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Salt intake, consumer understanding, and health research

It looks like the big food manufacturing companies are preaching the results of studies of their products to more dietitians as well as some of the largest health-focused associations. For example, the American Heart Association brought together over 100 key stakeholders and thought leaders at a special conference in June 2013 to discuss sodium intake. Proceedings from the conference were published in the May 2014 edition of Circulation. Among the top priorities identified by the group were increasing consumer understanding for the need to reduce sodium intake and the use of food technologies to reduce sodium in the food supply as much as possible.

Salt intake, consumer understanding, and health research.
Photo by Sean Gallup/Getty Images

Sodium intake around the world continues to be of concern and public health authorities hypothesize ( Brown IJ, Tzoulaki I, Candeias V, Elliott P. Int J Epidemiol. 2009; 38:791) that it may be linked with cardiovascular disease risk, according to the Institute of Medicine. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press; 2013.) In an effort to identify ways to reduce the amount of sodium consumed and provided in the food supply, the American Heart Association brought together over 100 key stakeholders and thought leaders at a special conference in June 2013. Proceedings from the conference were published in the May 2014 edition of Circulation (Antman EM, Appel LJ, Balentine D, et al. Circulation. 2014; 129: published online May 5, 2014.)

Among the top priorities identified by the group were increasing consumer understanding for the need to reduce sodium intake and the use of food technologies to reduce sodium in the food supply as much as possible. In an effort to advance sodium reduction technology, Tate & Lyle showcased an ingredient at the conference, SODA-LO® Salt Microspheres, which has the potential to be a major contributor for reducing sodium in the marketplace, according to the June 11, 2014 news release, "American Heart Association conference highlights solutions for reducing sodium intake."

According to the American Heart Association publication, new food technologies, like SODA-LO® Salt Microspheres, can lower the sodium content of foods and are one part of the solution for meeting public health recommendations (Antman EM, Appel LJ, Balentine D, et al. Circulation. 2014; 129: published online May 5, 2014.)

Sodium Reduction Innovation: SODA-LO® Salt Microspheres

SODA-LO® Salt Microspheres is a salt-reduction ingredient that tastes, functions, and may label like salt because it is salt. However, labeling rules vary from country to country. It can reduce sodium by 25 to 50% in food applications such as bread and salty snacks. SODA-LO® is created using a patented technology that transforms standard salt crystals into free-flowing, hollow salt microspheres that efficiently deliver salty taste by maximizing surface area relative to volume.

Research presented at the conference showed the potential impact of replacing salt with SODA-LO® on overall sodium intake. Using US National Health and Nutrition Examination Survey (NHANES) 2007-2010 data, the potential usage of SODA-LO® in 953 foods allowing 20-30% sodium reduction was modeled assuming a 50 or 100% market penetration. Results of the dietary modeling demonstrated that sodium intakes could decrease by 4% to 9% across age, sex, and ethnic groups.

This reduction is equivalent to 130 to 360 mg/day. SODA-LO® Salt Microspheres can serve as one solution to help decrease population sodium intake. While changing consumer palates for foods lower in sodium may require significant time, interim technologies like SODA-LO® can provide an immediate solution for sodium intake reduction.

"Tate & Lyle, as a leader in sodium reduction technology, can offer food manufacturers a novel, great tasting ingredient that can be used in products that consumers will enjoy and continue to demand," stated Mike Harrison, according to the June 11, 2014 news release, "American Heart Association conference highlights solutions for reducing sodium intake." Harrison is Senior Vice President of New Product Development at Tate & Lyle.

SODA-LO® Salt Microspheres is the result of Tate & Lyle's Open Innovation team that creates partnerships to bring the most exciting new food ingredient technologies to market. Through a license agreement with Eminate, a wholly owned subsidiary of the University of Nottingham, UK, Tate & Lyle has exclusive, worldwide rights for product development, manufacturing and commercialization of the SODA-LO® Salt Microspheres technology. (Hooper L, Bartlett C, Davey SG, Ebrahim S. Advice to reduce dietary salt for prevention of cardiovascular disease. Cochrane Database Syst Rev 2004.1:CD003656.) for more information, you may wish to check out the website, "American Heart Association Conference Highlights."

About Tate & Lyle

Tate & Lyle is a global provider of ingredients and solutions to the food, beverage and other industries, with operations in over 30 locations worldwide.

Tate & Lyle operates through two global divisions, Speciality Food Ingredients and Bulk Ingredients, supported by our Innovation and Commercial Development group. The Group's strategy is to become a leading global provider of Speciality Food Ingredients through a disciplined focus on growth, and by driving Bulk Ingredients for sustained cash generation to fuel this growth.

Speciality Food Ingredients consists of three platforms: Texturants, which includes speciality starches and stabilizers; Sweeteners, which comprises nutritive sweeteners and our range of no-calorie sweeteners including SPLENDA® Sucralose; and our Health and Wellness portfolio which includes speciality fibres and our salt-reduction offering. Additionally, our Food Systems business provides a wide variety of blended ingredient solutions.

Tate & Lyle Bulk Ingredients includes bulk sweeteners, industrial starches and fermentation products (primarily acidulants). Corn co-products from both divisions are primarily sold as animal feed. Tate & Lyle is listed on the London Stock Exchange under the symbol TATE.L. American Depositary Receipts trade under TATYY. In the year to 31 March 2014, Tate & Lyle sales totaled £3.1 billion. SPLENDA® is a trademark of McNeil Nutritionals, LLC.

The difference between sodium and chloride, and how each affects some people: Where's the balance?

The yin-yang effect of sodium and chloride presents a salt conundrum, says new a study that shows how chloride is an independent indicator of mortality in hypertensive patients. 'Eat less salt' is a mantra of our health-conscious times and is seen as an important step in reducing heart disease and hypertension.

Too much salt in the diet – and specifically sodium – is widely acknowledged as a major risk factor for high blood pressure. However, scientists have found that salt's other oft-overlooked constituent chloride might also play an important role, reports a September 8, 2013 news release, "Yin-yang effect of sodium and chloride presents salt conundrum." Blood pressure responses to dietary sodium and potassium interventions vary among individuals.

A study by researchers at the University of Glasgow has revealed that low chloride levels in the blood is an independent indicator of mortality risk in people with hypertension

The role of chloride in hypertension has received little attention from scientists up to now. After analyzing data from almost 13,000 patients with high blood pressure, followed up over 35 years, the researchers found that low levels of chloride was associated with a higher risk of death and cardiovascular disease.

The group with the lowest level of chloride in their blood had a 20% higher mortality rate compared to the other subjects. The results are published in the journal Hypertension (Journal of the American Heart Association).

Dr Sandosh Padmanabhan of the Institute of Cardiovascular and Medical Sciences, explains in the news release, "Sodium is cast as the villain for the central role it plays in increasing the risk of high blood pressure, with chloride little more than a silent extra in the background. "However, our study has put the spotlight on this under-studied chemical to reveal an association between low levels of chloride serum in the blood and a higher mortality rate, and surprisingly this is in the opposite direction to the risks associated with high sodium. "It is likely that chloride plays an important part in the physiology of the body and we need to investigate this further."

Chloride is already measured as part of routine clinical screening and so monitoring of chloride levels could easily be incorporated into clinical practice to identify individuals at high risk

Dr Padmanabhan adds in the news release, "The results we see from this study are confounding against the knowledge that excess salt is a bad thing, yet higher levels of chloride in the blood seems to be an independent factor that is associated with lower mortality and cardiovascular risk. We seem to have entered a grey area here that requires further investigation.

"It is too early to draw any conclusions about relating this finding to salt intake and diet. We need more research to establish exactly what the relationship between chloride and health risk is." Also check out "There is more to salt than just a pinch of sodium," and see, "Salt and Sensitivity." Also, you may wish to check out the abstract of a study, "Reproducibility of Blood Pressure Responses to Dietary Sodium and Potassium Interventions."

Why is calcium chloride in various brands of canned tomatoes or in some packaged ready-made salads?

In some Sacramento food markets, when you reach for a package of prepared take-out salad, on the ingredients label sometimes you'll see one ingredient that you'd normally not be aware of on freshly cut vegetables. That's calcium chloride. See the article, Hypertension, High Blood Pressure Control, Heart Palpitations. According to the article, "Calcium chloride can raise the systolic blood pressure by 20mm and the diastolic blood pressure by 15mm within a hour or two.

Is it the chloride some people are sensitive to, or is it the combination? After all, calcium or magnesium citrate won't have that effect. See the article, The Calcium Cholesterol Connection - Lower Your Cholesterol. But be careful, studies have come out saying calcium alone increases the risk of heart attack. Your body needs a balance of multiple minerals.

Sodium chloride will raise your blood pressure if you’re salt-sensitive and also have inherited your family’s gene variation for hypertension. But it’s the chloride in sodium as well as the chloride in calcium chloride (put into some canned vegetables to preserve color) that significantly raises your blood pressure. Is it chloride in calcium and chloride in sodium rather than sodium by itself that aggravates hypertension?

Some people sensitive to calcium chloride put in packaged salads to preserve color may also find the calcium chloride will raise their blood pressure as will potassium chloride, but not potassium citrate or calcium citrate. Then again, magnesium chloride is used by prescription to lower blood pressure. But some people may take magnesium citrate supplements to prevent blood pressure from rising. It's complicated.

At the Solay Wellness Inc. site and at Natural, you’ll see an article published Dec 14, 2005, “Blaming dietary sodium for high blood pressure is too simplistic; the real problem may be mineral deficiencies.” The problem to be solved may be about imbalance in minerals: how too little or too much of magnesium, calcium, and potassium (out of balance) play a role in your hypertension. Can ionic multiple minerals that might be more absorbable actually help if your body isn't absorbing minerals from other sources?

A variation in genes working together may be why some people respond to salt with hypertension and others are salt-resistant. See the book, Healing with Vitamins: Straight from Nature, Backed by Science--The Best Nutrients to Slow, Stop, and Reverse Disease (Rodale Health Books) by Editors of Rodale Health Books (Paperback - Mar 17, 2009)

Research on how sodium alone, as in baking soda (bicarbonate of soda) affects hypertension are ongoing. Baking soda contains sodium but not chloride. It’s known that calcium chloride put into food cans to preserve color significantly raises the blood pressure in some people that are sensitive to calcium chloride. And sodium chloride also raises the blood pressure of salt-sensitive people.

The best way to handle the issue is to find out which mineral raises your blood pressure. In the meantime, balance is important, the balance of potassium along with magnesium and calcium. On one hand people can’t live without salt, but salt is found in many foods such as celery, carrots, and animal protein.

Scientists are researching how potassium lowers blood pressure by relaxing small vessels and helping to remove excess water and sodium. But too much potassium can kill you.

Find out whether you're deficient in magnesium in your cells, not just in your bloodstream. You can research multiple minerals in balance in a form you can absorb such as ionic minerals. Check out the Eidon ionic liquid multiple minerals site. The point is to find out what you need first and then research where you can get what you need in a form that's balanced.

If the potassium is unbalanced with other minerals it can raise blood pressure. A number of studies have found that limiting sodium alone doesn’t lower blood pressure in many people unless potassium intake is upped simultaneously. But some people using the potassium chloride in salt substitute find their blood pressure rising after they stopped eating salted foods. What's happening?

There are a lot of issues involved. For example, your individual blood pressure problem could be associated with a high level of rennin. It’s an enzyme released by the kidneys that eventually leads to the formation of angiotensin and the release of aldosterone. These compounds cause the blood vessels to constrict and the blood pressure to increase. If you cut out salt completely, your blood pressure could rise significantly from the imbalance of too much potassium.

See The Encyclopedia of Nutritional Supplements. It lists foods by their sodium:potassium ratio. Also see Debra’s Natural Gourmet site. Be careful if you’re sensitive to the potassium chloride in salt substitutes. That's why researching with your health care team what your body requires is important, since different people react in various ways to the intake of a variety of minerals.

For example, a salt substitute could have too much potassium for your individual body's healthiest response. If your kidneys or heart can’t handle that much potassium chloride, your blood pressure could skyrocket, especially if you’re not eating salt and other minerals in a balanced state. That's why it's important to be tested anytime you are taking something like potassium, magnesium, sodium or any supplements. You need tests of what minerals actually are being absorbed in your cells and how your body is reacting to anything you're eating whether the thing is food or supplements.

What's happening inside your body? In which minerals are you deficient? What are your cells actually absorbing? Is your doctor ordering the correct test of what minerals are being absorbed by your cells and not just what's in your blood serum?

Or if you have "elevated intracellular sodium or decreased intracellular potassium levels," maybe you’d respond better to magnesium supplementation.

Only you and your doctor can find out by testing or giving you a four-week trial of a mineral such as magnesium to see how your body is reacting to that basic mineral. The goal is to see what could be out of balance or deficient in some areas.

Your doctor may want to put you on a month-long trial of taking magnesium. No one wants to be low on magnesium if and when that person ends up in the emergency room.

If you don't like the way conventional medicine is handling your nutrition questions, talk to a reputable medical doctor who also has training in naturopathy, complementary medicine, preventive medicine, integrative medicine, or alternative medicine and nutrition...and who knows what tests to give.

Is there competition between what big business gains by selling more drugs versus various natural solutions? And do these solutions appear in a variety of natural health-oriented books? Such solutions include “eating four stalks of celery to lower essential hypertension (for one week on and three weeks off).” There also are studies on drinking beet juice or using slow breathing machines.

Read the label printed on a container of a particular antioxidant supplement that has a little baking soda added to its capsules. I see the following statement: “Research suggests that sodium may impact blood pressure in some individuals only when it is consumed as sodium chloride (NaCl) table salt and not in other forms.”

This means maybe your next topic to research is whether sodium alone, such as found in baking soda has a different effect on your hypertension than table salt, including sea salt and mineral salt, which is sodium chloride. Could that be why magnesium is added to restaurant salt shakers in parts of Finland?

Read those studies online about sodium alone affecting the hypertensive person differently than sodium chloride. And I'd also like to know how much sodium (as in baking soda) is okay to use to make a dozen muffins rise without making one's pressure rise as well.

Magnesium Citrate Powder

You need minerals. But which minerals? And how many in what quantities? Find out from your health care professionals that actually know about measuring your minerals. Ask whether your body type needs more magnesium than calcium and why. One book recently published is called The Calcium Lie by Robert Thompson, M.D. and Kathleen Barnes.

View The Calcium Lie uTube video on this link. Another recently published book is Dr. Carolyn Dean, M.D. N.D's The Magnesium Miracle. And don't forget the section on the health benefits of magnesium (in the proper amount) stated in Dr. Sherry A. Rogers, M.D. book titled, Is Your Cardiologist Killing You? View two of Dr. Roger's videos on uTube on the effects of air pollution on your body and other health and nutrition topics.

Another recently published book is titled, How Nutrigenomics Fights Childhood Type 2 Diabetes & Weight Issues.

What you need to know about magnesium is that it is an essential nutrient. Why are so many people deficient in magnesium? You need the right amount for your body, not too much and not too little.

In Finland, salt shakers in some restaurants have begun offering magnesium to sprinkle on food, sometimes mixed with other spices or condiments such as garlic and onion, dulse, or dried herbs. What you need to know is magnesium's role in lowering cholesterol.

Find out the vital role this mineral plays in your own body. Most doctors have not considered that mineral cofactors are involved in our biochemical reactions. This means in plain language that we all need a mineral balance.

Are you taking a small amount of multiple minerals and silica to balance your minerals? Your first step is to investigate what multiple minerals in ionic form you do need. What works best for you?

UC Davis Study

According to a new study by UC Davis researchers published as an article in an October, 2009 issue of Clinical Journal of the American Society of Nephrology, ""Dietary Sodium and Cardiovascular Health in Hypertensive Patients, the Case Against Universal Sodium Restriction,"the human brain naturally regulates its own sodium intake for the entire body. It's a controversial article based on a research study that has prompted nutritionists to ask more questions than the study answers.

The 2009 study gives UC Davis researchers the opportunity to challenge FDA guidelines asking consumers to reduce sodium levels when eating, especially when choosing processed or restaurant food. According to the study, "Dietary Sodium and Cardiovascular Health in Hypertensive Patients, the Case Against Universal Sodium Restriction," the Journal of the American Society of Nephrology reports in the newly published abstract of the study that, "Only a single study has been reported in hypertensive patientsthat links baseline sodium, measured by 24-hour urinary excretion,and subsequent cardiovascular outcomes."

If the Salt Institute has any say with the entire nation's salt industry, perhaps only one study had been performed because grant money for more studies of salt wasn't available during those times. But in the UC Davis 2009 study, controllingfor other risk factors, there was a "significant, independent,inverse association of urinary sodium excretion and coronarymorbidity and mortality. Indeed, an increase of 66 mmol/24 hwas associated with a 36% reduction in events."

The study's abstract reports, "Taken together,these data provide no support for the notion that either normotensiveor hypertensive individuals should routinely decrease (or increase)dietary sodium intake." So what should you do, decrease or increase your salt intake or just follow your doctor's orders without asking?

That's the decision nutritionists are trying to make based on the evidence. And nutritionists also are asking is the plausible evidence valid for people in various health situations? What if your kidneys are not doing well on the salt diet you have? That's a medical question answerable only by your personal physician and medical team.

The study doesn't even mention what happens when restaurants or food packagers process foods not only with a lot of added salt, but also flavor extenders such as monosodium glutamate (MSG) to amplify flavor. When adding salt to food or even MSG and salt, is the motive possibly to get customers addicted to the enhanced taste so they'd buy more of the same food and make more money for the food industry or restaurant?

Or is the real reason for adding so much salt or other types of sodium or even calcium chloride, known to raise blood pressure in some people who are sensitive to it, to processed food simply to preserve the food or its color? What the study actually was focusing on is whether the body adjusts to sodium levels naturally, regardless of what you put in your body. And the brain is what does the adjusting.

Just as government intervention had proposed an ideal level of salt intake for restaurants and food processing companies to think about and voluntary reduce salt in their products, this new study comes out in the face of nutrition policy advocates that want to inform people to reduce sodium intake because excess sodium, most nutritionists say, is not healthy.

Physicians know there are salt sensitive people as well as salt resistant people

It's genetic. Either you have a common gene variant that controls how your kidneys process and eliminate excess salt in a certain way, or you have a salt resistant gene that lets your kidneys process and get rid of salt in another way. Also hypertension runs in families.

Scientists know that around 60 percent of hypertensive people where the cause usually is said to be unknown may be sensitive to salt and react to excess salt by releasing renin and a form of angiotensin, whereby the blood pressure could be raised too high.

It's supposed to be genetic the way you handle salt. But the new study now is controversial because it is saying sodium (salt) intake is regulated by the brain. Now you have to separate the human reaction to salt (sodium) as in bicarbonate of soda from sodium chloride (table salt).

You have to ask whether it's the chloride raising the blood pressure in salt-sensitive people rather than the sodium. In some cases, a small amount of sodium from baking soda (sodium bicarbonate) doesn't raise the blood pressure. So is it the chloride in sodium, just as calcium chloride raises blood pressure when it's put in some canned vegetables to preserve color? These are some questions nutritionists are asking.

Do chefs put too much salt or spices into foods instead of letting customers decide whether they want to use the salt and pepper shakers on the tables?

What annoys nutritionists is that for years emphasis has been put on restaurants and food packagers and processors to lower the salt they put in food such as bread, frozen meals, canned soups, cheese, and other processed food items including restaurant food. The new study is saying that because sodium intake is regulated by your brain, your own body won't let you eat outside of that boundary. Your brain controls how much salt your body needs. Some people don't like spicy foods and others want the burning sensation of certain strong spices such as "ghost pepper" on various foods.

Nutritionists disagree and argue that if you put food in front of a person, the individual won't be able to tell how much salt his or her brain is going to limit the person from eating at that meal or during the day. Researchers also say that although the food supply contains too much salt, that doesn't necessarily mean that people are eating that much salt. On the other hand, the UC Davis researchers explain that your brain won't let you go very far outside the boundary of how much salt your brain tells your body that you really need.

The argument nutritionists have against the new evidence is that they might doubt your body actually would gravitate toward low sodium foods once you had enough salt?

In the study, researchers collected data from 20,000 adults in 32 countries. What researchers looked at was the evidence that the adult range of sodium intake was a narrow 2,700 to 4,900 mg of sodium (table salt or sea salt) each day. The cultures varied widely. This amount of sodium is far beyond what doctors, nutritionists, and HMOs hand out to patients to keep their salt levels below 1,500 mg a day if they have essential high blood pressure, and around 2,000 mg a day if they are not salt sensitive and don't have high blood pressure.

What the new research concludes is that people all over the world keep a normal range of salt intake for their own body, a pretty strict lower and upper limit on salt intake as determined by the human brain controlling what the rest of the body will eat.

The UC Davis study published evidence that your body, specifically your brain naturally adjusts the salt levels that you need without you adjusting your salt levels from the outside

Nutritionists want the FDA dietary guidelines to stay as they are. But the study's researchers think the FDA dietary guidelines regarding salt intake is too strict. The current FDA guidelines recommend no more than 2,300 mg of sodium be eaten each day, which is 14.8 percent lower than the latest research study's lower limit of 2,700 mg of salt daily.

The amount of salt the FDA recommends as the upper limit, is that for large males or small women, both, or averaged out? That's one question consumers would like to know. As for the study, even thought he evidence is clear, what should the priorities be for the average consumer--on salt intake or on childhood obesity? That's the big nutrition question of the year.

The studies are scientifically plausible. But as a consumer, who are you going to follow, your doctor that tells you to eat less salt to avoid the risk of heart disease and strokes or because your blood pressure is too high? Or the plausible evidence of the study?

Where you could turn to in order to read information on the topic is the Center for Science in the Public Interest, a Washington, DC nutritional advocacy group. Should you lower your salt intake or not? You'll find information online telling you to do one or the other. High salt intake mostly comes from processed foods. In prehistoric times, humans didn't use salt at all. They received salt from eating foods that already contain salt such as various animal proteins and plants such as celery, carrots, and parsley.

If you look at various tribes in Australia, for example and other areas of the world, many don't add salt to their natural foods and live on less than 1,000 mg of sodium daily

You can search the names of these areas online or look at the programs in various European countries such as Finland that has mixed magnesium in salt shakers on some restaurant tables in the past to get people to balance their sodium intake with magnesium and other multiple minerals in small, balanced amounts.

The decision you'll have to make as a consumer is whether the amount of salt you eat is posing a risk of heart disease, heart attack, or stroke or not, or whether your multiple minerals are balanced and in small enough amounts not to do any harm. So the ball is back in the nutritionist's court for now, but of course, the studies do go on, and the research, remember, is plausible. For further information, see the Sacramento Bee article, October 17, 2009, "Don't sweat your salt intake, UC Davis study says," by Anna Tong.

Some people might ask such questions as whose side are you going to take, if you take sides at all-- the UC Davis researchers, Center for Science in the Public Interest, or the UC Davis nutritionists?

How much hidden salt do you eat daily?

Ask yourself why is 180 mg of salt put into some brands of unsweetened almond milk, so that a salt-sensitive person can't enjoy drinking almond milk all day with meals when home-made almond milk is made only from soaked almonds and water? And is your health fine or challenged based on your sodium intake? You may want to check out the article, "Dietary Sodium and Cardiovascular Health in Hypertensive Patients: The Case against Universal Sodium Restriction," by Michael H. Alderman, Journal of the American Society of Nephrology, January 15, 2004. Or see, " DASH-Style Diet Associates with Reduced Risk for Kidney Stones," by Eric N. Taylor, Teresa T. Fung, and Gary C. Cu August 13, 2009. Journal of the American Society of Nephrology.

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