Your body depends on the mineral potassium to help control the electrical balance of your heart as well as metabolize carbohydrates and build muscle.

Low potassium levels can cause muscle weakness and heart rhythm disturbances. On the other hand, too much potassium can cause dangerous heartbeat irregularities and even sudden death. If you have heart failure, you need to pay close attention to how much potassium you get each day. What’s more, some heart failure drugs can cause your body to excrete too much potassium, while others can cause your body to retain too much potassium.

Your doctor can tell you how the medications you need will affect your potassium levels. You’ll likely need to have your potassium level checked regularly to be sure it is within a good range for you.

If you need to raise your potassium level:

If your potassium level is too low, the solution may be as simple as taking potassium supplements.

If you need to get your potassium level down:

If your potassium level is too high, you may need to cut back on certain foods (see the table). These tips can also help:

• Soak or boil vegetables and fruits to leach out some of the potassium.
• Avoid foods that list potassium or K, KCl, or K+ — chemical symbols for potassium or related compounds — as ingredients on the label.
• Stay away from salt substitutes. Many are high in potassium. Read the ingredient lists carefully and check with your doctor before using one of these preparations.
• Avoid canned, salted, pickled, corned, spiced, or smoked meat and fish.
• Avoid imitation meat products containing soy or vegetable protein.
• Limit high-potassium fruits such as bananas, citrus fruits, and avocados.
• Avoid baked potatoes and baked acorn and butternut squash.
• Don’t use vegetables or meats prepared with sweet or salted sauces.
• Avoid all types of peas and beans, which are naturally high in potassium.

From fast food restaurants and delis exploding with high-calorie sandwiches to salad bars stocked with high fat and high sugar salad add-ons — lunchtime can be a minefield of temptation for those trying to eat a healthy and balanced diet.

But a healthful and enjoyable lunch can be done. These simple tips can help.

Your meal should include lean protein, whole-grain carbohydrates, and produce. Roughly half of your plate should be vegetables or fruit; one-quarter should be lean protein such as fish, chicken, turkey, tofu, beans, or low-fat cottage cheese; and one-quarter should be whole grains, such as one slice of whole-grain bread, or half a cup of brown rice, whole-wheat pasta, or quinoa. You might include a small amount of healthy fat, such as a tablespoon of oil-and-vinegar dressing on your salad.

Salad can be a good way to go, but you need to be careful. Regular salad dressings, cheeses, and mayonnaise-based salads (such as tuna, chicken, and egg salads) can contain unhealthy fats, hidden sugar, and salt. Not to mention lots of calories. Here’s the trick to a healthy and satisfying lunch salad.

Step 1: Build a vegetable base. Load your plate with leafy greens and raw or grilled vegetables.

Step 2: Add some protein — a few scoops of garbanzo or kidney beans. Beans are an excellent source of fiber — and they’re filling! Other good selections include grilled chicken, low-fat cottage cheese, or chopped eggs. Go light on the cheese. A sprinkle of a strongly flavored cheese like feta or Parmesan can deliver flavor with fewer calories.

Step 3: Add a small amount of healthy fat. Sprinkle on the nuts and seeds. They are high in heart-healthy unsaturated fat and healthy protein, give you a feeling of fullness, and help food stay in your stomach longer. You might also opt for a dash of oil and vinegar.

Step 4: Whole grains and fruit make a nice addition to a creative salad. Look for whole grains like barley or bulgur wheat to sprinkle on top. Or add a few slices of fruit.

If you want to learn about other effective strategies for healthy eating contact Ronald on 07929 256856

Osteoporosis means ‘bones with holes’. Bones lose their strength and density, become fragile and break (fracture) more easily because of calcium loss. Breaks are most common in the spine, hip and wrist and often occur after only a minor fall or knock. Osteoporosis particularly affects women in their middle and later years, although some men are also affected.

Most people show no signs of developing osteoporosis until a fracture occurs. Both men and women can take steps from a young age to avoid developing the condition in later life. Reduce your risk of fractures by taking steps to prevent and treat osteoporosis (or brittle bones) and avoid falls wherever possible. Activity and a healthy diet rich in calcium and vitamin D are both important.

Osteoporosis and bone growth
Bone is formed by specialised cells. Like the rest of the body, bone is constantly being broken down and renewed. It is living tissue that needs exercise to gain strength, just like muscle. In the early years of life, more bone is made than is broken down, resulting in bone growth. By the end of your teens, bone growth has been completed and ‘peak bone mass’ is achieved.

Sex hormones, such as oestrogen and testosterone, have a fundamental role in maintaining bone strength in men and women. The fall in oestrogen blood levels that occurs during menopause results in accelerated bone loss. During the first five years after menopause, the average woman loses up to 10 per cent of her total body bone.

Fractures of the spine caused by osteoporosis can lead to loss of height, pain and changes in posture such as the ‘Dowager’s hump’. This hump is caused when spinal fractures are compressed due to the force of gravity, resulting in an abnormal bending of the spine (kyphosis).

Symptoms
Osteoporosis causes no specific pain or symptoms. However, it does increase the risk of serious or debilitating fractures. If you think you may be at risk of developing osteoporosis, see your doctor.

Risk factors for osteoporosis
Several factors can place a person at risk of osteoporosis. Risk factors include:

• Family history of osteoporosis (mother, sister or grandmother)

• Inadequate amounts of dietary calcium

• Low vitamin D levels

• Cigarette smoking

• Alcohol intake of more than two standard drinks per day

• Caffeine intake of more than three cups of tea, coffee or equivalent per day

• Lack of physical activity

• Early menopause before the age of 45

• Loss of menstrual period if it is associated with reduced production of oestrogen, which is vital for healthy bones (the menstrual cycle can cease following excessive dieting and exercise)

• Long-term use of medications such as corticosteroids for rheumatoid arthritis and asthma.

Some conditions place people at a higher risk of osteoporosis. These conditions include:

• Thyroid disease or an over active thyroid gland

• Rheumatoid arthritis

• Chronic liver and kidney disease

• Conditions that affect the body’s ability to absorb nutrients, such as Crown’s disease, coeliac disease and other inflammatory bowel conditions.

Preventing osteoporosis
Both men and women can take steps from a young age to prevent osteoporosis by making sure that they:

• Have a healthy and varied diet with plenty of fresh fruit, vegetables and whole grains

• Eat calcium rich foods

• Absorb enough Vitamin D

• Avoid smoking

• Limit alcohol consumption

• Limit caffeine

• Do regular weight bearing and strength training activities.

A varied and calcium rich diet is the key
We need calcium to build and maintain strong and healthy bones, help our muscles work and support our nervous system. Good sources of calcium include:

• Dairy foods – low fat varieties are available to reduce the risk of weight gain or raised cholesterol levels

• Canned fish with edible bones – for example, sardines.

The minimum recommended daily intake of dietary calcium is:

• Infants (under 12 months) – 210–270mg calcium per day

• Children (over four years) – 700–1,000mg calcium per day

• Adolescents – 1,300mg calcium per day

• Women under 50 and men under 70 – 1,000mg calcium per day

• Post menopausal women and men over 70 – 1,300mg calcium per day.

Adequate vitamin D
Vitamin D levels are increased with sun exposure. People who are housebound or who dress with most of their body covered are at risk of vitamin D deficiency. The majority of women have inadequate levels of vitamin D during winter months. All that is needed is 10–20 minutes of sun exposure to the arms and face daily, without sunscreen and not through glass. Sun exposure is safest before 11am or after 3pm.

Avoid smoking
Evidence has shown that smokers have a lower bone density. Nicotine is known to be toxic to bone cells.

Limit alcohol intake
Excessive alcohol consumption is associated with the development of osteoporosis. Restrict your alcohol intake to no more than two standard drinks on any one day for both men and women to reduce your risk. Everyone should have at least two alcohol-free days each week.

Reduce caffeine intake
A large amount of caffeine (more than two to three cups per day of cola, tea or coffee) has also been associated with an increased risk of osteoporosis.

Do regular weight bearing and strength training activities
You should exercise at least 30 minutes three to four times a week to maintain healthy bones. Recommended activities are:

• Walking

• Jogging

• Tennis

• Dancing

• Using weights.

This helps maintain bone strength and balance so falls are reduced.

Diagnosis
The most reliable way to diagnose osteoporosis is to measure bone density using a DEXA scan. This is done with x-ray technology that involves minimal radiation, is accurate and can be used to follow up treatment.

Ultrasound tests are available at many pharmacies and involve an ultrasound measurement of the heel. These tests are not as accurate in assessing for osteoporosis as a DEXA study and are not recommended by doctors.

It’s never too late for treatment
If you have osteoporosis, it is never too late to seek treatment. Treatment can halt bone loss and significantly reduce the risk of fractures. It is important that your doctor excludes other medical conditions that can cause osteoporosis, including vitamin D deficiency.

Medications and treatments are available to strengthen bones and prevent fractures by slowing down bone loss. They may improve bone density in women with osteoporosis after the menopause.

Available medical treatments include:

• Bisphosphonates – such as alendronate, risedronate and zolindrinic acid, which can be combined with vitamin D and calcium

• Strontium ranelate – also called Protelos

• Selective oestrogen receptor modulators (SERMs) – in the form of raloxifene

• Vitamin D derivatives and calcium supplements

• Hormone replacement therapy (HRT) – short-term use of oestrogen and progestogen at menopause.

Other potential therapies that may be used as treatment include parathyroid hormone.

Hormone replacement therapy
All treatments for osteoporosis aim to prevent fractures. Oestrogen replacement at menopause prevents bone loss and fractures, but the effect lasts only as long as oestrogen is used.

Oestrogen can be is used to prevent fractures mainly for younger women with premature menopause. This is because most fractures do not occur until after the age of 65 and long-term oestrogen use is not recommended.

Falls are a risk for people with osteoporosis
For people with osteoporosis, even minor trauma – such as coughing, knocks on the limbs and simple falls – can lead to fractures. Falls are a particular problem in the elderly as they are often more likely to result in fractures, particularly of the hip. Any fracture occurring from minimal trauma should be investigated as it may indicate underlying osteoporosis.

There are several ways to reduce your risk of falls. It may be necessary to see a physiotherapist and/or occupational therapist to provide assistance with walking aides and ensure your home environment is safe. Talk with your doctor or contact your community health centre to find the services you need.

Things to remember

• Osteoporosis occurs when bones lose their density and strength.

• A healthy lifestyle throughout life (adequate dietary calcium and regular physical activity) can help prevent osteoporosis.

• Oestrogen replacement helps maintain bone density in women with premature menopause.

Stroke is the interruption of blood to the brain. This may be due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain. The most common type of stroke is ischaemic, caused by a blood clot blocking an artery or blood vessel. The brain cells in the immediate area die and those in the surrounding areas are affected by the reduced blood flow. Once brain cells die, their functions die with them.

An estimated 150,000 people have a stroke in the UK each year.Stroke accounts for around 53,000 deaths each year in the UK. Stroke is the third most common cause of death in England and Wales, after heart disease and cancer. Stroke accounts for 9 per cent of all deaths in men and 13 per cent of deaths in women in the UK. Stroke has a greater disability impact than any other chronic disease. Over 300,000 people are living with moderate to severe disabilities as a result of stroke. The direct cost of stroke to the NHS is estimated to be £2.8 billion. The cost to the wider economy is £1.8 billion. The informal care cost is £2.4 billion. Stroke patients occupy around 20 per cent of all acute hospital beds and 25 per cent of long term beds. Stroke units save lives: for stroke patients general wards have a 14% to 25% higher mortality rate than stroke units. Each year over 130,000 people in England and Wales have a stroke. About 10,000 of these are under retirement age.

Stroke is influenced by different risk factors. Some of these – age, gender and family history – are beyond your control. However, you can substantially reduce your overall risk by making healthy changes to your diet and lifestyle.

TIA or transient ischaemic attack
A transient ischaemic attack (TIA) is often called a ‘mini stroke’. It is a powerful warning that a severe stroke may follow. The symptoms are identical to those of a full stroke, but disappear in a few minutes and last no longer than 24 hours. A TIA can appear hours, days, weeks or months before a full stroke but is more common within days or a few weeks. Just like full strokes, TIAs need emergency treatment and should not be ignored.

Warning signs
Stroke is a medical emergency. The longer a stroke remains untreated, the greater the degree of stroke-related brain damage. The warning signs of both stroke and TIA include:

• Sudden blurred or decreased vision in one or both eyes

• Numbness, weakness or paralysis of the face, arm or leg

• Difficulty speaking or understanding

• Dizziness, loss of balance

• Difficulty swallowing

• Severe headache.

High blood pressure
Blood pressure is a measurement of the force your blood puts on blood vessel walls as it travels through your body. High blood pressure is medically known as ‘hypertension’ and is one of the most important risk factors in stroke.

Normal blood pressure is around 120/80. High-normal blood pressure is between 120/80 and 140/90. If your blood pressure is consistently over 140/90, you have high blood pressure. The levels for normal blood pressure are a guide only. In general the lower your blood pressure, the lower your risk of stroke. Your doctor can talk to you about your blood pressure and risk of stroke and may recommend treatment if required.

You can control hypertension by reducing your weight, exercising regularly, eating a low salt, low fat and high fibre diet, and taking antihypertensive medication (if necessary).

Cigarette smoking
Smoking can increase your risk of stroke by increasing blood pressure and reducing oxygen in the blood. Seek advice on how to quit smoking by calling the NHS Free Smoking Helpline: 0800 022 4 332 Monday to Friday 9am to 8pm, Saturday and Sunday 11am to 5pm for guidance and support.

Diabetes
Diabetes can damage your entire circulatory system and is a risk factor for stroke. Type 1 usually occurs from a young age and is treated with insulin injections. Type 2 usually occurs from 30 years of age onwards and is treated with either tablets or, in some cases, insulin. Talk to your doctor about controlling diabetes if you are diabetic.

Other important risk factors
Other factors that can increase your risk of stroke include:

High cholesterol
High cholesterol is a contributing factor to blood vessel disease, which often leads to stroke. To reduce cholesterol in your blood, eat foods low in saturated fat. Choose lean meats and low fat dairy products. Your doctor may prescribe medication to lower your cholesterol but diet changes and exercise are still important.

Obesity
Being overweight or obese can increase the risk of stroke. Too much body fat can contribute to high blood pressure and high cholesterol and may lead to heart disease and type 2 diabetes. If you are unable to maintain your weight within recommended levels, ask a doctor or nutritionist for help.

Alcohol
Your risk of stroke may be reduced with moderate alcohol intake (one to two glasses a day). Excessive amounts of alcohol can raise blood pressure and increase your risk of stroke.
Diet and exercise
A diet low in fat and salt will reduce your risk of stroke. Eating a balanced diet of fresh foods (wherever possible) is recommended. Avoid processed or canned foods as they can be high in sodium, or salt. Check a food’s sodium content in the list of ingredients on the label (low salt food has a level of less than 120mg/100g).

A good balance between exercise and food intake is important to maintain a healthy body weight. People who participate in moderate activity are less likely to have a stroke. Try to build up to at least 30 minutes of moderate physical activity most days of the week. Talk to your doctor about an exercise program – people with high blood pressure should avoid some types of exercises.

Irregular pulse (atrial fibrillation)
You are more at risk of stroke if you have an irregular pulse due to the condition atrial fibrillation (AF). Your doctor can diagnose this condition and advise you on how best to manage this if it happens. If you experience symptoms such as palpitations, weakness, faintness or breathlessness, it is important to see a doctor for diagnosis and treatment.

Risk factors beyond your control
Stroke is influenced by some risk factors that are outside a person’s control. These include:

• Age – the majority of people who suffer from stroke are 65 years or older.

• Gender – men are at higher risk than women.

• Family history – a family history of cerebrovascular disease may make you more susceptible to stroke.

Statistics on stroke
Each year over 130,000 people in England and Wales have a stroke:

• One in three people die within a year of having a stroke.

• Stroke kills more women than breast cancer.

• Almost one in five people who experience a stroke are under the age of 55.

• Men are more likely to suffer a stroke and at a younger age.

Things to remember

• Stroke may occur due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain.

• Many strokes are avoidable and can be caused by unhealthy diet and lifestyle choices.

• Some of the major risk factors for stroke include high blood pressure, cigarette smoking and diabetes.

Stroke prevention

Strokes can be fatal but the risk can be reduced. Many stroke risk factors are lifestyle related, so everyone has the power to reduce their risk of having a stroke. Some stroke risk factors, such as gender, age and family history, can’t be controlled.

Lifestyle factors that increase your risk of stroke include high blood pressure, smoking, diabetes, high blood cholesterol levels, heavy drinking, a diet high in salt and fat and lack of exercise. You can reduce your risk of having a stroke by making a few simple lifestyle changes.

Causes of stroke
‘Stroke’ is a term used to describe the interruption of blood flow to an area of the brain. This can occur in the following ways:

• Haemorrhagic stroke – an artery may rupture and cause bleeding into the brain tissue.

• Ischaemic stroke caused by atherosclerosis – an artery may become blocked by progressive thickening of its walls.

• Ischaemic stroke caused by embolism – a clot blocks an artery and prevents blood getting to part of the brain.

The brain cells in the immediate area are killed because they are deprived of oxygen. The dead area that results from stroke is known as an infarct. Without prompt medical treatment, the area of brain cells surrounding the infarct will also die.

Risk factors
Some stroke risk factors can’t be controlled. These include gender, age and family history. However, many stroke risk factors are lifestyle related. Everyone can reduce their risk of having a stroke by making a few simple lifestyle changes.

Lifestyle-related factors that increase your risk of stroke include:

• High blood pressure

• Cigarette smoking

• Diabetes

• High blood cholesterol levels

• Heavy drinking

• High fat, low fibre diet

• Lack of exercise.

It has been reported that the use of some birth control pills may increase a woman’s risk of stroke, but the evidence is limited.

Reduce high blood pressure
High blood pressure (hypertension) is the most significant risk factor for stroke. Blood pressure refers to the pressure inside the arteries. Hypertension means that the blood is exerting more pressure than is normal or healthy. Over time, this weakens and damages blood vessel walls, which can lead to cerebral haemorrhage.
Hypertension may also cause thickening of the artery walls, resulting in narrowing and eventual blockage of the vessel (ischaemic stroke). In atherosclerosis (hardening of the arteries), the pressure of your pumping blood could ‘hose off’ debris from damaged artery walls. The circulating debris (embolism) can cause a stroke by lodging in and blocking a blood vessel of the brain.

Strategies to reduce high blood pressure include:

• Check your blood pressure regularly and know your numbers.

• Maintain a healthy weight for your height.

• Exercise regularly.

• Choose a low fat, high fibre diet.

• Reduce or eliminate salt from your diet.

• Limit your alcohol intake to two or less standard drinks per day.

• Stop smoking.

• Take antihypertensive medications to help control high blood pressure.

Quit smoking
Smoking can double or even quadruple your risk of stroke. Some of the chemical ingredients in cigarette smoke (such as nicotine and carbon monoxide) accelerate the process of atherosclerosis. Clots are more likely to form because smoking thickens the blood and makes clotting factors, such as platelets, much more ‘sticky’. Cigarette smoke forces arteries to constrict – a narrowed diameter makes it harder for the thickened blood to move through the vessels.

Strategies to quit smoking include:

• Seek advice on how to quit smoking by calling the NHS Free Smoking Helpline: 0800 022 4 332 Monday to Friday 9am to 8pm, Saturday and Sunday 11am to 5pm for guidance and support or see your doctor for information and advice.

• Decide on a strategy, such as ‘cold turkey’ or using nicotine replacement therapy.

• Keep a smoking diary so that you are aware of your smoking triggers (such as stress or boredom).

• Decide on a quit date.

• Ask your family and friends for support.

• Don’t be discouraged by a slip-up. If you smoke a cigarette, put it behind you and keep going.

Manage your diabetes
Diabetes is a chronic condition in which the body is unable to utilise blood sugar. A person with diabetes is around twice as likely to have a stroke as someone of the same gender and age who doesn’t have diabetes. This is because the high blood sugar levels contribute to the development of atherosclerosis. It is very important that diabetes be kept under control.

Strategies to reduce the effects of diabetes include:

• See your doctor regularly for check-ups.

• Monitor your blood sugar levels regularly.

• Maintain a healthy weight for your height.

• Exercise regularly.

• Choose a low fat, high fibre diet.

• If you are on medication, make sure you are taking it correctly.

Keep cholesterol levels in check
Cholesterol is a fat-like substance that is made by the human body. It has many essential roles to play, but it becomes a problem if levels in the blood are too high. Blood cholesterol contributes to the formation of a substance called atheroma, which sticks to artery walls and leads to atherosclerosis.

Strategies to lower blood cholesterol levels include:

• Have your blood cholesterol levels checked regularly by your doctor.

• Switch to a high fibre diet.

• Reduce your intake of saturated fats (commonly found in animal products).

• See your doctor for information and advice. Medications may be recommended.

Avoid heavy drinking
Some studies have indicated that drinking moderate amounts of alcohol (such as one or two standard drinks per day) can actually reduce the risk of stroke. However, people who drink heavily are three times more likely to have a stroke, regardless of their age. It is important to limit your alcohol intake.

Suggestions include:

• Limit your consumption to no more than two standard drinks per day.

• Have at least two alcohol-free days every week.

• See your doctor for information and referral if you are finding it difficult to limit your alcohol intake.

Eat a healthy diet
Various studies show that diet is an important risk factor in the development of stroke. Suggestions include:

• Limit or moderate salt intake.

• Choose fresh rather than processed foods.

• Increase your intake of vegetables, fruit and whole grains.

• Cut out or reduce sugary and fatty foods like cakes, lollies and junk food.

• See a dietitian who can help you plan a well-balanced low fat, high fibre diet.

Exercise regularly
A sedentary lifestyle increases the likelihood of obesity, high blood pressure and high blood cholesterol levels. These are all important risk factors for stroke.

Suggestions include:

• See your doctor for a check-up if you haven’t exercised for a while.

• Choose a range of activities you enjoy.

• Start your new exercise program slowly and only increase the intensity and duration as you become fitter.

• Exercise with a friend or join a team sport to add a fun social element to the activity.

• Remember to warm up and cool down.

• Contact a physiotherapist or gymnasium instructor for advice and information regarding appropriate exercise.

• Try to get moderate exercise for at least 30 minutes on (at least) five days of the week.

Things to remember

• A stroke interrupts blood flow to an area of the brain.

• Most stroke risk factors are lifestyle related, so everyone has the power to reduce their risk of having a stroke.

• Some stroke risk factors, such as gender, age and family history, can’t be controlled.

• Lifestyle factors that increase your risk of stroke include high blood pressure, smoking, diabetes, high blood cholesterol levels, heavy drinking, high salt and high fat diet and lack of exercise.

Salt

Salt is a chemical compound (electrolyte) made up of sodium and chloride. It is commonly used to preserve and flavour foods, and is the main source of sodium in our diet. A small amount of salt is important for good health – it helps to maintain the correct volume of circulating blood and tissue fluids in the body. However, most people consume much more sodium than they need for good health.

The kidneys are the main regulators of sodium levels in the body. Too much sodium can cause high blood pressure and many other health conditions. On the other hand, if sodium levels drop too low, the hormone aldosterone is released and this increases the amount of sodium held in the body by reducing the amount lost in urine. Excessive sodium loss is very rare, but low sodium levels in the body can be dangerous if not treated.

Many of us in the UK eat much more salt than we need
As part of its continued drive to reduce people’s risk of developing coronary heart disease, the Food Standards Agency has today published revised, voluntary salt reduction targets for industry to meet by 2012. More challenging targets for 2012 have been set for 80 categories of foods, to ensure the momentum in reducing salt levels is maintained by food retailers and manufacturers. The revised targets also reflect the Agency’s long-term commitment to reducing the daily average population intake of salt to 6g a day. Around 75% of the salt we eat is already in everyday foods. The targets have been set for foods that make the greatest contribution of salt to our diet, such as bread, meat products and cereals, as well as convenience foods such as pizza, ready meals and savoury snacks.

High sodium intake and blood pressure
The scientific literature linking sodium intake to blood pressure is extensive and dates back more than 100 years. Populations with a high average salt intake have a higher average blood pressure and higher levels of hypertension (high blood pressure).

Reducing the amount of salt you have will lower high blood pressure – the extent depends on your age and blood pressure. People with high blood pressure, diabetes or chronic kidney disease, and those who are older or overweight, are particularly susceptible to the effect of too much sodium on blood pressure. However, sodium reduction may not lower blood pressure in younger people with low or normal blood pressure.

High sodium intake and other health conditions
Excessive sodium intake has also been linked to other conditions, such as:

• Heart failure

• Kidney problems and kidney stones

• Oedema

• Stroke

• Gastric cancer

• Left ventricular hypertrophy

• Osteoporosis.

A high level of salt intake increases the amount of calcium excreted in the urine, which may also contribute to osteoporosis and increased risk of fracture.

The balance of sodium and water in the body can also be disrupted if there is not enough water. This may be caused by a damaged thirst mechanism or by limited access to water. Hypernatremia is a very serious condition that occurs when your sodium levels rise above 145mEq/L. It can lead to death. A major symptom is thirst and treatment usually involves controlled water replacement.
Salt loss is rare but can be dangerous
The body loses salt through urine, perspiration, vomiting and diarrhoea. If too much salt is lost, the level of fluid in the blood will drop. Hyponatremia is a condition that occurs when the sodium in your blood falls below the normal range of 135–145 milliequivalents per litre (mEq/L). In severe cases, low sodium levels in the body can lead to muscle cramps, nausea, vomiting and dizziness. Eventually lack of salt can lead to shock, coma and death.

Severe salt loss is very unlikely to happen because our diets contain more than enough salt. The only time this is likely to occur is when someone has acute gastroenteritis (causing vomiting and diarrhoea), severe sweating or water intoxication (from drinking too much water).

Muscle cramps need water not salt
Some people believe that salt has to be replaced during hot weather or strenuous exercise to avoid muscle cramps. This is not correct. What you need to replace is water. The human body can happily survive on just one gram of salt a day, as hormones keep a check on sodium levels and make adjustments for hot weather. A genuine sodium shortage brought on by hot weather or exercise is extremely rare, even among hard-working athletes.

The muscle cramps that sometimes follow a bout of sweating are due to dehydration, not lack of salt. To prevent cramps, drink plenty of water on hot days and before, during and after exercise. This will also help to even out the water–sodium ratio in the body.

Sodium and potassium in the body
Potassium is important for the nerves, muscles and heart to work properly. It also helps to lower blood pressure. However, some people with kidney disease, or who are taking some medications, need to be careful not to get too much potassium in their diet.

Our bodies are designed for a high potassium diet, not a high salt diet. Food processing tends to lower the potassium levels in many foods while increasing the sodium content. So it is better to eat unprocessed foods such as fruit, vegetables, wholegrain breads and cereals. Foods high in potassium include bananas, apricots, mushrooms and spinach.

Sodium in food
Many foods – whole grains, meat and dairy products – naturally contain traces of sodium, while processed foods tend to contain a lot of salt. Some foods contain higher amounts of salt than you may expect. For example:

• A jam sandwich has approximately 30 per cent less salt that a marmite sandwich because most of the salt comes from the bread.

• Sea salt, onion, celery or garlic salts are not low sodium substitutes.

• A bowl of cornflakes has about the same amount of salt as a small packet of plain chips.

• Some sweet biscuits contain as much or more salt than savoury biscuits.

• Ricotta, cottage, mozzarella and Swiss cheeses are lower in salt than most other cheeses.

Reducing salt in our diet
Some suggestions for reducing the amount of salt in our diet include:

• Avoid adding salt to cooking and at the table.

• Choose reduced salt bread and breakfast cereals – bread is a major source of sodium in the diet.

• Avoid high salt foods.

• Cut back on processed foods.

• Cut back on takeaway and fast foods.

• Buy fresh vegetables rather than canned.

• Buy ‘low salt’ (contains less than 120mg/100g) or ‘salt free’ versions of commonly used foods, such as commercial sauces.

• Use herbs and spices such as garlic, oregano and lemon juice to add flavour to meals.

Fortunately, nutrition labels on food packaging now make this a lot easier. Nutritional information labels are usually on the back of the packaging. Look at the figure for salt per 100g:

• High is more than 1.5g salt per 100g (or 0.6g sodium). May display a red traffic light.

• Low is 0.3g salt or less per 100g (or 0.1g sodium). May display a green traffic light.

Many foods also display information on the salt content on the front of the packaging. This may show the salt content as a percentage of your Guideline Daily Amount, or display a traffic light to show whether the food is low, medium or high in salt. Where traffic lights are used, red means high: leave these foods for an occasional treat, and aim to eat mainly foods that are green or amber.

If the amount of salt per 100g is in between 0.3g and 1.5g, that is a medium level of salt, and the packaging may display an amber traffic light.

Some people believe that sea salt is a healthier alternative to normal table salt, but both are composed of sodium chloride.

Avoid processed foods
High salt foods that should be eaten sparingly include:

• Most ‘fast’ foods, such as pizza

• Most snack foods, such as potato chips

• Processed meats, such as sausages, salami, hot dogs and luncheon meats

• Canned vegetables

• Dehydrated or packet foods, such as instant pasta or soups

• Pre-packaged sauces and condiments, such as tomato sauce and soy sauce, and processed tomato products in general

• White bread and bread rolls.

Iodine
Our bodies need iodine to make sure our thyroid gland and the hormones that regulate our metabolism work normally. Iodised salt is probably the most common source of iodine for Australians and can provide enough iodine to avoid low thyroid activity. Another good way to make sure you get enough iodine is to eat seafood at least once a week.

This is especially important for pregnant women, who may need a dietary supplement, as low iodine may cause intellectual disability for the child. However, some types of fish contain high levels of mercury, which is dangerous to a developing foetus. Take care when choosing the types of fish you eat during pregnancy to reduce this risk.

Vegetarians or people who do not eat seafood can get iodine from multivitamin supplements.

Things to remember

• Salt is needed by the body to help regulate fluid levels.

• You don't have to add salt to food to be eating too much: 75% of the salt we eat is already in food when we buy it.

• A diet high in salt has been linked to high blood pressure.