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SA’s health department unmoved by new salt study

The Department of Health has dismissed as a “red herring” a scientific review which found no evidence that cutting down on salt led to fewer heart attacks and deaths, and says it is pushing ahead with its plans to regulate the amount of the additive in processed food, Business Day reports.

Last week the Cochrane Library published an analysis of seven studies on salt consumption and health, which included 6 250 people with normal or high blood pressure. The reviewers concluded that small reductions in salt intake led to slightly lower blood pressure, but the data did not show a direct link between less salt and a reduced risk of cardiovascular disease and death. More research, involving many more patients, was needed to establish this tie, they said.

“It’s a bit of a storm in a tea-cup,” said the health department’s cluster manager for non-communicable diseases, Prof Melvyn Freeman. “I don’t think anyone is denying that hypertension pressure is a major cause of mortality. Our figures suggest high blood pressure is responsible for 40% … to 70% of heart disease and 50% of stroke.”

“There is nothing in the (Cochrane review’s) recommendations that suggests one should not be reducing salt in food. If anything it reinforces our belief you have to regulate (industry), because the studies didn’t follow up (participants) to see if they stuck to the diet recommendations afterwards,” he said. The health department planned to run public education campaigns to encourage South Africans to add less “discretionary” salt to their food, as regulation could only affect a portion of what South Africans put on their plates, he said.

Prof Krisela Steyn from the University of Cape Towns’ department of medicine agreed with Prof Freeman’s interpretation of the Cochrane review, saying the studies it included were too small to show lower salt intake meant lower risks of heart disease and death, but did not rule it out. So, too, did Sunita Potgeiter, a lecturer in nutrition from the University of Stellenbosch, who said:

“A 2009 review published in the Journal of Human Hypertension (found) strong evidence linking a high salt intake with the risk for developing high blood pressure and cardiovascular disease. (It) also concluded that a diet high in salt may lead to stroke, renal stones and renal disease, obesity, osteoporosis and stomach cancer, and that a reduction in salt intake can have a major impact on health.”

Health Minister Aaron Motsoaledi said in his budget speech to parliament on May 31 that he wanted to see the salt content of processed food regulated, as the amounts currently consumed by South Africans were dangerously high. The World Health Organisation recommends adults consume no more than five grams of salt a day, but the average South African consumed almost double that, at 9.8 grams, according to Prof Freeman.

He said the department had commissioned research into the sources of salt in South Africans’ diets, and would use this information to identify which products to target. Bread, gravy, soup, seasoning mixtures and cereals were among the products that were likely to come in for close scrutiny, he said. The research findings are due to be presented to the health department later this month.

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