How can implementing a population-wide salt-reduction program be so hard?
For most of human evolution, the average daily diet contained a fraction of a gram of salt and our physiology developed accordingly.1 A few thousand years ago, with the discovery that salt could preserve food, average intake started to rise. Now, with salt poured into the food supply, average Australian consumption levels are many times our physiological need.2 Populations eating the level of salt upon which we evolved are now few, but they provide a window into normal physiological processes. One of the most notable findings is that their blood pressure levels do not rise with age.3
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- 1. Denton D. The hunger for salt: an anthropological, physiological and medical analysis. Berlin: Springer-Verlag, 1982.
- 2. Keogh JB, Clifton PM. Salt intake and health in the Australian population [letter]. Med J Aust 2008; 189: 526. <MJA full text>
- 3. Oliver WJ, Cohen EL, Neel JV. Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a “no-salt” culture. Circulation 1975; 52: 146-151.
- 4. Stolarz-Skrzypek K, Kuznetsova T, Thijs L, et al. Fatal and nonfatal outcomes, incidence of hypertension, and blood pressure changes in relation to urinary sodium excretion. JAMA 2011; 305: 1777-1785.
- 5. World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5–7 October 2006, Paris, France. Geneva: WHO, 2007.
- 6. National Blood Pressure and Vascular Disease Advisory Committee. Guide to management of hypertension 2008. Updated December 2010. Melbourne: National Heart Foundation of Australia, 2010.
- 7. Webster JL, Dunford EK, Hawkes C, Neal BC. Salt reduction initiatives around the world. J Hypertens 2011; 29: 1043-1050.
- 8. Bibbins-Domingo K, Chertow GM, Coxson PG, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med 2010; 362: 590-599.
- 9. Huggins CE, O’Reilly S, Brinkman M, et al. Relationship of urinary sodium and sodium-to-potassium ratio to blood pressure in older adults in Australia. Med J Aust 2011; 195: 128-132. <MJA full text>
- 10. Intersalt Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure: results for 24 hour urinary sodium and potassium excretion. BMJ 1988; 297: 319-328.
- 11. Begg S, Vos T, Barker B, et al. The burden of disease and injury in Australia 2003. Canberra: Australian Institute of Health and Welfare, 2007. (AIHW Cat. No. PHE 82.)
- 12. Australian Institute of Health and Welfare. Health expenditure Australia 2003–04. Canberra: AIHW, 2005. (AIHW Cat. No. HWE 32.)
- 13. Rodgers A, Ezzati M, Vander Hoorn S, et al. Distribution of major health risks: findings from the Global Burden of Disease Study. PLoS Med 2004; 1 (1): e27.
- 14. Briganti EM, Shaw JE, Chadban SJ, et al. Untreated hypertension among Australian adults: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 2003; 179: 135-139. <MJA full text>
I am the Chair of the Australian Division of World Action on Salt and Health. I receive research support from the Australian Food and Grocery Council and New South Wales Health, and am a member of the PepsiCo Global Scientific Advisory Board. I receive salary support from an Australian Research Council Future Fellowship.