil
- 2 onions, roughly diced
- 3 cloves garlic, roughly chopped
- 1 tbsp Za’atar
- 2 tsps Lebanese spice mix
- 1 tbsp dried marjoram (OPTIONAL)
- 2 tbsp tomato puree
- 2 tbsp apple cider vinegar
- 2 tbsp honey, date molasses or maple syrup
- 1 small bunch parsley, chopped
- 2 tins tomatoes (800g)
- 2 tins cannellini beans (800g)
Quickly saute the onions and garlic in the olive oil (3 minutes is about right).
Add the Za’atar, spice mix and marjoram if using and cook for another 3 minutes.
Add the tomato puree, vinegar, honey, parsley and tinned tomatoes.
Simmer for 20 mins so it reduces a bit. Then add the beans and simmer for another 5 minutes.
Taste and salt (with restraint), if you wish.
Annabel
You don’t mention exercise, which is surely important where salt is concerned as exercise makes one sweat, and sweat contains salt?
Yes, you’re right! There’s always so much more to say but we try and keep our posts short. The more you exercise/sweat, the more salt you need to replace… which is why a single recommendation/guideline can never suit everyone. And why salt is so much more complex than sugar … or most things, other than alcohol perhaps.
Thank you for this and for many more interesting articles.
I am 58 and was diagnosed with hypertension about 5 years ago. It came as a huge surprise to me and to my doctor because I was in good health, was the right weight, a ‘good’ vegetarian in that I ate a well balanced diet that included pulses for protein, and was low in sugar, fat and salt. I was a non smoker who enjoyed a few glasses of red wine over the weekend. I also had an active outdoor life at work and at play. My blood pressure was 175/105mm. My dentist refused to finish treatment until after I was treated with medication. I said, ‘that may not be necessary.’ He said, ‘ look at you, what else can you do to improve your lifestyle? Your only remaining option is medication.’ I googled it! The only thing I could find was to eat more walnuts and bananas and I did to no avail. I have been on the maximum dose of Ramipril ever since.
The only difference between then and now is I am no longer a vegetarian. I now eat meat a couple of times a week and, because of back problems, I am not as active as I was but I am still moderately active.
The good news is my blood pressure is under control though I would like it to be lower and would dearly love to come off the medication. For that reason your article interested me. Any article does that may offer me a route away from Ramipril but alas as my dentist said there appears to be nothing more I can do. However I live in hope!
Regards
Catherine
There’s also a genetic factor to high blood pressure. If someone in your family had/has it, you may be more susceptible. Great news that you have it under control, but don’t assume you’ll never come off Ramipril. The research that found the DASH diet combined with a low-sodium diet (there’s a link on the post) sounded very encouraging, particularly for those with least hope! Good luck!
As far as I have read, it’s THE KIND OF SALT YOU EAT that matters most.
Iodised, “table” salt is awful.
Real sea salt, etc is quite a different substance …
You’re right that so-called table is the worst. I quite like Himalayan pink salt, but Maldon sea salt is my go-to. Thanks for the comment, Mandy.
Thank you for all your comments.
My diet is the DASH diet, has been since long before the phrase was coined. I already use sea salt so another box ticked. I have reduced my salt intake further which, because I don’t eat processed foods, was never really that high anyway. As to genetics. I have a big family and famillee high blood pressure doesn’t figure. I seem to be the only one with high blood pressure. Because of mylifestyle choices I was always regarded as the ‘healthy one’ in my family. Really quite mystifying.
That is mystifying. You probably already know this but meditation also has a good track record for lowering blood pressure. Having said that, it’s not done much for my father’s blood pressure. Fasting can also reduce blood pressure, if you felt inclined to try it. Let us know how you get on…
Fasting? Really? I do remember trying a detox many years ago but caved not because I was hungry but because I was so very cold and just couldn’t get warm.
I am up for anything to manage my blood pressure because although, as you say, medication has a good track record, I really would rather not! Do you have any advice about fasting? Bearing in mind that I have recently moved to a big old house that currently, save for a couple of long burners, has no central heating and we have had more snow in recent months than in living memory, mine at least! So although I generally do not feel the cold I am definitely feeling it now!
Two books that cover fasting: Prof Longo’s Longevity Diet and a book by Jason Fung (called Fasting I think). I love Dr Fung. He’s Canadian and a big fan of fasting, which he also touches on in The Obesity Code. I do short fasts (24 hours is the longest I do because I’m underweight and have low blood pressure) to help manage my autoimmune disease. I think it’ working! Discuss it with your doctor, perhaps?
Well thank you for that Annabel. I shall certainly look into it. I do tend to go long stretches without eating, primarily when I am busy or engrossed in something but that isn’t sensible and I am sure not the right way to go about it.
It occurred to me this morning that I have been reading a lot of articles about being unable to get a good nights sleep and it’s implications on your health. If I see an article about the topic I immediately zone in on it because I find it difficult to get off to sleep and wake two or three times in the night often I cannot get back off to sleep at all. Though not perhaps a direct cause of hypertension I imagine it cannot help so more Zzzzz are in order if I can work out how!
Regards
Catherine
Ah yes, sleep! I suspect it’s the nearest thing to the elixir of life. I’ll be writing about some new research on how we sleep very soon. Stay tuned!