Chijioke Iremeka
Nutritionists and cardiovascular experts have warned against high sodium (salt) intake due to its ability to increase blood pressure, the danger it poses to cardiovascular health and its ability to predispose people to noncommunicable diseases.
They, however, recommend the consumption of potassium salt substitutes instead of dietary salt (sodium chloride) to reduce such risks.
According to them, sodium and chloride in salt can cause an expansion of the extracellular fluid volume, which over time, causes a rise in blood pressure that results in strokes, heart failure, heart attacks, and kidney disease.
While calling for the replacement of sodium chloride with salty-tasting potassium chloride, experts said decreasing dietary salt intake from the current global levels of 9–12 grams per day to the recommended level of less than 5 grams per day would have a major impact on blood pressure and cardiovascular disease.
The professionals said that salt reduction strategies are best in the prevention of global noncommunicable diseases and can avert over yearly 2.5 million deaths from heart attacks and strokes.
According to the World Health Organisation, potassium salt substitutes are alternatives to regular salt both as an ingredient of pre-packaged foods and as salt added to food and beverages by consumers.
The WHO noted that the use of potassium salt substitutes also known as low-sodium salt substitutes is increasingly being considered as a potential blood pressure-lowering strategy by national health authorities and public health organisations.
“The amount of dietary salt consumed is an important determinant of blood pressure levels and of hypertension and overall cardiovascular risk. Annually, 17.5 million deaths are attributable to cardiovascular disease, which accounts for an estimated 31 per cent of deaths globally.
“It is also estimated that one out of every 10 cardiovascular deaths are attributable to salt intake of more than 5g per day,” the United Nations agency added.
Speaking exclusively with PUNCH Healthwise a Registered Dietitian Nutritionist, Olusola Malomo said dietary salt is essential to the body, but its high intake can also raise blood pressure, which can damage the body in many ways.
He said high blood pressure has been linked to heart disease, stroke, kidney failure, and other health-related problems, adding that potassium salt substitute provides a seasoning alternative for manufacturers looking for how to reduce sodium.
He added, “Potassium has many important functions. It allows the nerves to respond to stimulation and muscles to contract, including those in the heart. It reduces the effect of sodium in table salt on blood pressure.
“It helps to move nutrients into cells, and waste products out of cells. Salt substitutes made from potassium chloride alone look like regular salt and have a salty flavour, but have zero sodium.
“However, potassium doesn’t activate the same taste cells as sodium. That’s why people complain that these substitutes often leave a bitter or metallic aftertaste. Salt substitutes contain potassium chloride, either alone or mixed with regular salt.”
Malomo added that potassium salt is less processed than table salt and retains trace minerals, which add flavour and colour, insisting that sea salt is also available as fine grains or crystals and is often promoted as being healthier than table salt.
On its impact on cardiovascular health, a Consultant Cardiologist at the Lagos University Teaching Hospital, Idi-Araba, Dr Akinsanya Olusegun-Joseph, said the human body needs a small quantity of salt for optimal health and development but too much of it causes the body to retain water.
“This increase in fluid in the body increases blood pressure, which puts a strain on blood vessels, the heart and kidneys. With this, people with high blood pressure have an increased risk of coming down with heart disease and stroke.
“It’s, therefore, safe to say that everyone should pay attention to and reduce their dietary salt intake. Potassium salt is available in Nigeria and we recommend it to some patients. A lot of people don’t know the quantity of salt they consume daily.
“Too much sodium and the accompanying fluid retention in the body can be very dangerous. But potassium has a way of dilating the vessels and by doing this, the blood pressure will be reduced. The spiral resistance reduces and blood pressure comes down.
“Sodium causes retention of fluid but potassium doesn’t. Potassium will reduce high blood pressure but sodium will increase it. So, potassium salt substitutes have a greater advantage when compared with sodium chloride.”
Buttressing this position, a study published in the National Library of Medicine titled, ‘Potential use of salt substitutes to reduce blood pressure’,’ by Clare Farrand and her team, affirmed that higher intakes of potassium are associated with decreased blood pressure independent of sodium intake.
The study also suggested that increased consumption of potassium can mitigate the negative effects of high sodium consumption on blood pressure, indicating that the sodium‐potassium ratio of the diet is therefore a major determinant of blood pressure.
“Both sodium and chloride in salt lead to an increase in blood pressure and then cause strokes, heart failure, and heart attacks, as well as kidney disease,” the study stated.
The authors recommended a reduction in sodium use in food manufacturing and processing, and to explore the use of potassium‐based sodium replacers.
“Further consideration may need to be given to how best to label salt substitutes (namely potassium) in processed foods to ensure that people who may be adversely impacted are aware,” the study recommended.
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