Heart failure and salt

Now the salt in the food is healthy after all.

For years, they said, “Less salt! But consuming less of it could even be harmful.

The salt shaker should simply be banned, as many doctors have claimed for years. Salty food raises blood pressure, makes people ill and shortens their lives, the reason given for the non-lifelike request. But the harmfulness of salt is by no means clearly proven, and its effects on blood pressure are minimal, according to new studies.

According to new studies, strict low-salt diets can even endanger health. According to studies, the daily salt intake of Germans is nine grams (men) or 6.5 grams (women). Too much, say experts among other things of the citizens of Berlin Federal institute for risk evaluation: The salt admission is to be reduced to 3,5 to six gram. The World Health Organization (still) expresses itself similarly.

Too little salt can be fatal

But the doubts have grown. As early as 2009, the Institute for Quality and Efficiency in Health Care (IQWiG) in Cologne, which is committed to independence, evaluated the data from seven overview studies that were judged to be of high methodological quality. Result: The restriction of salt consumption lowers blood pressure to varying degrees. But a benefit of a diet reduced by salt for cooking in patients with high blood pressure has “so far not been proven”. With little salt, the blood pressure drops, but therefore one does not live better or longer.

The salt hypothesis suffered a further setback as a result of a particularly extensive analysis by experts from the Cochrane Collaboration. This non-profit research organisation uses strict criteria to produce systematic overviews for therapy assessment.

A team led by Niels Albert Graudal from the University Hospital of Copenhagen evaluated the results of 167 studies with thousands of participants. Result: A salt restriction causes only a minimal reduction in blood pressure. The upper value drops on average by 1.27 mmHg, the lower by only 0.05 mmHg. However, this is bought by an increase in stress hormones.

The last setback for the time being was suffered by the anti-salt fraction through six major studies with 2747 participants. They all had heart failure and ate either normal or very small amounts of salt. The determinants were total mortality, sudden cardiac death and heart failure. The experts were astonished by the result: The group of people with a low salt diet was almost without exception more at risk than the heart patients with normal salt consumption.

The war over salt in food is reminiscent of the battle between butter and margarine, which has been undecided since the 1970s. Economic interests also play a role in salt, which can also have an effect on scientific studies. Most of the salt consumed every day does not come from the salt shaker, but from finished products, preserves, bread, pastries, cheese and sausage.

There is no doubt that table salt (NaCl = sodium chloride) is indispensable. It regulates the water balance, maintains tissue tension and activates metabolic processes. Sodium and chloride also act as signal substances in the nervous system.

The renouncement of salt can be particularly risky with older humans, says the resident of Munich nourishing expert Peter Schnabel, because with the age the liquid content of the body changes: ?While the liquid portion of a baby lies with approximately 82 per cent of its body weight, the value sinks up to the old age to approximately 52 per cent. Older people are full faster, have less thirst and drink too little.

Dehydration, i.e. the lack of fluid and salt or of fluid alone, is therefore a frequent disturbance of the fluid and electrolyte balance of older people.”

Enjoyment is especially important in old age

The situation is aggravated by nutritional deficiencies, such as dental problems, a scarce pension or isolation in old age. Taking medication can also affect the balance of body fluid. Peter Schnabel: “This is particularly the case with drugs that have a direct influence on water excretion or electrolyte metabolism. Taking diuretic drugs, for example, results in an excessive loss of fluid to the point of dehydration, but also in the loss of sodium or potassium”.

The still frequently given advice to abstain from salt because of the often increased blood pressure in old age can thus upset the organism’s balance and cause the blood pressure to drop excessively – with the result that the brain and other organs are undersupplied.

Dehydration can also cause confusion, which the environment thinks is dementia. However, seniors are mentally fit again after a sufficient supply of fluids. For many elderly people, good food is the last “pensioner’s happiness”. Dietary regulations of earlier times – bland and soft – have long been a thing of the past, and rightly so. And according to the state of medical research, senior citizens do not have to save on salt either.

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