Hidden salt puts Canadians' health at risk

When Michael Jacobson's researchers went in search of salt hidden in processed foods, they found cheese slices with the salt concentration of Atlantic seawater. One half cup of some cottage cheeses contained more sodium than a large order of McDonald's fries. 

A children's pre-packed, ready-to-eat lunch was loaded with more than half an adult's maximum recommended daily allotment of sodium. We dutifully scrutinize food labels for trans fat and calories, but most people have no idea how much salt they are eating, says Jacobson, executive director of the Center for Science in the Public Interest, a Washington, D.C.-based consumer health group. "It hasn't been in the news for many, many years. When people look at the labels, I doubt they look at the sodium. 

They should." Salt is sodium chloride, and it's the sodium that's important. Sodium increases blood pressure, and high blood pressure increases the risk of heart attacks, strokes and kidney failure. Twenty-five per cent of Canadians have hypertension, and half the 30,000 hospitalizations for stroke every year in Canada have been blamed on hypertension. Yet, 90 per cent of Canadian men aged 31 to 50, and half of Canadian women in the same age range, regularly consume more than the U.S. Institute of Medicine's "upper tolerable intake" of 5.8 grams of salt per day. 

The U.K. has set salt limits and has launched an aggressive public campaign to encourage people to reduce their salt intake from a daily national average of nine grams, to no more than six grams, the equivalent of about one teaspoon of salt. The World Health Organization is urging people to restrict salt intake to less than five grams a day. But, Health Canada has only a vague recommendation that diets be "reduced in sodium content," and the old rainbow food guide makes no mention of salt. 

Critics say this "do nothing approach" means Canada is falling behind other G-7 countries in working to reduce the salt content of food. Now, a growing number of scientists are pushing for change. The Canadian Stroke Network is urging Health Canada to include a warning about salt in the new food guide. "I want a statement to the effect that excessive salt intake is harmful to your health," says Dr. Antoine Hakim, CEO and scientific director of the Ottawa-based research network. Others want more. Dr. Norm Campbell, professor of medicine at the University of Calgary and Canadian Institutes for Health Research Chair in Hypertension Prevention and Control, says salt is so ubiquitous in processed foods, and in such high amounts, that the only way to lower the population's intake is to reduce the salt content of packaged foods. 

About 80 per cent of the salt we eat is added to prepared foods by manufacturers. "In my opinion, everyone, regardless of age, should be concerned about salt additives," says Campbell. In animal studies, "age is not a factor." Research suggests that if a single millimetre of mercury reduction in the average blood pressure of Canadians could be achieved, it could mean 480 fewer deaths per year from stroke, 1,580 fewer deaths from coronary heart disease and hundreds fewer "silent" strokes, undetected brain infarctions that show up by chance on MRI scans and are now suspected to be a major cause of dementia. 

The salt industry says salt is being unjustly demonized and that not a single study proves that the general population benefits, in terms of fewer strokes and heart attacks, from a salt-restricted diet. The Salt Institute, the salt industry's trade association, says people haven't lowered their salt consumption despite admonishments from experts for more than 20 years. "The real question is, 'is adding salt to food safe? Has it been proved safe?' In actual fact, it has been demonstrated to be unsafe from the perspective of causing hypertension," says Campbell. 

Why so much salt? Economics, according to Kevin Willis, director of partnerships with the stroke network. The only way to make inexpensive processed foods that are often high in saturated fat palatable is by adding "flavour enhancers." Salt, says Willis, "is the cheapest option." The human body needs just half a gram a day of salt, says Dr. David Spence, director of stroke prevention and the atherosclerosis research centre at the Robarts Research Institute in London, Ont. It's thought humans have an innate liking for salty taste because it signifies the presence of sodium, and sodium is crucial for nerve conduction, muscle and other functions. 

But when we eat more salt, we get more salt in the blood. In order to maintain the concentration at a "physiologically acceptable level," we have to take in more fluids, Willis explains. That increases the pressure in the vessels. People who salt their food before tasting it are receiving, on average, 20 grams of salt a day, or 40 times what their bodies needs, Spence says. Some companies are reducing salt levels in response to consumer demand. Campbell's announced in February its top-selling tomato, chicken noodle and cream of mushroom soups will be available in 25 per cent less sodium versions. Campbell's' "Kids" soups will be reformulated with 25-per-cent less sodium. 

Twenty-six per cent of 52 food companies surveyed last year by Food and Consumer Products of Canada said they were reformulating prepared foods "to address salt and sodium content issues," says Phyllis Tanaka, director of food and nutrition policy. Serving Up Salt Sodium content in popular processed foods, with the serving size, followed by the amount of sodium. For purposes of comparison, one level teaspoon of salt contains about 2,300 mg of sodium, considered the "upper tolerable intake" per day by the U.S. Institute of Medicine. 

Kraft Singles thick slice cheese: 1 slice, 530 mg Stouffer's Macaroni and Cheese: 1 cup, 970 mg Kraft Dinner: 3/4 cup prepared, 430 mg Ragu Old World Style Traditional Spaghetti Sauce: 1/2 cup, 720 mg Campbell's Condensed Classic Vegetable Soup: 1/2 cup, 890 mg Pillsbury Flaky refrigerated biscuits: 1 biscuit, 720 mg Uncle Ben's Teriyaki Chicken Rice Bowl: 1 container, 1,450 mg KFC Original Recipe Fried Chicken Breast: 161 grams, 1,150 mg Pizza Hut thin crust cheese pizza: 1 slice, 490 mg Burger King fries, medium (salted): 116 grams, 590 mg McDonald's medium fries: 110 grams, 290 mg KFC Greek salad with one pouch of Greek Feta Vinaigrette: 372 grams,1,620 mg McDonald's Caesar Salad with Grilled Chicken and 2 oz Newman's Own Creamy Caesar Dressing: 337 grams, 1,320 mg Wendy's Jr. cheeseburger, small: 129 grams, 810 mg

*Sharon Kirkey, CanWest News Service, The StarPhoenix