White poison or not: Do you need to eat less salt
Salt is declared "white death" alternately with sugar - and the complete rejection of it sometimes begins to seem like a simple solution to all health problems at once. On the other hand, the amount of salt in the diet is often, on the contrary, overlooked when discussing proteins, fats, carbohydrates and calories. The solution, as usual, is somewhere in the middle: in a healthy diet, diversity, moderation and balance are important. We understand the danger of excess salt, which threatens its lack and whether there is the best and most useful salt.
Text: Elena Motova, dietician of the Rassvet clinic, author of the book “My best friend is the stomach. Food for smart people” and a blog about evidence-based medicine
What is food salt
Food salt - sodium chloride - is 40% sodium and 60% chlorine, and for health (or problems with it) the amount of sodium entering the body matters. But we get most of the sodium in the form of table salt, mainly from industrial products: sausages, canned goods, pickles, snacks, sauces, bread, cheese, carbonated drinks, fast food, and so on.
The general recommendation that the World Health Organization gives is to consume no more than five grams of salt per day, which is about a teaspoon. On average, people eat different amounts of salt per day: from 0.5 grams in Indians by yanomami in Brazil to 25 grams in northern Japan, and in Europe, according to the same WHO, it is on average 9-12 grams (i.e. eaten in less than five years). Moreover, such indicators can be achieved without touching the salt shaker.
What is its danger
Clinical studies have shown that there is a statistically significant, direct, progressive relationship between salt intake and blood pressure. Simply put, the more salt in the food, the higher the blood pressure: the effect is determined by the dose. The best scientific evidence suggests that reducing the amount of sodium in the diet is especially important for middle-aged and older people and all patients with hypertension. The recommendations of the international cardiological associations are being updated, and the numbers of optimal pressure are becoming less and less, so reducing salt intake for the prevention of hypertension is quite a reasonable measure.
At the same time, the sensitivity to salt in people is different. Some affect sodium blood pressure more strongly - while others are supposed to be generally resistant, that is, resistant to this effect. Even in observational studies, it is difficult to measure blood pressure correctly, due to the large number of factors affecting it. Sensitivity to sodium can affect age, ethnicity, gender, weight, and certain conditions, such as diabetes or kidney disease.
Less salty is not only possible prevention of myocardial infarction and stroke associated with high blood pressure. Excess salt increases the risk of stomach cancer; a large amount of sodium leads to the fact that with urine calcium is more actively excreted - and this is a risk factor for urolithiasis and osteoporosis. In general, it is not in vain that nutritionists' favorite word is moderation.
Not too bad
Sodium is needed by the body - it plays a role in maintaining water-salt balance and the transmission of nerve impulses. However, hyponatremia, that is, a decrease in the concentration of sodium ions in the blood, can develop not only because of serious diseases such as cirrhosis of the liver or heart failure. In people without chronic conditions, “water intoxication” can occur: if you drink several liters of water in a few hours, the sodium concentration decreases, which in turn can lead to heart problems, kidney problems and the most dangerous complication - brain edema. Hyponatremia can also occur when playing sports, when a person loses fluid and sodium with sweat for a long time, and only fills up water. This effect can also occur among those who drink a lot of beer - so, by the way, to call it an isotonic drink is incorrect.
Why do we pull on salty
Salt is a seasoning, with which everything becomes tastier, of course, if you add it in reasonable quantities. Forget to put a pinch of salt in the bread dough or even in a sweet cake - and the taste will not be so expressive. Before refrigerators appeared, salt preservation helped preserve food, and it was literally worth its weight in gold. However, today, when seasoning is cheap, and you can buy it everywhere, we suffer more from excess than from salt deficiency.
In addition to the dining room, there is a mass of other varieties of salt - for example, sea, which often costs much more than usual. Salt can be an extraordinary gastronomic attraction and even a luxury item: Himalayan pink salt, fleur de sel from Brittany or Majorca, black Hawaiian salt, moist Gerande salt, smoked and kosher salt and many others.
Sea and table salt differ in texture, taste and processing. Sea is obtained by evaporation from, of course, sea water, and stone is mined in deposits - salt deposits at the site of ancient reservoirs, turned into salty lakes. Both sea salt and dining room are similar in composition and are completely equivalent in terms of sodium content. You can give preference to one or another brand of salt because of its taste and texture, but you should not consider expensive salt with admixtures of other minerals more useful than usual. Trace amounts of potassium, iron, magnesium in salt do not affect anything except taste, and these microelements are easily obtained from other foods.
Salt as a source of iodine
Since salt is an affordable and cheap everyday product, almost a hundred years ago it was invented to be enriched with iodine, so that everyone could get a vital trace element. Iodine is necessary for the synthesis of thyroid hormones, and if it is scarce in food and water, the thyroid gland grows and forms a goiter - so it tries to “capture” more of the necessary substance. With a moderate lack of iodine, which is called a hidden deficiency, external manifestations will not be, because the thyroid gland adapts to this state, but not to the end. The most dangerous situation occurs when a woman lacks iodine during pregnancy and breastfeeding - this can lead to a delay in the cognitive development of the child.
To avoid iodine deficiency in children and adults, in many countries (but not in Russia) complete salt iodization has been introduced. There, iodized salt is not only sold in stores - it is cooked in restaurants and cafes, it is used in food production. If a person eats the recommended 5 grams of such salt per day, even taking into account the loss of iodine during storage and culinary processing, 100-200 micrograms of iodine are injected into the body - just the physiological norm.
There is a myth that iodized salt reacts with products, but it is not. Now potassium iodate is used for salt iodization: it is stable during storage and heating, so that modern enriched salt can be used even in breadmaking. Additional sources of iodine are algae and fish, but in sea salt there is little of it, because it is lost during evaporation and drying.
What to do
As a rule, most people should take a closer look at the amount of salt that enters their bodies with food — in order, if possible, to bring it to the recommended five grams. In this way, adjusting the diet can help: for example, reducing the amount of industrial food in it, which is always a lot of sodium. To make homemade food tastier, salt can be replaced with spices, herbs, lemon juice, onions and garlic; if you buy salt for cooking, then iodized. By the way, a person gets used to less salty food quickly: two or three weeks are enough for taste buds to adapt. Among other things, there are substitutes for salt with a high content of potassium - however, before using them, you should consult with your doctor.
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