Perils of salt put into focus

High intake tied to hypertension

city launches education initiative

August 12, 2008|By Kelly Brewington | Kelly Brewington,Sun reporter

Baltimore has launched a citywide effort to educate the public on the dangers of high salt intake, which is associated with high blood pressure, particularly among African-Americans.

In a city that is nearly 65 percent black, the risks of hypertension, which can lead to heart attack, kidney failure and stroke, are especially high. The city Health Department is bringing together researchers and public health advocates starting in September to try to untangle the reasons for high salt consumption and offer recommendations for how city officials and food suppliers can decrease it.

The six-month-long effort was born out of a recent Health Department initiative to reduce health disparities caused by cardiovascular disease, the leading cause of death in Baltimore.

"The rates are much higher in Baltimore than other areas of the state," said Joshua M. Sharfstein, the city's health commissioner. "There are a lot of lives to be saved by reducing cardiovascular disease. You can connect the dots from high salt intake to excessive death rates in cardiovascular disease."

African-Americans have a particular sensitivity to the effects of salt on blood pressure and as a result tend to have higher blood pressure than other racial groups, city health officials said. In 2005, about 35 percent of the city's black population had high blood pressure, compared with nearly 27 percent of whites, according to the Health Department. And blacks are 15 percent more likely to die from heart disease than whites, officials say.

The National Heart, Lung and Blood Institute recommends that the elderly, those with high blood pressure and African-Americans of all ages restrict their sodium consumption to 1,500 milligrams per day. Meanwhile, the institute recommends no more than 2,300 milligrams for other groups. The average adult consumes nearly twice that recommended figure - 4,000 milligrams a day.

Dr. Elijah Saunders, a cardiologist and an expert on hypertension at the University of Maryland School of Medicine, said the effects an excessively salty diet can be dangerous. He hopes the effort to reduce salt consumption is similar to anti-smoking campaigns.

"We got criticized years ago for encouraging people not to smoke, and many people argued it was a choice," he said. "But we feel that sodium consumption and hypertension are very similar to smoking in that people need to be protected from things that can harm them."

Saunders said members of the task force will consider pushing restaurants and food industries to reduce salt in their products. And if necessary, they will work with the legislature to create sodium guidelines.

The issue is more complex than simply encouraging people to eat healthier, Sharfstein said.

"If every option you have has too much salt in it, you don't have much of a choice," he said. "I'm not saying every restaurant has this problem. But if there are not enough low-salt options, then what kind of choice is it?"

Education and awareness will be essential to the initiative, Sharfstein added.

"A lot of people don't know what's in the food they are eating," he said. "It's hard to hold them responsible if they are not getting the information to make a wise decision."

kelly.brewington@baltsun.com

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