Cutting out hidden salt cured my high blood pressure virtually overnight: How one woman took the natural approach to tackling her condition
21:00 GMT, 1 September 2012
21:00 GMT, 1 September 2012
One person in three in the UK suffers from high blood pressure. It is the main cause of strokes and heart attacks, the country’s most common causes of death – killing 350 Britons every day. So when my GP said he was concerned about my blood pressure, I took his comments seriously.
In my 50s and with my blood pressure at 140/86, it was a borderline decision whether I required medication, but before I started taking any tablets – and once you do, it is usually for life – I wanted to try to bring it down by natural means.
Choose carefully: Angela Levin shows it's a balancing act to swap her high-salt favourites for low-sodium versions
Health benefits: Just by reducing salt intake, levels of high blood pressure could be brought down dramatically
Last week, a study found that a healthy lifestyle was just as effective as the most commonly given drugs – reducing the risk of high blood pressure by nearly 50 per cent in men and 30 per cent in women.
They looked at regular exercise, and a balanced diet – the latest thinking is that a diet high in salt is the most common cause. And, by reducing my salt intake, I could reduce my levels automatically. The question was how low could I go
HOW WE GOT HOOKED ON SALT
Before I embarked on the experiment, I sought the advice of Professor Graham MacGregor, of the Wolfson Institute of Preventive Medicine, a world authority on salt and blood pressure.
Prof MacGregor, who is chairman of Consensus Action on Salt and Health (CASH) and the Blood Pressure Association, has fought for decades to persuade the UK food industry to reduce the amount of salt they put in food. He has won several battles but not the war.
‘Nearly all the salt we consume comes from processed food,’ he says. ‘The body needs less than 1g each day to function properly, yet the official daily recommendation for salt intake is 6g a day. The average person usually eats about 9g.’
The reason for the large amount of salt in manufactured food is simple: it makes it taste better. The problem is that the brain becomes accustomed to saltiness, and levels have to be increased to give the same ‘hit’.
‘I have worked hard to persuade manufacturers to reduce salt in prepared food by 20 to 30 per cent over the past seven years, and in June it was revealed that the percentage of salt in food went down a further six per cent.
‘It is encouraging but there is still some way to go. Manufacturers have reduced it slowly so the consumer won’t necessarily realise and stop buying the product. Anything that helps reduce blood pressure will significantly prevent many people of dying of strokes and heart attacks.’
WEEK 1: THE BASE LINE MEASUREMENT
To test the effect of salt on my blood pressure, Prof MacGregor suggested I follow my normal diet for a week, then change to a high-salt diet for two weeks followed by a low-salt diet for a further two weeks. I was to take my blood pressure each day. Urine samples taken during the last two days at the end of each block would give a measure of my salt intake.
My first week of eating normally – I don’t add salt to cooking, buy prepared meals or eat meat – was easy. Prof MacGregor told me that it was common for blood pressure to be ten points lower when taken at home than in a doctor’s surgery, as anxiety raises blood pressure, and at the end of the week my reading was 133/84 and the tests showed my salt intake was 6.9g a day.
Prof MacGregor says: ‘Although this is not as bad as the readings taken by your GP, anything over 130/80 is a cause for concern. Hypertension is diagnosed at a reading of 140/90 or more, but a healthy person of your age should be looking for a reading of about 120/75.’
Blood pressure at end: 133/8
WEEKS 2 & 3: THE HIGH-SALT CHALLENGE
Working out how much salt you are consuming is complicated – a degree in biochemistry and nutrition would have been useful to understand some food labels.
There is no consistent way that salt amounts are listed. Some products show ingredients in descending order of what proportion they constitute rather than by amount, but if salt is two or three on the list, the product obviously contains a substantial amount.
Other labels record the amount of salt in 100g, per milligram, per portion, per one sixth of a pot (in the case of Waitrose’s houmous, for example), or as a percentage of your recommended daily allowance, leaving the consumer to use whatever mathematical skills they have to work out the exact amount they are eating.
Salt, which is used as a preservative
as well as a flavouring, is a crystal made up of 40 per cent sodium and
60 per cent chloride. Some manufacturers choose to record the amount of
sodium salt in their food. This gives the wrong impression as sodium is
the part that puts up blood pressure. One gram of sodium equals 2.5g of
To increase my salt intake for the two
high-salt weeks, Prof MacGregor suggested I used a celebrity cookbook.
‘They almost always use masses of salt,’ he explains. ‘You should also
buy food from well-known manufacturers, rather than own brands. The
former have cut salt less because of concerns that changing the taste
might lose customers.
‘Supermarkets, on the other hand, do so more confidently as they believe customers will stay loyal to cheaper products. Sainsbury’s has been most amenable to cutting salt and having clear labels. Tesco was more reluctant but eventually met the target.’
And so I found myself in the bizarre predicament of shopping for foods that were highest in salt. I didn’t have to search very hard. Bread is a surprising culprit. Brown bread, often considered a healthier option than white, accounted for four of the five saltiest loaves tested by Prof MacGregor’s team in a recent sample of 300 popular brands sold in British shops.
One loaf of brown ‘pain de campagne’
from upmarket chain Paul contained 2.83g of salt per 100g – a higher
concentration of salt than in seawater. The salt level can also vary
from loaf to loaf within the same store. Marks & Spencer Eat Well
Multigrain Bloomer had the fourth-highest salt in bread, with 1.15g per
100g, while its Eat Well Oaty Bloomer had the third-lowest salt content
at 0.65g per 100g.
average, a slice of bread contains about 0.5g of salt, the equivalent of
a small packet of crisps. Eat six slices a day and you are consuming
half the recommended daily intake of salt.
a favoured calorie-saver of mine, has 0.9g salt per piece, almost
double a slice of bread, so hardly healthy. Cereal can be high in salt
too, Kellogg’s Corn Flakes, for example, has 1.3g salt per 100g.
Over the two weeks, to spare my family’s diet, I sprinkled salt on whatever I ate rather than using recipes from celebrity cookbooks. I had lots of toast with Marmite (10.78g salt per 100g), cheddar cheese (1.80g per 100g,) and Pecorino Romano – a fearful 7.5g per 100g.
I munched on tinned anchovies, (1g per anchovy), Caldron marinated tofu pieces (1.5g per 100g), smoked haddock (1g per 100g) and stir-fries with plenty of soy sauce (15g per 100g). I also snacked on salted nuts and crisps.
It became a nightmare. I felt nauseous and had a terrible taste of salt in the back of my throat all day. After a week I felt lethargic, dizzy, had headaches, put on several pounds in weight and felt I was being poisoned.
Most significantly, my blood pressure climbed steadily from its starting point of 133/84 to 145/88.
I couldn’t continue, so I cut right down on the salt and felt much better after a couple of days.
However, as the urine tests weren’t done until the end of the second week, they didn’t record my salt level at its highest. Prof MacGregor said I should go on the low-salt diet and try again with the high salt at the end of the fortnight, but this time just for a week.
Blood pressure at end: 145/88
WEEKS 4 & 5: THE SALT FAST
Eating a really low salt diet is also more difficult than it first appears.
Who would imagine that there is salt in supermarket prepared salad and so-called healthy miso soup (2g per portion)
In fact, healthy foods can often be one of the worst culprits. Marigold Swiss Vegetable Bouillon stock powder, for example, has 17.6g of sodium per 100g – the equivalent of 44g of salt.
Concerned I might fail this test too, I went for the easy option and ate natural foods such as avocados, fresh fish, fruit and vegetables and made my own salads. I lapsed only twice, in a restaurant and at a dinner party.
Overall I felt great, energetic and optimistic. My blood pressure fell steadily.
By the third day it had dropped to a healthy 112/72, and by the end of the second week it was a stable 111/72.
The urine tests showed my salt intake had dropped to show I had eaten only 3.2g of salt.
I was amazed to discover that cutting my consumption by half had resulted in my blood pressure dropping by more than 20 points.
Blood pressure at end: 111/72
WEEK 6: BACK ON THE SALT
When I went back on a high-salt diet – this time for seven days – the nausea and lethargy returned and my blood pressure shot up again. After only three days it reached 132/73. I just about managed the week and the test results showed an average of 10.9g of salt.
Blood pressure at end: 132/73
I am now monitoring my salt intake carefully but not obsessively. My
blood pressure has levelled at about 118/72. Of course life is not much
fun without eating a little of what you fancy. The good news is that
different varieties of the same food can contain very different salt
levels, so it’s worth looking for the lowest-salt option.
For example, Ghille and Green’s smoked salmon has 3.18g salt per 100g while Waitrose’s own brand has 2.85g.
Duchy shortbread biscuit has 0.39g per biscuit, whereas Waitrose
own-brand shortbread has 0.23g. And takeaway pizzas contain up to
two-and-a-half times more salt than the average supermarket pizza.
of the studies I have done have been with people who already have high
blood pressure,’ says Prof MacGregor. ‘So it has been fascinating to see
the effect of salt on someone in the normal range. It emphasises the
importance of getting everyone to reduce their salt intake.’
lots of salt can become addictive. The body gets used to it and craves
more. Luckily, the reverse is equally true. When you first cut down on
salt, your food might seem tasteless. But after a few days the body
adjusts and what you eat will taste of itself and anything salty will,
with luck, be intolerable.
Your body will almost certainly reward you.