Home' Australian Pharmacist : Australian Pharmacist April 2013 Contents 46 Australian Pharmacist April 2013 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
COUNSELLING IN PRACTICE
• None of the studies involved were
designed to look at patient orientated
outcomes e.g. stroke or heart attack
• It does not suggest that a high salt
intake is good for health.
It is important that established opinions
and recommendations are periodically
re-appraised, but it is concerning when
selective reporting misrepresents the
facts and threatens to derail a public
health message that has taken many
years to gather momentum. Pharmacists
are ideally placed to put the recent story
into context for consumers, so that they
can make informed choices about their
diet and lifestyle.
Should I keep limiting the amount
of salt in my diet?
In most cases, limiting salt intake is
appropriate and should be in line with
the recommendations described below.
As discussed earlier, one potential
exception is for those with medically
diagnosed postural hypertension.
There are a number of management
options for this condition, including
avoiding sudden changes in posture,
sympathomimetics and fludrocortisone,
but increased intake of salt (and water)
is also widely recommended, and exerts
its effect by expanding plasma volume.
In some cases this may be done by dietary
modification, but in other cases sodium
chloride tablets may be indicated.
What is an appropriate amount of
salt to consume per day?
There is a general consensus amongst
authorities around the world on this,
with most recommending the population
should aim to consume no more than 6 g
of salt per day.
People with elevated blood pressure
should aim for less than 4 g salt per day.
The same target is widely recommended
for those with cardiovascular disease
in general, but in particular heart
failure, given that sodium promotes
fluid retention and may therefore lead
to exacerbation of symptoms. In many
cases a lower intake may be desirable if it
can be achieved.
It has been estimated that the average
Australian consumes around 9--10 g salt
per day and in some cultural groups
(e.g. those from Eastern Europe and
Asia) typical intakes are likely to be
I'm confused by food packaging,
some things list salt, others sodium,
are they the same?
Yes and no. Salt (sodium chloride)
is generally considered to be the major
source of sodium intake for human
beings, but it is not the only one.
Other sodium salts that may be found in
the diet include monosodium glutamate,
sodium bicarbonate, sodium benzoate
and sodium nitrite. Whilst some foods
naturally contain a source of sodium
(e.g. milk and beets), it is sodium salts
added to processed and take-away
foods that provide the main source of
sodium for many people. This is a major
component of concerns accompanying
the trend towards greater consumption of
Many countries around the world now
mandate the use of nutritional labelling
to help consumers make informed
choices regarding their diet. Whilst this
is well-intentioned, it may actually be a
source of confusion and frustration when
it comes to watching sodium intake.
Sodium comprises about 40% of sodium
chloride, consequently something
containing 1 g salt provides around
400 mg of sodium. For those foods where
the nutritional labelling lists the sodium
content, it is necessary to multiply this
by 2.5 to convert to the salt equivalent.
As those monitoring their intake are
probably most likely to have a 'salt' target,
this is particularly important, otherwise
they may misinterpret the level and
ingest more than intended.
Where can I get more help?
Many of the organisations representing
the interests of patients with conditions
that may be affected by salt intake
produce a suite of excellent resources,
including information on healthy
eating generally and salt in particular.
These include the National Heart
Foundation and Stroke Foundation.
'...it is concerning
facts and threatens to
derail a public health
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