Salt is, according to experts, one of the world’s biggest hidden killers. Eating less salt can lower your blood pressure and protect your heart, according to the World Health Organisation (WHO). The specialized UN agency responsible for global public health advises us to eat a low salt diet today for a healthier tomorrow.
According to WHO, excess sodium is linked to adverse health outcomes, including increased blood pressure, increasing risk of cardiovascular diseases, gastric cancer, obesity, osteoporosis, Meniere’s disease, and kidney disease. An estimated 1.89 million deaths each year are associated with consuming too much sodium (salt), a well-established cause of raised blood pressure and increased risk of cardiovascular disease.
Dr. Vincent Mutabazi, an epidemiologist in Kigali, explained the impact of salt intake on blood pressure and overall health. He emphasized that salt primarily contains sodium, a chemical element that retains water in the body. When sodium is ingested, the body holds onto water, increasing blood vessel pressure. Additionally, the heart is forced to work harder to circulate blood, which could result in heart conditions. When salt intake is reduced, the body expels excess water, leading to a reduction in blood pressure, he added.
Dr. Mutabazi explained that raw and processed salt contain the same amount of sodium, so neither is safe when consumed in excess. He stressed that reducing salt intake is crucial for managing blood pressure, which plays a vital role in maintaining overall heart health.
The effect of salt on blood pressure can vary depending on age, as older individuals often experience a loss of elasticity in their blood vessels, making them more prone to hypertension, he said. As blood vessels lose their elasticity, they become more rigid, and blood pressure rises, even in the absence of excessive salt intake.
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Sodium, an essential nutrient, increases the risk of heart disease, stroke and premature death when eaten in excess. The main source of sodium is table salt (sodium chloride), but it is also contained in other condiments such as sodium glutamate.
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According to WHO, reducing sodium intake is one of the most cost-effective ways to improve health and reduce the burden of non-communicable diseases, as it can avert a large number of cardiovascular events and deaths at very low total programme costs. In Rwanda, noncommunicable diseases account for a staggering 44% of all deaths, contributing to 58% of the nation’s annual mortality when combined with injuries and disabilities.
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For every US$ 1 invested in scaling up sodium reduction interventions, WHO says, there will be a return of at least US$ 12. WHO recommends several sodium-related best buy policies as practical actions that countries should undertake promptly to prevent cardiovascular disease and its associated costs. These include lowering sodium content in foods; implementing front-of-pack labelling; mass media campaigns; and public food procurement and service.
How much salt is too much?
The global mean intake of adults is 4,310 mg/day sodium (equivalent to 10.78 g/day salt), according to WHO. This is more than double the World Health Organization recommendation for adults of less than 2,000 mg/day sodium (equivalent to
Dr. Mutabazi referenced WHO’s recommendation for adults to consume no more than five grams of salt per day, which is roughly one and a half teaspoons. He noted that processed foods often contain high amounts of salt, which can contribute to excessive intake.
"The body also adapts to salt over time, meaning individuals may feel that food lacks salt if they are used to a higher intake, which can further worsen the problem,” he added.
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For children aged 2–15 years, WHO recommends adjusting the adult dose downward based on their energy requirements. This recommendation for children does not address the period of exclusive breastfeeding (0-6 months) or complementary feeding with continued breastfeeding (6–24 months).
"All salt that is consumed should be iodized (fortified with iodine), which is essential for healthy brain development in the foetus and young child and optimizing people’s mental function in general,” says WHO.
Other risks of high salt intake
Martine Umuhire, a nutritionist and dietician at Nutri-Sante Rwanda, a comprehensive nutrition clinic in Kigali, said that for people on blood pressure medication, particularly diuretics, high sodium intake can reduce the medicine’s effectiveness by lessening its ability to remove excess fluid from the body.
She said: "Reducing salt intake doesn’t only manage high blood pressure but also lowers the risk of serious health issues like heart disease, stroke, and other cardiovascular complications.”
Umuhire warned that high sodium levels can also lead to kidney disease, swelling in the hands and feet, and even osteoporosis, a disease that weakens bones.
"Excessive sodium can irritate the stomach lining, increasing the risk of ulcers and inflammation that may lead to cancer. It can also result in fluid retention, contributing to weight gain and discomfort,” Umuhire said.
How can you reduce your sodium intake?
The World Health Organisation recommends several ways to reduce sodium intake: