Today marks the start of this year’s ‘Know Your Numbers Week’ – a campaign run by Blood Pressure UK every year to raise awareness about high blood pressure – often known as ‘the silent killer’.  Six million people in the UK have high blood pressure and are unaware they even have it. We’ve paired up with guest blogger Dr Pippa Gibson RNutr to explore the importance of lowering salt in the diet – the single biggest cause of high blood pressure[i]. She shares top tips, and a delicious low salt baked beans recipe.

 

Salt intake in the UK

In most of the world’s population, salt intakes greatly exceed the minimal physiological need. Sodium is needed in small amounts by the body for physiological requirements, but too much can cause health problems such as water retention, high blood pressure, cardiovascular disease and kidney disease.

The UK’s recommended salt intake is set at a maximum of 6g per day (equivalent to about 1 teaspoon). Unlike most other dietary reference values (DRVs) this isn’t a target to aim for, but rather a goal to stay under. However, the most recent National Diet & Nutrition Survey showed that the average person was eating 8.4g salt in 2018-2019[ii].

 

The importance of lowering salt intake

Previous studies have looked at reducing salt intake and the relationship to health outcomes. Two well-controlled studies have shown the salt intake has a dose-response relationship with blood pressure where participants were assigned different levels of salt intake[iii],[iv].  Both studies showed that the lower the intake of salt, the lower the blood pressure.

Why is this important? Increased blood pressure is a risk factor for development of cardiovascular disease, with substantial evidence directly linking high salt intakes with poorer cardiovascular outcomes – including myocardial infarction and stroke[v],[vi],[vii].

 

What are the targets for salt intake?

The World Health Organisation (WHO) have issued a global target of 5g/day by the end of 2025[viii] while the UK National Institute for Health and Care Excellence (NICE) have recommended 3g/day as the long-term population salt intake target, aiming to achieve this by 2025[ix]. It is estimated that an average reduction of 1 gram of salt from the UK diet could save 4147 lives and save the NHS £288 million annually[x].

 

How can I help reduce my salt intake?

It’s estimated that 75% of the salt we eat is already in the foods we purchase, whereas only about 11% comes from discretionary use (where salt is added during cooking or at the table by the consumer or food handler)[xi]. Previous data has highlighted the highest contributors to dietary sodium, apart from table salt, are processed meats, bread and baked goods, dairy products and sauces[xii]. Other foods including breakfast cereals can be high contributors of dietary sodium due to the large volumes eaten.

In addition, around 8% of our salt intakes comes from pre-prepared vegetables such as frozen chips, mashed potatoes and tinned produce which don’t even taste salty[xiii].  It’s a good idea to watch out for tinned goods such as beans, pulses and vegetable, including tinned tomatoes, as some manufacturers add salt to the water; while salt is a preservative, it is not really needed in these products.

 

How much salt is too much salt?

Understanding food labels can be challenging, as the terms ‘salt’ and ‘sodium’ can be used interchangeably. Table salt is made up of sodium chloride, and 1g of sodium is equivalent to 2.5g of salt. Therefore if a food label says ‘sodium’, remember to multiply that value by 2.5 to get the salt content.

The recommended limits of salt intake are as follows:

  • <1g/d salt for babies ages 0-6 months
  • 1g/day for babies aged 6-12 months
  • 2g/day for infants aged between one and three years
  • 3g/day for children aged four to six years
  • 5g/day for children aged seven to ten years
  • 6g/d for healthy people aged 11 and over

 

How can I reduce my salt intake?

There are some simple steps you can take to help reduce your salt intake:

  1. Try not to automatically reach for the salt at the table. First try your food to see if it does need any further seasoning.
  2. Gradually reduce your salt intake. Your tastebuds will adjust after a few weeks and become more sensitive to the reduced salt content of your food.
  3. Try to add flavour in other ways – for example, a squeeze of lemon or lime, herbs, spices or a grind of pepper.
  4. Check the food labels to see if there is a difference in salt content between different brands of foods. Additionally, look for tinned vegetables and beans which are in plain water rather than salted water.
  5. Try make some of your favourite foods at home and see if you can naturally reduce the salt content of these dishes.

 

Healthy Low Salt Baked Beans Recipe

Image courtesy of Dr Pippa Gibson

Did you know that the average standard tin of baked beans contains at least 1g of salt per suggested serving (ranging between 1.0-1.6g/200g)? Here’s my Smokey Baked Beans Recipe, which is full on flavour without the added salt.

Per serving , the naturally-occurring salt is just 0.06g – just be sure to check the tinned tomatoes and beans don’t contain any added salt.

 

Makes 7 portions

Ingredients

  • 2 large garlic cloves, roughly chopped
  • 1 large carrot (100g), grated
  • 1 tbsp extra virgin olive oil
  • 500g passata
  • 2 tsp smoked paprika
  • 1/2 tsp ground white pepper
  • 1/4 tsp mixed herbs
  • 1/2 tsp white wine vinegar
  • 2 tbsp tomato puree
  • 1 tin of haricot beans in water
  • 2 tins of mixed pulses in water

Method

  • Add the garlic, carrots and oil to a large pan and cook over a gentile heat for 5 minutes till softened.
  • Add the passata, herbs and spices, vinegar, tomato puree and 100ml water. Cook for a further 15-20 minutes over a low heat till the carrots become soft.
  • Blend to a smooth sauce and add the beans.
  • Cook over a low heat with the lid on for 15 minutes, stirring occasionally.

Store any leftover beans in an airtight container in the fridge for three to four days, or alternatively freeze in handy portions ready for a quick and easy meal.

 

Related MyNutriWeb Content

Reducing Blood Pressure – An Effective Approach – 60 mins webinar

Key Resources: Reducing Blood Pressure – resource blog

The Lowdown On The Dash Diet – blog by Priya Tew

All Things Diet and Heart Health – 60 mins webinar

Key Resources: Diet and Heart Health – resource blog

Cardiometabolic Health Part 1 – 60 mins webinar

Cardiometabolic Health Part 2 – 60 mins webinar

 

Summary

High blood pressure can lead to several health problems including stroke, heart disease and heart attacks. Whilst there are many factors which can contribute to high blood pressure, eating too much salt is the single biggest cause. In the UK, we are exceeding maximum recommendations for salt intake and thus it is of great importance that we are aware of practical tips and measures to help reduce salt intake.

 

References

[i] Understanding Your Blood Pressure (2021), Blood Pressure UK

[ii] National Diet & Nutrition Survey (2020), Public Health England

[iii] Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension (1989), G A MacGregor et al

[iv] Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group (2001), Sacks F M et al

[v] Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials (2011), He J Feng & MacGregor Graham A

[vi] Lipid peroxidation activity mediated by NADPH-cytochrome C reductase purified from rabbit liver microsomes (1978), Kamataki T et al.

[vii] Effect of lower sodium intake on health: systematic review and meta-analyses (2013), Aburto N

[viii] Sodium intake for adults and children (2014), World Health Organisation

[ix] Cardiovascular disease prevention (2010), National Institute for Health and Care Excellence

[x] Health Matters: Combating High Blood Pressure (2017), Public Health England

[xi] Relative contributions of dietary sodium sources (1991), Mattes R D and Donnelly D

[xii] Sodium content of processed foods in the United Kingdom: analysis of 44,000 foods purchased by 21,000 households (2011), Mhurchu C et al

[xiii] UK Salt Reduction, Action on Salt

(all websites accessed August 2021)