Take only a pinch of salt to avoid strokes, says top doctor

Low-sodium diet could prevent up to 1 in 4 heart attacks according to the Pan American Health Organization
By Kumudini Hettiarachchi

Reduce salt and prevent a brain attack, urges a top doctor, warning that there is sodium in the most unexpected of foods.

Eating too much salt raises the blood pressure and triples the risk of stroke, stresses Consultant Neurologist Dr. Padma Gunaratne who is also President of the National Stroke Association of Sri Lanka(NSASL).

It is not only the salt in Sri Lankan curries which poses a threat, the Sunday Times learns, but also that liberal sprinkling from the salt-shaker and the “unexpected” food that does not taste highly salted but can contribute significant quantities of sodium to our diet. Pre-packaged and processed food is a major danger.

Citing the example of bread, tomato sauce, cake and biscuits, Dr.Gunaratne gives people a jolt by pointing a finger at many easy “but deadly” takeaway food including fish and chips, hamburgers and Chinese food which are “highly salted” and bottled mineral water.

“Bottled mineral water can contribute a significant amount of sodium, so check the sodium content on the label before you drink it,” warns this Neurologist who along with the NSASL has been battling to save Sri Lankans from stroke, which results in death and disability. There is one stroke patient among every 100 adults in Colombo, stresses Dr. Gunaratne, pointing out the enormity of the danger.

Stroke is the third biggest killer in a majority of countries and the leading cause of severe adult disability. With ‘Salt Awareness Week’ (March 26-April 1) which ends today having the theme ‘Reducing salt; preventing stroke’, Dr. Gunaratne who is spreading the message on behalf of the NSASL focuses on the inextricable link between salt, increased blood pressure and the risk of stroke.

The current target is to reduce the salt intake to an average of 5 grams a day for adults and even less for children, from the current average of 8.6 grams a day. This in turn is expected to cut the risk of both strokes and heart attacks, the Sunday Times understands.

Dealing with the benefits of cutting back on the salt intake, Dr.Gunaratne says that it will lower blood pressure and work to prevent a rise in blood pressure that usually occurs with age. “Reducing your blood pressure can lower your risk of having a stroke, while less salt in the diet will also bring down the occurrence of cardio-vascular disease (CVD) that includes both heart attacks and stroke,” she says, adding that though salt awareness is relevant to heart disease as well, blood pressure is a much more important risk factor for stroke.

The need to cut the salt intake is substantiated by evidence that a low-sodium diet could prevent up to 1 in 4 heart attacks and/or strokes, according to the Pan American Health Organization. In the wake of such findings and the urgent need for a reduction in the global salt intake to cut CVD risk, a multi-sectoral approach has been initiated. The World Heart Federation has set targets for reducing the sodium intake, said Dr. Gunaratne.

Going practical, she pinpoints how men, women and children can control their salt intake. “We all have the ability to taste salt, but the extent to which we like our food salted can be modified by experience.
It is important to choose food and ingredients with a lower salt content. Don't add extra salt at the table or during cooking and read the labels of pre-packaged and processed food to identify high salt containing food,” she says.

The amount of salt we consume cannot be wholly controlled by the moderate use of the salt-shaker at the dinner table for it only amounts to about one-third of our daily intake, according to her. “Up to half of our salt intake is from processed food, with the balance occurring naturally in food and water. The amount consumed in processed food is difficult to control, although with highly salted foods, taste is a reliable guide.”

An increase in potassium intake seems to offset the adverse effects of sodium on blood pressure. Foods that contain significant amounts of potassium and also low levels of sodium are fresh and frozen fruits and vegetables. However, Dr. Gunaratne warns that there is no justification for the unrestricted use of potassium salts as substitutes for sodium, as this would present new problems. Potassium supplements and salt substitutes can be potentially hazardous to health and should only be used under medical supervision.

‘Salt Awareness Week’ launched by the Consensus Action on Salt and Health (CASH), a group concerned with salt and its effects on health, supported by 25 expert scientific members, has been running for 11 years.

Taking projections for the United Kingdom, Dr. Gunaratne adds that salt reduction is expected to cut strokes by around 22% and heart attacks by 16%, saving 17,000 lives in addition to giving other health benefits.

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