17th March 2014 A report last week suggested children and teenagers are eating too much salt (well, 0.75g/ day among 5 – 6 year olds to be exact), with much of it coming from processed food. Of course no-one is disputing kids are eating too much processed foods or that too much salt can raise blood pressure, but is the focus on salt all a bit of a red herring? 
Firstly, there are many other factors that raise blood pressure – being overweight, not taking enough exercise, excess alcohol, low intakes of fruit and vegetables, potassium, calcium and magnesium. In other words, we need to look at the bigger picture and not just focus on salt! Second, we need to look at health outcomes (e.g. cardiovascular disease) not just markers (blood pressure). When we do this, it turns out the evidence linking salt to heart attacks and stroke is weak. A study published in the American Journal of Hypertension, which analysed data from over 6,000 people, failed to find an association between lowered salt intake and risk of heart attacks, strokes, or death. Most large-scale studies have found that following a lowsalt diet produces only minimal reductions in blood pressure in most people. For most adults and children, there is no need to worry about salt. The kidneys regulate the amount of sodium in our bodies so if we consume more than we need, then it is excreted in the urine. It will cause just a temporary increase in blood pressure as extra water is drawn into the bloodstream to dilute it. But this soon returns to normal as the sodium is excreted and blood volume returns to normal. However, some people are more salt-sensitive than others (and generally as we get older our sensitivity to sodium increases). For these people, cutting salt may be beneficial as will eating less processed food, losing weight (if overweight), being more active and eating more fresh produce. The bottom line is that if we eat mostly ‘real’ food we won’t need to worry about salt. As 75 per cent of the salt in most people’s diets comes from processed foods, it’s virtually impossible to eat a lot of salt if we base our diets on unprocessed foods. Eating less processed foods (ham, bacon, sausages and burgers, bread, soups, sauces, cheese, ready meals, pizzas, baked beans, breakfast cereals and biscuits) not only means less salt, but also fewer calories and less added sugar. And it’s the latter two factors that push up your risk of obesity, high blood pressure and cardiovascualar disease. In other words, salt is a marker for processed food consumption generally. The focus on salt is a red herring. Public health initiatives should shift focus away from single nutrients to what matters more: reducing processed food consumption, encouraging fresh foods (e.g. making them more affordable and available) and cooking meals from scratch.