Salt and themediterranean diet

Transcription

1 World Food Day 2015 / Svetovnidan hrane2015 Salt and themediterranean diet Urška Blaznik

2 Salt Love without kisses is like bread without salt. Slovenian proverb 2015

3 Objectives Salt types and characteristics Recommendations for the intake of salt Salt and health risks Sources of salt in the Mediterranean diet Salt and health benefits Challenges for the future

4 Salt types and characteristics Food grade salt - salt used as an ingredient of food, both for direct sale to the consumer and for food manufacture. The content of NaCl shall not be less than 97%. It is obtained from the sea, from underground rock salt deposits or from natural brine.

5 Salt types and characteristics Sea salt Slovenia Piranske soline. On the market variety of salts (underground rock salt, evaporated salt, rarely salt from natural brine).

6 Salt types and characteristics The remainder (< 3%) - natural secondary products, present in varying amounts depending on the origin and the method of production of the salt. Natural contaminants.

7 Recommendations for the salt intake Sodium x 2,5 = NaCl (salt) WHO, 2012

8 Salt intake in Slovenia Children (food diaries, weighing meals): 5 g NaCl/p/d (Hlastan Ribič et al., 2006) Adolescents (foodfrequencyquestionnaire): 10,4 g NaCl /p/d (Štimec etal., 2009) Adults (24h urine samples, excretionofna): 12,4 g NaCl /p/d (Hlastan Ribič et al., 2010)

9 Salt intake in Slovenia Salt intake (g/d) Male (n=61) Female (n=82) Mean SD Hlastan Ribič C et al. Public Health Nutrition 2010;13(11): Salt intake (g/d) Alps Seacoast Central Region Mean SD

10 Salt and health risks Experimental, epidemiological, migration, and intervention studies have shown a causal relation between habitual dietary salt intake and blood pressure. Population based intervention studies and metaanalyses of randomised controlled trials have shown that it is possible to achieve significant reductions in blood pressure with reduced salt intake in both hypertensive and normotensive individuals. WHO, 2012

11 PREVALENCE OF HIGH BLOOD PRESSURE IN ADULTS IN % (CINDI HEALTH MONITOR SURVEY ) NIJZ,

12 PREVALENCE OF HIGH BLOOD PRESSURE IN ADULTS EDUCATIONAL LEVELS IN % (CINDI HEALTH MONITOR SURVEY ) NIJZ,

13 Salt and health risks Higher salt intake is associated with significantly greater incidence of strokes and total cardiovascular events, with a dose dependent association A difference of 5 g a day in habitual salt intake is associated with a 23% difference in the rate of stroke and 17% difference in the rate of total cardiovascular disease. Each year a 5 g reduction in daily salt intake at the population level could avert some one and a quarter million deaths from stroke and almost three million deaths from cardiovascular disease worldwide. Strazzulo, 2009

14 Sources of salt in the diet 75% of sodium intake comes from processed or restaurant foods, 10 12% is naturally occurring in foods, 10 15% discretionary use of salt in home cooking or at the table. Elliott, 2006

15 Sodium availability in food in Slovenia The key food group contributors of sodium in Slovenia were breads and bakery products (35.0%), meat products (27.9%), processed vegetables (6.6%) and cheeses (5.3%). Hlastan Ribič,

16 SALT CONTENT IN BREAD, MEAT PRODUCTS AND MEALS Salt content in meat products Year Interval g/100g N ,7 2, ,0 4, ,6 2,8 20 Salt content in meals Year g/100g ,3 (mean value) 2012 Interval 0,3 1,9 20 % of all samples > 10g NaCl per meal! Source: Nacionalni akcijski načrt za zmanjševanje uživanja soli pri prebivalcih Slovenije MZ, 2010; neobjavljena raziskava IVZ, 2012

17 COMMUNICATION TOOLS - POSTERS

18 The Mediterranean diet Among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events. Estruch, 2013 Studies suggested an independent, protective effect of healthy dietary habits on CVD risk, with an attributable risk varying from 9 to 37%. Inclusion of diet component in CVD risks scores, may increase the accuracy of the models, and better identify people at high risk. Georgousopoulou,

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20 Sources of salt in the Mediterranean diet Hidden salt Visibly salt BREAD CHEESE PICKLED OLIVES PROCESSED FOODS COOKING AT THE TABLE

21 Salt and health benefits Moderate consumption of salt. Reducing salt in processed foods and meals. Healthier food NATIONAL ACTION PLAN TO DECREASE DIETARY SALT CONSUMPTION IN SLOVENIAN POPULATION IN THE PERIOD Promotinghealthand consumer education Better blood pressure monitoringin primary healthcare settings

22 Salt and health benefits - iodine In iodine-deficient areas, food grade salt shall be iodised to prevent iodine-deficiency disorders (IDD) for public health reasons. Codex Alimentarius, Codex Standard for Food Grade Salt, 1985 Reduced incidence of goiter in mediterranean areas is probably a consequence of iodine intake from all food sources, especially fish and seafood.

23 GOITER PREVALENCE IN SLOVENIAN SCHOOLCHILDREN AND ADOLESCENTS Goiter prevalence in % mg KI / kg (1953) 22, mg KI / kg (1999) 0, Year of survey Kotnik P, Sirca Campa A, Zupancic M, Stimec M, Smole K, Mis NF, Battelino T, Krzisnik C. Goiter prevalence and urinary iodine concentration in Slovenian adolescents. Thyroid Aug;16(8):

24 Challenges for thefuture Salt intake can be reduced with salt reduction in bread and with moderateuse of salty cheeses, meat products or pickled vegetables. With gradual reduction of salt intake also intake of iodine would be reduced - which shall be carefully followed with appropriate actions.

25 Thank you /Hvala NACIONALNI INŠTITUT ZA JAVNO ZDRAVJE Trubarjeva Ljubljana info@nijz.si 2015