Pinch of good advice on salt intake

I refer to the letter of Maurice G. Agius in which he enquired (July 2) about the recommended daily intake of salt.

Earlier this year, the American Institute of Medicine issued new lower guidelines for daily salt intake.

As Mr Agius stated, the newly recommended intake has been reduced to 1,500 milligrams daily – down from the previous level of 2,300 milligrams.

This, as our understanding of salt metabolism is improving.

Our own Health Promotion leaflet still quotes a figure of less than 5 grams daily. I believe the information on this leaflet should be reviewed.

Roman soldiers were partially paid in salt (salarium) – because they needed to replace the large amount of salt they lost in their sweat. Like modern athletes in endurance competitions, Romans could have required to replace one litre of sweat as well as between one and two grams of salt every hour, while on the march.

Modern man living in normal everyday conditions requires much less salt for his well being – so that 1,500 milligrams (1.5 grams) daily appears to be more than adequate. Indeed it is likely that the recommended daily salt intake will be lowered further in the future, as our understanding of salt metabolism continues to improve.

A study conducted some years ago in Malta showed that men were ingesting 11 grams of salt daily, while women were close runners-up with nine grams. We were ingesting some 6.6 times the presently recommended amount of salt every day. No wonder then that one in five of the Maltese population suffers from hypertension.

Since around 80 per cent of our salt intake comes from pro­cessed/tinned foods – (for instance 10 pieces of a particular type of “salted pretzels” contained 500 mg of salt) – the best current advice has to be: Do not add salt to your food and read the label!

It may still be useful to know what these amounts represent in terms of everyday utensils such as teaspoons. Teaspoons vary in size, the average teaspoons accommodating from three to 6.5 grams of salt.

It is a simple matter to weigh the amount of salt contained in a level teaspoon on modern kitchen scales – my own teaspoons (level measure) contain three grams of salt.

Excess salt may cause ill health particularly in “salt sensitive” individuals. Elderly patients as well as diabetics have an increased risk of being salt sensitive. In general, 30 to 50 per cent of the population is “salt sensitive” and needs to restrict salt intake.

High blood pressure is the commonest medical problem in Malta, affecting 22 per cent of the Maltese population. Restriction of salt may help to lower blood pressure.

Generally speaking, “do not add salt” must remain the general advice. Clearly if excess salt loss has been experienced such as on a hot day, or after exercise, small amounts of salt can be added.

It should be noted that this is general advice and that there are groups of persons with special salt requirements e.g. athletes, those with cystic fibrosis, those working in hot humid environments etc.

Elsewhere, I have proposed the establishment of a Salt Museum which would be informative as well as serve as a tourist attraction. In my view this would be ideally placed in the new Salini Project.