Now avaliable in your local 'chao shi'

Last year the Beijing Municipal Health Bureau started promoting the use of low sodium salt in the city by making it accessible to most consumers and restaurants. Citing this as part of drive to improve the blood pressure (BP) health of Beijing citizens, you can now find 450g bags of low sodium salt in many of Beijing’s supermarkets.

Are you salt sensitive?

Many people belief that consuming too much sodium can contribute to an increase in blood pressure. The truth is that the blood pressure response to reducing salt intake can vary quite a bit amongst individuals. It is called salt sensitivity,  that means that for those whose blood pressure rises with increased salt intake, their health can benefit somewhat by watching their sodium levels.

In the United States, 30% of people with normal blood pressure are salt sensitive, while 50% who are already hypertensive are salt sensitive and it is also more prevalent among African Americans, older persons, and individuals with renal insufficiency (kidney problems) or diabetes. In an interesting study published in 2010, it appears that the Chinese ethno type maybe quite sensitive too, with 39% of adults in a China rural study deemed as sodium sensitive. That effect is compounded if someone had symptoms of metabolic syndrome at the same time. Metabolic syndrome is not just one disorder; rather it is a combo of medical disorders that increase the risk of developing cardiovascular disease and diabetes. If an individual has three or more of the following disorders they are classified has having metabolic syndrome:

• abdominal obesity,
• raised blood pressure,
• high triglyceride concentration,
• low HDL cholesterol, or high glucose,

In a large study of a non-diabetic Chinese population, those with metabolic syndrome had a three-fold increase in salt sensitive related changes in blood pressure.

In my opinion the use of the salt substitute has some limited effectiveness because it really can only partially benefit those with borderline high BP who are salt sensitive with no other major risk factors.  Whether it will work on 22 million people and to what extent remains to be seen.

Nice to have options here now

Lifestyle change! Not only reduce salt intake…

Of course there are other pertinent factors involved in the emergence and control of high blood pressure. It ranges from lifestyle factors such as how much stress one is exposed to (think Beijing traffic), amount smoking and exercise one gets, to dietary factors such as the amount of saturated fat, refined carbohydrates and essential fatty acids that you get. The sodium is only a fraction of the big picture.

What made me raise an eyebrow was the move includes encouraging restaurants and work units to use them. If that does get some traction, it would still only help a fraction of individuals who are salt sensitive and to what degree it works is debatable. There is not much perceptible taste difference it turns out, so it will be more of a perception issue and potentially a cost issue for commercial use.

Furthermore low sodium salt does not mean no sodium. At the amount that is typically used in restaurants here, you will still get a nice kick of sodium even when low sodium salt is used. The World Health Organization (WHO) recommends an intake of no more than 6g of sodium per day, however according to the latest reports, the average city resident consumes about 13.4g of sodium while rural residents tend to take in more about 16.5g (this is possibly because of the increased use of salting as method of preservation). The low sodium salts described in The China Salt Substitute Study uses a 65% sodium mix. That means an average Chinese citizen would potentially still consume about 8.71g of sodium if usage volume are maintained and only if low sodium salt was used everywhere. The net result is it is still above what WHO recommends.

So there is still a long way to go and the war is pitted against human nature.