MBALE – In most rural Ugandan homes, you will find a small tin of salt on the table.
And you will notice that every time the head of the family is given food and sauce, he adds salt to it before even testing.
In urban centres, most restaurants, hotels and homes have a salt shaker placed strategically in the kitchen and at the dining table for those who require more salt.
Salt, also known as sodium chloride, is about 40 per cent sodium and 60 per cent chloride.
According to Dr Muhammed Mulongo [Bulambuli district], it is true that the human body can’t live without some sodium [salt], it is needed to transmit nerve impulses, contract and relax muscle fibers (including those in the heart and blood vessels), and maintain a proper fluid balance but that it does not take much to do this.
Dr Mulongo adds that only a quarter of our daily intake comes from salt we add into food ourselves – the rest is hidden in the food we buy, including bread, sauces, soups and some cereals.
“It is true that all of us want to sprinkle some or add a pinch of salt during meal time but research shows there’s a danger in this,” said Dr Mulongo..
A Harvard heart letter by Harvard medical school titled ‘Take it with a grain of salt’ says to everyone else, salt is sodium chloride, the white crystals left over when seawater evaporates adding that it is the sodium in salt that causes most of the human health problems.
“One teaspoon of sodium chloride “” table salt “” contains 2,300 milligrams (mg) of sodium and there is some evidence that salt can directly affect the heart, aorta, and kidneys without necessarily increasing blood pressure,” reads the health report from the Heart letter.
The Harvard letter adds that some people are exquisitely sensitive to salt “” their blood pressure rises and falls as a direct result of how much salt they get but that others don’t seem to be affected at all.
Dr Mulongo advises that the salt sold in supermarkets and salt shakers in restaurants should be required to carry a front-of-pack, tobacco-style health warning especially by the World Hypertension League and leading international health organisations.
Dr Julian Abeso says that salt makes your body hold on to water and that if you eat too much salt, the extra water stored in your body raises your blood pressure so the more salt you eat, the higher your blood pressure.
“And the higher your blood pressure, the greater the strain on your heart, arteries, kidneys and brain,” says Dr Abeso, a pediatrician at Mbale regional hospital.
Dr Abeso warns that people should limit their sodium intake in order to slash their risk of serious diseases.
She revealed that medical personnel across Uganda envision salt shakers and table salt bought in supermarkets to have a label on the front saying “limit your use”.
“They should have something like “Excess sodium can cause high blood pressure and promote stomach cancer. Limit salt use.” Dr Abeso added.
Dr Norm Campbell, former President of the World Hypertension League and a General Internist, a Professor of Medicine, Community Health Sciences and Physiology and Pharmacology wrote in the Journal of Clinical Hypertension, that it was time for a more hard-hitting approach to dietary salt reduction.
“Unhealthy diets are a leading cause of death globally and excess salt consumption is the biggest culprit, estimated to have caused over three million deaths globally in 2017.”
“The World Health Organisation established a target for countries to reduce sodium intake by 30 per cent by 2025, and governments and the food industry have been working together to reduce salt in processed foods. However, urgent action now needs to be taken to raise consumer awareness of these dangers,” added Dr Campbell.
According to World Health Organisation, the human body requires a small amount of sodium to conduct nerve impulses, contract and relax muscles, and maintain the proper balance of water and minerals.
WHO says that it is estimated that we need about 500mg of sodium daily for these vital functions.
In an article published 31 January 2013 | GENEVA on WHO issues new guidance on dietary salt and potassium WHO recommends that adults should consume less than 5 g (just under a teaspoon) of salt per day (1) and for children: WHO recommends that the recommended maximum intake of salt for adults be adjusted downward for children aged two to 15 years based on their energy requirements relative to those of adults.
Sodium is found naturally in a variety of foods, including milk and cream (approximately 50 mg of sodium per 100 g) and eggs (approximately 80 mg/100 g). It is also found, in much higher amounts, in processed foods, such as bread (approximately 250 mg/100 g), processed meats like bacon (approximately 1,500 mg/100 g), snack foods such as pretzels, cheese puffs and popcorn (approximately 1,500 mg/100 g), as well as in condiments such as soy sauce (approximately 7,000 mg/100 g), and bouillon or stock cubes (approximately 20,000 mg/100 g).
WHO also adds that too much sodium in the diet can lead to high blood pressure, heart disease and stroke and it can also cause calcium losses, some of which may be pulled from the bone.
Dr Jonathan Wangisi, the DHO Mbale says while salt is an important component in our everyday diet, excess can make it hard for the kidney to function properly and could have other health complications on the body.
He said apart from the salt people add to the food they cook at home, there are other sources taken subconsciously.
“Most processed foods are preserved using salt and that increases the salt intake and yet the body requires about 1.5g to 2.3g of salt a day but most people only think of the salt they used when cooking. They forget that the small snacks will make their salt intake above the recommended grammes,” Dr Wangisi adds.
He added that. “People are not aware of how much salt they consume daily and the impact has on their blood pressure and warnings would deter many from consuming unnecessarily high levels of salt,” he says.
Dr Wangisi says a low salt diet leads to an increase in life expectancy since it reduces the risk of hypertension by 30 per cent and the benefit of medication is doubled when daily salt intake is reduced by 4.6g, he says.
According to WHO research has found that too much salt causes high blood pressure, which can lead to strokes and heart disease, and experts broadly agree that the evidence against salt is compelling.
The report says that a human body retains water when we eat salt, increasing blood pressure until our kidneys flush it out and that too much salt over a long period of time can put strain on our arteries and lead to prolonged high blood pressure, known as hypertension, which causes 62% of all strokes and 49% of coronary heart disease events.
Dr Rose Nanyonga, a vice-chancellor of Clarke International University, simple lifestyle changes covering diet, physical exercise and regular check-ups can help reduce the risk of hypertension and other non-communicable diseases.
“Simple modifications in how people live can make a difference – minimising salt intake, active lifestyle and minimising weight gain,” Dr Nanyonga added.
Dr Paul Kasenene of Well care good services says that salt makes the body hold on to water and if one takes too much, the extra water stored in the body raises the blood pressure.
“So, the more salt you eat, the higher your blood pressure, the higher your blood pressure, the greater the strain on your heart, arteries, kidneys, and brain. This can lead to heart attacks, strokes, dementia and kidney disease,” Dr Kasenene adds.
He explained that the type of salt most people use is processed table salt and that this is like processed sugar not designed like natural salt and so has 2 challenges; lacks many of the essential and beneficial minerals in natural salt and it is processed and so the chemical and additives used to make it, mean it will have some drawbacks.
“And this processed salt is really one of the major reasons that salt is harmful, even most research that is done that shows salt to be harmful is done using such salt that doesn’t have much benefit,” said Dr Kasenene..
WHO adds that research has shown that if the kidney disease is left untreated and the blood pressure is not lowered, the damage can lead to kidney failure; this is when the kidneys are no longer able to filter the blood and the body becomes poisoned by its toxic waste products.
The World Health Organization recognises salt reduction as a cost-effective intervention for reducing the burden of ill-health around the world.
The member States at the 2011 United Nations High Level Meeting on NCDs agreed a global target of a 30% reduction in mean population intake of salt/sodium by 2025.
The signatories to the position statement; reduction in mean population intake of salt/sodium by 2025, include World Hypertension League, Resolve to Save Lives, World Health Organisation Collaborating Centre on Salt Reduction, The George Institute for Global Health, World Action on Salt and Health, Consensus Action on Salt and Health, World Health Organisation Collaborating Centre for Nutrition, University of Warwick, Hypertension Canada and the British and Irish Hypertension Society.
But other studies also point out that low sodium intake has also been linked to several other adverse health effects and that consuming too little salt may lead to increased cholesterol and triglycerides, insulin resistance and hyponatremia (too little sodium in the blood.
