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Center for Health Literacy Promotion Blog

Health Literacy Challenge: How to Save 92,000 lives & $24 Billion in Healthcare Costs Annually

A body needs about 500 mg per day. The American Heart Association recommends not more than 1500 mg per day. The average American adult consumes 3400 mg per day. The average 4 year old consumes 2500 mg. More than 2300 mg is linked to high blood pressure, hypertension, PMS, and kidney dysfunction. Can you name it?
 
It's Na, sodium, soda—salt
If we reduced our average salt intake by 3g per day, strong and clear scientific evidence says we'd have 60,000 to120,000 fewer new cases of heart disease annually, 32,000 to 66,000 fewer strokes and 44,000 to 92,000 fewer deaths from any cause. All segments of the population would benefit, particularly African Americans, women, elderly, children. Even if we gradually reduced salt intake by 1g per day over the next 10 years,  that would be more cost-effective than using medications to lower blood pressure in all persons with hypertension.
 
That's why the Food and Drug Administration just issued sodium reduction targets  for the food industry. The news release includes a link to a summary of the evidence.
 
The Health Literacy Challenge
The evidence is undeniable. We need to reduce salt intake. But it's a strident challenge. The American Heart Association offers some good infographics advising us to "change our salty ways"; but the advice is far from simple, and likely to have limited effect.
 
1.     Change your sodium palate.  Hardly plain language. The imperative assumes understanding that a body wants what it is used to getting. So if you eat less salt, after a few weeks you lose your taste for it. And if you feed a toddler salty food, s/he develops a taste for salt.
 
2.     Start enjoying foods with less salt.  That means don't use the salt shaker at the table; but only about 6% of our total salt intake comes from the shaker. About 75% comes from processed and prepared foods. The rest is naturally occurring in almost all foods. So the message means eat fresh fruit, vegetables and meats. That works if you can find fresh food in your neighborhood, can afford to buy it and store it, and have time and skills to prepare it. But we average Americans eat at fast food restaurants 4 to 5 times a week. We favor "The Salty 6": breads and rolls, cold cuts and cured meats, pizza, canned soup, sandwiches, poultry.
 
3.     Look for lower sodium items. This directive assumes you know that salt and sodium are the same thing and items means food. Looking for such items means reading food labels (about 48% say they do), and knowing to add up items listed as Na, soda, baking soda, sodium, salt— all salt.
 
The Numeracy Challenge:  What's a mg?
Sodium content is listed in mg —milligrams or g —grams.  This is not informative. Only scientists talk about grams.  Here's translation: 500 mg, the daily amount of salt a body needs to function, is 1/4 teaspoon (that's a measuring spoon, not a spoon to stir tea) or 3-4 shakes of the shaker. The recommended maximum intake is 1500mg or 3/4 tsp. The FDA wants the food industry to gradually reduce sodium in food processing and preparation to get our average daily intake down to 2300 mg, about 1 tsp.  One gram is about 1/5 tsp. Here is a converter
 
These challenges are part of the reason the FDA is working with restaurants and food producers to lower the amount of sodium in the food supply over the next ten years. You can read the proposed guidelines and comment on them. For best consideration comment within 90 days.  Meanwhile, health educators, any way a person can reduce salt intake even a little is likely to enhance their health.
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