Preventing cardiovascular disease by reducing salt intake
Excessive salt consumption and its links to hypertension, or high blood pressure, are well documented. The impact of a high salt diet can ultimately be fatal.
Hypertension is a leading risk factor for cardiovascular disease and there is conclusive evidence of the adverse effect of high salt intake on blood pressure. Yet a moderate reduction in salt consumption can reduce blood pressure and lessen the risk of cardiovascular disease.
Rising salt consumption
Whilst health campaigns in the West have endeavoured to highlight the risks of high salt diets, developing countries such as Nigeria are experiencing a surge in cardiovascular disease. This is partially caused by increased salt consumption as a result of dietary and lifestyle changes.
Cardiovascular disease is the primary cause of death in sub-Saharan Africa in adults over 30.
In 2015, more than 23% of Nigerian adults suffered with hypertension - and the figure is rising.
People in urban areas report eating a greater quantity of processed food, which is far higher in salt than food eaten in rural areas.
Dried salted fish is popular, and often eaten in stews
In Nigeria, health care services don’t always meet demand, so prevention of cardiovascular disease is crucial. There are substantial benefits to reducing salt consumption - not least, a decreased risk of disease.
However, trials into the effectiveness of salt reduction interventions are usually lengthy and expensive. There is currently little evidence to guide the implementation of salt reduction strategies in Nigeria.
Illustrating the benefits of salt reduction
A research project, led by the University of Warwick’s Dr Olalekan Uthman, was undertaken to provide evidence that a salt reduction intervention would be both beneficial to Nigeria's population, and economically cost-effective.
Added salt at the 'table'
The project involved several aspects:
- Recording levels and patterns of dietary salt intake
- Identifying major contributors to dietary salt
- Examining local knowledge, attitudes and behaviour regarding salt
- Determining preferences for different salt reduction initiatives
- Creating a salt reduction plan.
The project estimated participants’ salt levels by measuring 24-hour urinary sodium excretion. It is also examined the main sources of dietary salt, as well as knowledge levels and attitudes to salt.
Dr Uthman explains: “Ultimately, our research can help contribute to effective prevention of cardiovascular disease. This will help achieve major social and economic results, as death and disability will be reduced. The cost of caring for disabled people will decrease, and a healthier population will result in increased productivity, which will have real economic benefits.
Organisations such as the World Health Organisation and World Action on Salt and Health are keen to see evidence that can be used to develop cost-effective and solutions to high salt intake in Africa.”
Data collection in progress during the project
Working with policy makers and community groups
The team worked closely with policy makers from the Nigerian Ministry of Health. Evidence generated highlighted the extent of the problem and allowed them to develop solutions for Nigeria's urban environments. "The research helped identify locations of unhealthy food outlets, and where such food is marketed and promoted, which will be useful for salt reduction strategies."
"Communities were actively involved with the design and implementation of the project. This was to ensure their needs and perspectives were considered, increasing the likelihood of effectiveness. Plus, fieldworkers collecting the data and other community groups gained specialist knowledge of the effects of salt" explains Dr Uthman.
The project directly addresses the UN’s Sustainable Development Goal of Good Health and Well-Being and has helped pave the way for large scale salt reduction initiatives to deliver lasting benefits to the Nigerian population.
Principal Investigator: Dr Olalekan Uthman
Country: Nigeria
UN Goal addressed:
