Salt
Introduction
A customer walked into your community pharmacy and would like to buy some iodized salt.
Sea Salt, Rock Salt and Iodized Salt
Essentially, salt is sodium chloride (NaCl).
Sea salt is a general term for salt produced by evaporation of ocean water or water from saltwater lakes. It retains trace minerals which add flavour and colour.
Rock salt, also known as halite, is the salt from the ocean that has already formed a rock. Similar to sea salt, it contains very small amounts of minerals such as zinc, copper, iron, manganese, potassium, calcium and copper.
Table salt is typically mined from underground deposits. It is processed to remove other minerals and commonly fortified with iodine.
Iodized salt is table salt mixed with a minute amount of various salts of the element iodine (i.e. potassium iodide or sodium iodide) to prevent iodine deficiency. Consequence of iodine deficiency may include
- Hypothyroidism
- Diffuse and nodular goitre
- Cretinism - due to deficiency of thyroid hormone in early pregnancy, leads to permanent intellectual disability and neurology and somatic defects.
- Neonatal and infant mortality
According to the World Health Organization in 1994, about 1600 million people were at risks of iodine deficiency disorders because they live in iodine deficient environments. Of these, 656 million had goitre and 43 million had some degree of mental defect, including 11.3 million overt cretins. As a result, to combat iodine deficiency, salt iodination is legally mandated in many countries.
Salt Restriction
Excessive sodium intake has an important, if not predominant, role in the pathogenesis of elevated blood pressure. Furthermore, dietary sodium reduction can
- Lower BP in both hypertensive and normotensive individuals,
- Prevent hypertension
- Enhance the BP response to most antihypertensive therapies, except possibly calcium channel blockers
In general, the extent of BP reduction as a result of reduced sodium intake is greater in Black patients, middle- and older-aged persons, individuals with hypertension, and, likely, patients with diabetes or kidney disease.
Almost all national and international organizations recommend dietary sodium reduction as part of the nonpharmacologic therapy for hypertension.
- In 2013, the WHO recommends that adults consume <2000 mg/day of sodium.
- The American Heart Association set 1500 mg/day of sodium as the recommended upper limit of intake for all Americans.
Strategies for sodium reduction include
- Make reading food labels a habit. When available, buy low-sodium, reduced-sodium or no-sodium versions of foods (e.g. breakfast cereals, canned or frozen foods).
- Rinse canned foods to remove some sodium.
- Stick to fresh foods (e.g. meats, fruits and vegetables) rather than their packaged counterparts.
- Reduce or eliminate salt use in cooking. Experiment with adding flavour with herbs, spices, garlic, onions or lemon instead.
- Request restaurant that your food be prepared without any added or less salt.
NOTE: Although sodium can be consumed in nonchloride forms [e.g. sodium bicarbonate (i.e. baking soda) and monosodium glutamate (MSG)], salt provides approximately 90% of dietary sodium.
External Links
- WebMD - What is Iodized Salt?
- Should you use iodized salt?, 2018
- UpToDate - Iodine deficiency disorders
- UpToDate - Salt intake, salt restriction and primary (essential hypertension)
- Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial, 2011
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