Saturday, September 19, 2009

Cutting Salt Intake in US Could Save $50 Billion a Year

As organ transplant recipients we must be vigilant about our salt intake to keep our blood pressure in check and to prevent renal (kidney) damage. The recommended highest daily allowance for everyone is 2300 mg/day and the 1,500 milligram level can lower blood pressure further and more recently is the amount recommended by the Institute of Medicine as an adequate intake level and one that most people should try to achieve.

Shopping for low-sodium food can be a frustrating experience these days. I always check for sodium content and it's alarming to find so many foods with high salt content. I check everything before I buy it, especially canned soups, packaged and prepared meals, processed foods, luncheon and deli meats. You will find them loaded with salt. I recently read the sodium content in a can of chili and was frightened to see over 1,000 mg in a half-can serving. I put it back on the shelf immediately. Also, check for the serving size listed for the sodium content. Many producers show a very small serving size so as to make the salt content appear to be reasonable. For sodium content of fast food in restaurants such as McDonald's go to this link:

By Lisa Nainggolan
Medscape Pulmonary Medicine

September 17, 2009 (Santa Monica, California) — One of the first studies to estimate the economic benefits of lowering sodium consumption among the US public has found that $18 billion in healthcare costs for hypertension could be saved every year if salt intake were reduced to the amount recommended by health officials.

n addition, quality of life would be improved for millions of people, with a further potential saving of $32 billion annually, say Kartika Palar (RAND Pardee Graduate School , Santa Monica, CA) and Dr Roland Sturm (RAND, Santa Monica, CA) in their paper in the September/October 2009 issue of the American Journal of Health Promotion.

"This study provides an important first step toward quantifying the benefits of reducing the intake of sodium by the American public," says Palar in a statement [2]. "These findings make a strong case that there's value in pursuing a population-based approach to reducing sodium intake among Americans."

30% of US Have Hypertension, Much Due to Excessive Sodium Intake

Excessive consumption of salt is a persistent health problem in many parts of the world, and the US is no exception, say Palar and Sturm. Using population-level data on blood pressure, antihypertensive medication use, and sodium intake from the National Health and Nutrition Examination Survey (NHANES 1999–2004), they estimated that American adults consume around 3400 mg of sodium a day, when the recommended amount is 2300 mg/day. Only about 30% of the population eats less than 2300 mg/day, they say.

Their objective was to quantify the potential benefits of reducing salt consumption at the population level by considering both savings in healthcare costs and increases in quality of life. They modeled sodium-reduction scenarios by using a cross-sectional simulation approach and calculated the following outcome measures: hypertension prevalence, direct healthcare costs, and quality-adjusted life-years (QALYs).

Reducing average population sodium intake to the amount recommended (2300 mg/day) could reduce cases of hypertension by 11 million, saving $18 billion in direct healthcare dollars and gaining 312 000 QALYs that are worth $32 billion annually, say Palar and Sturm.

"Our results are driven by the fact that nearly 30% of the nation's population has hypertension," says Palar, adding that one of the reasons that high blood pressure is so pervasive is that sodium consumption is so excessive.

And although she and Sturm note a number of limitations to their study, they say their estimates are likely conservative, because they were unable to calculate the savings for illnesses such as cardiovascular diseases, where sodium consumption plays a less well-defined role.

Strategies Desperately Needed to Lower Sodium Intake in US

They stress that much better strategies for lowering sodium intake need to be developed in the US and that the main drivers must be changes to government regulations and/or voluntary actions by companies.

"Although clinicians can educate their patients about sodium intake, it is very difficult for individuals to reduce sodium intake. Studies estimate that 75% of dietary salt intake in the US population comes from processed foods rather than sources added during cooking or at the table," they explain.

"Without more accessible information, voluntary actions by companies, or government regulation, consumers may have difficulty reducing sodium consumption on their own."

They discuss strategies that have been successfully adopted elsewhere in the world, such as in the UK, where the Food Standards Agency has encouraged companies to use a traffic-light, front-of-package labeling system that identifies food products as low (ie, green), medium (yellow), or high (red) in sodium. This agency has also run an aggressive advertising campaign to lower salt consumption, they note.

In the US, although the FDA has recently opened proceedings to evaluate the regulatory status of salt and sodium, this has remained "unchanged for more than 40 years," they point out.

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