Adding salt to your food at the table is a link

According to a study of more than 500,000 people published in the , people who add extra salt to their food at the table are at greater risk of dying prematurely from any cause European Heart Journal [1] today (Monday).

Compared to those who never or rarely added salt, those who always added salt to their diet had a 28% increased risk of dying prematurely. In the general population, about three out of every hundred people between the ages of 40 and 69 die prematurely. The increased risk from constantly adding salt to food found in the current study suggests that in this age group, one more person in every hundred may die prematurely.

In addition, the study found a shorter life expectancy in people who always added salt compared to those who never or rarely added salt. At age 50, life expectancy was reduced by 1.5 years and 2.28 years for women and men, respectively, who always added salt to their diet compared to those who never or rarely did.

The researchers, led by Professor Lu Qi of Tulane University School of Public Health and Tropical Medicine, New Orleans, USA, say their findings have multiple public health implications.

“To my knowledge, our study is the first to examine the link between adding salt to food and premature death,” he said. “It provides new evidence to support recommendations for changing eating habits to improve health. Even a modest reduction in sodium intake by adding less or no salt to table-side meals is likely to result in significant health benefits, particularly when achieved in the general population.”

Assessing total sodium intake is notoriously difficult because high levels of salt are added to many foods, especially prepackaged and processed foods, before they even hit the table. Studies that assess salt intake using urine testing often only do a urine test and therefore do not necessarily reflect common behavior. Also, high-salt foods are often accompanied by high-potassium foods like fruits and vegetables, which is good for us [2]. Potassium is known to protect against heart and metabolic diseases like diabetes, while sodium increases the risk of conditions like cancer, high blood pressure and stroke.

For these reasons, the researchers decided to study whether or not people salted their food at the table, regardless of whether salt was added during cooking.

“Adding salt to meals at the table is a common eating behavior that is directly related to a person’s long-term preference for salty-tasting foods and habitual salt intake,” said Prof. Qi. “In the Western diet, adding salt at the table accounts for 6-20% of total salt intake and provides a unique way to assess the association between habitual sodium intake and risk of death.”

The researchers analyzed data from 501,379 people who participated in the UK Biobank study. When participating in the study between 2006 and 2010, participants were asked via a touch screen questionnaire whether they (i) never/seldom, (ii) sometimes, (iii) usually, (iv) always, or ( v) prefer not to answer. Those who chose not to respond were not included in the analysis. The researchers adjusted their analyzes to account for factors that could affect the results, such as age, gender, race, deprivation, body mass index (BMI), smoking, alcohol consumption, physical activity, diet, and medical conditions such as diabetes, cancer and heart and blood vessel diseases. They followed participants for a median (average) of nine years. Death before the age of 75 was defined as premature death.

Not only did the researchers find that constantly adding salt to food was associated with a higher risk of premature death from all causes and a reduction in life expectancy, but they also found that these risks were lower in people who ate the highest amounts of fruit and fruit consumed tended to decrease slightly as did vegetables, although these results were not statistically significant.

“This finding did not surprise us as fruits and vegetables are important sources of potassium, which has protective effects and is associated with a lower risk of premature death,” said Prof. Qi.

He added: “Because our study is the first to show an association between adding salt to food and mortality, more studies are needed to validate the results before recommendations are made.”

In an editorial to the newspaper [3]writes Professor Annika Rosengren, a senior researcher and professor of medicine at Sahlgrenska Academy, University of Gothenburg, Sweden, who was not involved in the research, that the net effect of drastic reductions in salt intake for individuals remains a matter of debate.

“Given the various pieces of evidence that very low sodium intake may not be beneficial or even harmful, it is important to distinguish between individual-based recommendations and population-level interventions,” she writes.

She concludes: “Classical epidemiology argues that there is greater net benefit from the population-wide approach (achieving a small effect in many people) than from targeting high-risk individuals (a large effect but only a small one). number of people scored). . The obvious and evidence-based strategy in preventing cardiovascular disease in individuals is early detection and treatment of hypertension, including lifestyle changes, while societal-level salt reduction strategies lower the population’s mean blood pressure and result in less people develop high blood pressure, require treatment and become ill. Adding extra salt to food is unlikely to be harmful and could contribute to strategies to lower blood pressure in the population.”

A strength of Prof. Qi’s study is the large number of people included. It also has some limitations, including: the possibility that adding salt to food is indicative of an unhealthy lifestyle and lower socioeconomic status, although analyzes have attempted to address this; There was no information on the amount of salt added; Adding salt may be related to total energy intake and intertwined with intake of other foods; Participation in the UK Biobank is voluntary and as such the results are not representative of the general population and further studies are needed to confirm the results in other populations.

Prof. Qi and his colleagues will conduct further studies on the link between adding salt to food and various chronic diseases such as cardiovascular disease and diabetes. They also anticipate potential clinical trials to test the effects of reducing salt intake on health outcomes.

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[1] “Addition of Salt to Food and Risk of Premature Mortality”, by Hao Ma et al. European Heart Journal. doi:10.1093/eurheartj/ehac208

[2] An example of a typically salty food that also contains veggies is tacos, which are often filled with beans and veggies.

[3] “Salt – the Sweet Spot?”, by Annika Rosengren. European Heart Journal. doi:10.1093/eurheartj/ehac336