Health info

why is this meal good for me?

It’s impressive how much of a positive impact reducing salt in your diet can have, and the fact that we only use nutrient-dense herbs and spices here at EBM means that it’s a double win: we take out the disease-promoting stuff and add health-boosting spices. For example, the turmeric spice we added has powerful anti-inflammatory activity along with being a powerful antioxidant (1,2).

The reason salt has such an impact on heart health and cardiovascular disease is mostly down to there being ‘a dose-dependent relationship between sodium (which makes up half of the salt) reduction and blood pressure reduction’ (3). Meaning that for every milligram of sodium-reduced, your blood pressure goes down, the more you reduce it the more your blood pressure is lowered.

 

But how doe this work? Well, there are a lot of mechanisms including changes in renal function, and increasing the volume of fluid in blood vessels themselves (4). When looking for associations in studies there are lots of research showing that lower salt intake is associated with lower cardiovascular risk, however, there are some that also show that very low sodium intake is a risk factor for cardiovascular disease (5-8). This comes up because individuals who were living with high blood pressure or cardiovascular disease being overrepresented in the low salt group. This happens because ‘patients who are ill may have lower sodium intake because they eat less or are trying to eat lower-sodium foods, which may lead to a noncausal association between low sodium intake and increased cardiovascular events’ (9).

 

Rather than looking at associations, when putting the theory mechanisms and associations to the test to find if lowering salt consumption causes lower blood pressure and therefore reduced cardiovascular risk the results are consistent. The majority of trials show a reduction in risk with lower salt intake (3,10, 11, 12, 13) confirming the mechanisms and the majority of observational research;  ‘a modest reduction in sodium intake of 1 g/day reduces systolic blood pressure by 3.1 mmHg in hypertensive patients and 1.6 mmHg in normotensive patients’ (14).

 

Considering that 30-45% of people over 18 are living with high blood pressure (15), including many people who are unaware they have it, it is time to make a change. High blood pressure accounts for 9.4 million deaths a year via its impacts on cardiovascular disease, so make a positive change for yourself and your family and reduce your salt - a proven method for lowering blood pressure.

 

So putting this into practice what to do? Well, unfortunately, salt is everywhere, as the World Health Organisation states that it is found in ‘high amounts in processed foods, such as bread, crackers, processed meats as well as in condiments such as soy sauce, fish sauce, and bouillon or stock cubes’ (16). The easiest way is to stick to whole plant foods such as fruits, vegetables, nuts, seeds and pulses as in their natural form they contain next to no salt. The more processed a food is the more opportunity there is for the food industry to add salt, so avoiding processed foods is key and sticking to mainly fresh produce means that you don’t need to worry about checking as many food labels. However, checking food labels is key if there are processed foods you can’t do without but could make a salt healthy swap, 6g or one teaspoon is the MAX you want a day (17) and the lower the better.

 

Here at EBM we love sauces so we are going to check which are horribly high and see what we can swap out or just cut completely.

 

What high salt foods are there in your diet and what could you swap them for?

 

Recipe

how do i cook it?

Time: 30mins                     Servings: 4                      4 portions of veg per serving

 
Ingredients

 

 

  • 1 diced red onion

  • 1 tablespoon cumin, turmeric, cayenne pepper and garlic powder (or 4 cloves)

  • 500ml water

  • 400ml chopped tomatoes (1 tin)

  • 500g lentils

  • 3 sweet potatoes cut into 2cm chunks

  • Health boost: 2 handfuls of spinach and 400ml chickpeas (1 tin)

  • For serving: soy yoghurt, fresh coriander and 200g of brown rice

 

Cooking Instructions
 

 

-    Fry a diced red onion in 2 tablespoons of oil in a large saucepan over a medium heat for 3 mins or until soft.

-    Add the spices and fry for a further minute. Then add the water and chopped tomatoes. Add some chilli flakes at this point if you like flipping spicy!

-     Add the lentils and sweet potato (leave the skin on for a nutritional boost) and simmer on a medium/low heat for 20mins with the lid on.

-     Health boost: add a drained tin of chickpeas 10mins into the simmering and two handfuls of spinach 18mins into the simmering for best results.

-     Check the potato is cooked by pushing a fork through a chunk, if it passes quite easily through it’s ready, if not, leave to simmer for a further 5mins.

-     Serve with your desired sides - we chose brown rice, fresh shredded coriander and soy yoghurt.

Yum yum - you’re done!

 

Evidence

where is the science from?
  1. Chattopadhyay, I., Biswas, K., Bandyopadhyay, U. and Banerjee, R.K., 2004. Turmeric and curcumin: Biological actions and medicinal applications. CURRENT SCIENCE-BANGALORE-, 87, pp.44-53.

  2. Kocaadam, B. and Şanlier, N., 2017. Curcumin, an active component of turmeric (Curcuma longa), and its effects on health. Critical reviews in food science and nutrition, 57(13), pp.2889-2895.

  3. Sacks, F.M., Svetkey, L.P., Vollmer, W.M., Appel, L.J., Bray, G.A., Harsha, D., Obarzanek, E., Conlin, P.R., Miller, E.R., Simons-Morton, D.G. and Karanja, N., 2001. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England journal of medicine, 344(1), pp.3-10.

  4. Farquhar, W.B., Edwards, D.G., Jurkovitz, C.T. and Weintraub, W.S., 2015. Dietary sodium and health: more than just blood pressure. Journal of the American College of Cardiology, 65(10), pp.1042-1050.

  5. Graudal N, Jürgens G, Baslund B, Alderman MH. Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis. Am J Hypertens. 2014;27:1129–37. [PubMed] [Google Scholar]

  6. O’Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371:612–23. [PubMed] [Google Scholar]

  7. Pfister R, Michels G, Sharp SJ, Luben R, Wareham NJ, Khaw K-T. Estimated urinary sodium excretion and risk of heart failure in men and women in the EPIC-Norfolk study. Eur J Heart Fail. 2014;16:394–402. [PubMed] [Google Scholar]

  8. Mente A, O’Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016 May 20

  9. Cogswell, M.E., Mugavero, K., Bowman, B.A. and Frieden, T.R., 2016. Dietary sodium and cardiovascular disease risk—measurement matters. The New England journal of medicine, 375(6), p.580.

  10. Bibbins-Domingo, K., Chertow, G.M., Coxson, P.G., Moran, A., Lightwood, J.M., Pletcher, M.J. and Goldman, L., 2010. Projected effect of dietary salt reductions on future cardiovascular disease. New England Journal of Medicine, 362(7), pp.590-599.

  11. Graudal, N.A., Galløe, A.M. and Garred, P., 1998. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis. Jama, 279(17), pp.1383-1391.

  12. Aburto NJ, Ziolkovska A, Hooper L, et al. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013;346:f1326.

  13. He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and metaanalysis of randomised trials. BMJ. 2013;346:f1325.

  14. He, F.J. and MacGregor, G.A., 2002. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. Journal of human hypertension, 16(11), p.761.