Salt is a hard habit to shake off for kids

Salt is essential for our bodies, but experts say children are consuming far too much of it, which could lead to serious health problems. Clodagh Finn reports.

PARENTS steer their children away from fizzy drinks, sugary treats and fat-laden snacks, and even take the salt cellar off the table.

But most of the excess salt eaten by children is hidden in their favourite foods — the daily bowl of cereal, the lunchbox staples (bread, ham, processed meats, cheese dips, biscuits) and everyday dinners, such as pasta and sauce, pizza, beans or sausages.

A few squirts of tomato ketchup add one gram of salt to a dinner plate — that’s a third of a child’s daily intake.

Few realise that a slice of bread can have the same salt content as a bag of crisps. A ham sandwich contains half of a toddler’s recommended daily intake of salt.

Salt is essential to health. It is needed to maintain healthy blood pressure, thyroid function, muscles and nerves.

Nobody disagrees with that. What is controversial, however, are the figures. Just how much salt is too much?

The recommended guidelines are 6g for adults and 4g for children.

Last week, however, one report claimed that 6g was too little, but that 18g increased the risk of heart disease and death.

In Ireland, heart disease and stroke are our biggest killers, accounting for more than two in five (41%) deaths.

“If everyone in Ireland reduced salt intake by a half teaspoon (three grams per day), this would prevent approximately 900 deaths each year from stroke and heart attack,” the Irish Heart Foundation says.

And yet, the message has become confusing. A number of new studies suggest that low-salt diets are bad for you. Another found that other dietary factors, such as alcohol, were more likely to put people at risk of heart attack and stroke than salt.

But don’t rush to shake the salt cellar with impunity just yet.

Professor Ivan Perry, head of the Department of Public Health at UCC, warns against studies that claim low-salt diets are bad for your health.

The methods used to measure salt intake are often inaccurate and the quality of research in these studies falls far short of the level needed to change current thinking, he says.

“The evidence linking salt intake to blood pressure, stroke and heart disease has emerged from hundreds of studies over the past 50 years, including randomised controlled trials which provide evidence of the highest quality on the harmful effects of high salt intake in children and adults,” he says.

It’s best then, to take certain sensational salt stories with, well, a pinch of salt.

Dr Cliodhna Foley Nolan, safefood’s director of Human Health and Nutrition agrees. She says that some experts and studies focus too much on one nutrient, but the fact remains: our intake of salt is too high.

Salt is particularly damaging to children’s health. An Irish nutrition survey, in 2010-11, found that one- to four-year-olds were eating twice as much salt as they should: 2g daily, instead of 1g.

“We actually have the beginnings of clinical disease happening in very young children. Hypertension means we are expecting the heart to work harder. We’re damaging the structure of blood vessels, we’re impacting on kidney and other functions,” says Dr Foley Nolan.

“We are putting children at risk of diabetes and stroke early in life. It is really very serious.”

Her concerns were confirmed by a University College Cork study of primary schoolchildren, which found that a startling one in 12 children had high blood pressure, while more than half ate too much salt.

The Cork Children’s Lifestyle Study surveyed more than 1,000 third- and fourth-class pupils in 27 Cork primary schools in 2014. It found that half of the schoolchildren were eating more than the recommended 4 grams of salt a day.

It also found that salt intake was much higher in children who were overweight or obese, compared to normal-weight children, which makes sense, as foods that are high in salt also tend to be high in sugar and fat.

Irish adults eat a lot of salt, but UCC’s study now offers definitive evidence that this is tracking through to children.

Children eat more processed foods than in previous decades, one of the study’s authors, Dr Janas Harrington, says.

Whatever your view on salt, this means it is harder to establish what your child is eating.

Reading the labels will help, and Dr Harrington says new EU regulations, which oblige manufacturers to state how much salt is in a product, are a step in the right direction.

However, she says that a traffic-light system would help further — food high in fat, sugar and salt would be signalled as red; medium foods would be amber; and food low in those ingredients would get a green light.

That system is already on some products, but not all.

Dr Harrington says the study also highlights the urgent need for government regulation of the salt content of processed food.

Dietician Sarah Keogh estimates that Irish children are eating up to 6g of salt a day, while adults are consuming as much as 11g — and much of it in processed or pre-prepared food.

It’s not the salt in your cupboard that you need to worry about, but the hidden salt that manufacturers add to food. Some 70% of all the salt we eat is added by the food industry. In Britain, that adds up to a whopping 220,000 tons of salt, enough to fill St Paul’s Cathedral, in London.

Here, we don’t have an equivalent statistic, but the Food Safety Authority of Ireland pinpoints two food groups as the worst hidden-salt offenders: bread and meat/ fish (particularly processed meats).

So is it time to ban the ham sandwich?

Sarah Keogh thinks not. She says it’s important to consider what a child is eating throughout the day.

“If a child is eating a well-balanced diet, they will automatically be getting the correct amount of salt.”

The occasional ham sandwich is fine if a child is eating a good mixture of fruit and vegetables.

She also advises parents to think outside the box when packing lunches.

“Ham is fine now and again, but if you are cooking a roast (chicken or beef), save some of it for sandwiches,” she says.

Consider eggs, or hummus, or pasta salad.

While cooking from scratch is the most effective way of controlling the salt content of food, not everyone has time.

If that is the case, Sarah Keogh advises shoppers to start reading the labels.

She says 45% of shoppers claimed to do so in a study conducted at her nutrition clinic, but when the participants were studied shopping that figure went down to 29%.

“It’s worth sitting down and examining your week’s shop to see exactly how much salt it contains,” she says.

If you have to rely on convenience foods — and most people do, at some point — choose the ones that have lower salt content.

Also, ensure that children don’t develop a taste for salt when they are young.

“The more salt you have, the less likely you are to taste it. Don’t put it on the table. I know people who stopped using it and said they never realised that broccoli had a taste,” the dietician says.

And a final word of caution: don’t fool yourself. It doesn’t matter if it’s called rock salt, sea salt or garlic salt, it’s still salt.

READ THE LABEL

If the product contains 1.5 grams, or more, of salt per 100 grams, it is high in salt. If it has 0.3 grams, or less, it is low in salt.

Under new EU regulations, it is now mandatory to list ‘salt’ instead of ‘sodium’ on labels (salt is made up of 40 per cent sodium and 60 per cent chloride) but not all manufacturers have had time to adjust labels yet.

If the label lists sodium, simply multiply the sodium figure by 2.5 to get the salt content. For example, if a product has 1g of sodium per 100g, it contains 2.5g of salt.