The excessive salt intake leads to diseases

Unhealthy lifestyle is one of the main reasons for the development and progression of chronic noncommunicable diseases, therefore the evaluation of the diet is an important component of a comprehensive screening. Correction factors of an unhealthy lifestyle will affect on body weight, level blood pressure lipid and carbohydrate metabolism and can be a powerful tool for primary prevention.

One of the components of wrong nutrition is an excessive salt intake, the effects of which on the body of a patient is examined for several decades. Salt, or sodium chloride consists of 40% sodium and 60% chloride. Sodium is a chemical compound that has salty taste; about 75% of the sodium a person receives by consuming food in which sodium is added during cooking to improve the taste, around 25% gets through eating foods with natural sodium or dosagevalium dishes. Sodium performs several vital functions in the human body: maintain volume of extracellular fluid, osmotic pressure, acid-base balance and transmission of nerve impulses, regulates kidney function, affects cardiac output and reduction of cardiomyocytes. Although sodium is essential for the normal functioning of the human body, its consumption is ten times more than the recommended dose.

According to the recommendations of the world health organization (who), the daily amount of salt should not exceed 5g a day, which is equivalent to 2g of sodium. The American heart Association (American Heart Association, AHA) recommends 6g a day, equivalent to 2.3 grams of sodium, and patients with high blood pressure (BP) less than 1.5 grams of sodium per day. However, most people consume an average of about 9-12g of salt per day of sodium. According to World Hypertension League, Ukraine is a country with a very high daily intake of salt higher than 10-15g of salt, equivalent to 4-6g of sodium (the average level of 10.7 g of salt and 4.2 g of sodium) and ranks first in absolute number of cardiovascular mortality associated with excessive sodium consumption, according to the study NUTRICODE.

According to who, reducing salt intake less than 5 grams per day could prevent up to 1.7 million deaths each year. In addition, ANA recommends to increase the intake of Potassium along with a limited consumption of sodium. Potassium also has the ability to neutralize the negative effect of sodium. Due to the fact that average consumption of potassium a population of less than 3.5 g per day, you need to increase your intake of potassium in the diet for the prevention of cardiovascular disease (CVD). To reduce sodium and increase potassium in the diet can be applying a salt mixture with low sodium content and enriched with potassium, as a substitute of common salt.

Currently, however, debated the level of safe consumption of sodium. As excessive consumption and too low consumption of sodium chloride is associated with dyslipidemia, insulin resistance and high cardiovascular risk. A number of scholars, among them the President of the salt Institute USA Lori Roman, I believe that the negative impact of sodium on the body occurs when the daily intake of more than 12g of salt a day, and the optimum level of 2.8-5g of sodium a day.

It is worth considering that excessive consumption of sodium chloride leads to a decrease in the sensitivity of taste receptors of the tongue to salt, and cause excessive consumption of food and intake. Age and Smoking can also affect sensitivity to salt. With age, taste sensitivity to salt gradually decreases, so older people consume more salt than at a young age. Determined that Smoking also reduces taste sensitivity to salt. The greatest influence on the taste analyzer has a duration of Smoking, not the number of cigarettes smoked per day.

According to the results of numerous clinical studies have demonstrated a close relationship between the level of consumption of sodium chloride and increased blood pressure, which gave the opportunity to consider the excessive consumption of sodium chloride as a modified risk factor of arterial hypertension (AH) and cardiovascular diseases. Excess sodium consumption causes retention of sodium by the kidneys. Excess sodium leads to increased extracellular fluid volume. This results in the increased intracellular concentration of sodium, which causes swelling of the walls of the arteries, causing the narrowing of the lumen of arterioles and causes an increase in total peripheral resistance and increased blood pressure. Reduce the intake of sodium chloride reduces blood pressure, particularly in individuals with volume-and sodium-sensitive form of hypertension.

In addition to the negative effect on AD excessive sodium intake can increase the risk of stomach cancer. The number of observation, experimental studies, theory carcinogenic action of salt through synergic action with Helicobacter pylori infection, together with the independent factors as the increase in the rate of cell proliferation and endogenous mutations. In the study, Peleteiro B (2010) tested the hypothesis that high concentrations of sodium chloride can change the expression of genes of Helicobacter pylori. Found increased gene expression of Helicobacter pylori cagA in response to high concentrations of sodium chloride, which may be a factor contributing to the development of gastric adenocarcinoma. A comprehensive meta-analysis of studies revealed a strong adverse impact of the total consumption of salt and foods rich in salt, the risk of stomach cancer in the General population.

A large amount of salt in the diet can accelerate the process of cellular aging, which is responsible of telomeres. Called telomeres end parts of chromosomes whose primary function is to protect DNA from damage. With aging, the telomeres shorten. If telomeres reach a critical length, the cell dies. Research shows that longer telomeres are associated with fewer disease and lifespan. Shorter telomeres were associated with various age-related diseases, including cancer, stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis and diabetes. Experimentally it was found that large amounts of salt leads to the shortening of telomeres in adolescents with excess weight.

According to H. Zhu, a combination of excessive sodium intake and obesity may accelerate the aging of cells. Also obesity is associated with high levels of inflammation, which accelerates telomere shortening and increases sensitivity to salt.

F. He argues that with the excessive consumption of salt children consume large quantities of soft drinks and they have increased the risk of obesity.

В исследовании профессора Јепѕа Titze с Duke-National University, Singapore (2017) изучалось влияние потребления соли на жажду. В течение 2-х отдельных моделируемых исследований космических полетов (Mars) продолжительностью 105 и 205 дней исследовали 10 здоровых мужчин, которые жили и работали как космонавты на Международной космической станции. Продукты питания, суточный калораж рациона и физическая активность исследуемых были одинаковыми и постоянными, различалось только содержание соли в рационе. Исследовали эффект трех солевых рационов (низкое потребление соли – 6 г/д, среднее потребление соли – 9 г/д; высокое потребление соли – 12 г/д) на экскрецию с мочой минералокортикоидов и глюкокортикоидов, осмолярность мочи и водный баланс. Было обнаружено, что увеличение потребления соли повышает осмолярность мочи, но уменьшает клиренс осмотически свободной воды, что свидетельствует о накоплении избыточной жидкости за счет концентрации мочи. В результате исследуемые с высоким содержанием натрия в рационе употребляли меньшее количество жидкости и у них снижалось суточное выделение минералокортикоидов и повышающееся суточное выделение глюкокортикоидов.

Interesting was the fact that research on visokosolska diet was observed a stronger feeling of hunger compared to the low salt diet at the same intake of food, which can lead to overeating and obesity. In their experimental study on mice it was discovered that excessive salt intake they drank less water. An increased level of glucocorticoid hormones affect body fat and muscle. Their muscles and liver to spend more energy to produce urea, which is then used by the kidneys to maintain water balance. This forced the mice to eat more food.

These changes in metabolism may partially explain why a diet high salt content associated with obesity, metabolic syndrome, diabetes, osteoporosis, cardiovascular diseases.

That is why individualized correction salt diet can be a powerful tool for primary prevention of non-communicable diseases. Reduced consumption of sodium chloride can be made by informing the public about the source and content of sodium chloride in food products, improvement of legislation regarding informing consumers about the exact amount of salt, indicating their correlation with the recommended standards of consumption during the food labels and replace the regular salt in the salt mixture with low sodium.

Information sheet according to salt content

• 1/4 teaspoon salt = 575 mg of sodium
• 1/2 teaspoon salt = 1,150 mg of sodium
• 3/4 teaspoon salt = 1,725 ​​mg of sodium
• 1 teaspoon = 2,300 mg of sodium

Products with the highest sodium content:

Bread and bakery products, pizza, sausage, hot dogs, ham, salted fish, smoked meat and fish, shrimp, anchovies, cheese, condiments, bouillon cubes, yeast, soups, olives, pickles, peanuts, soy sauce , ketchup, mayonnaise.

Natural sodium content:

• one egg contains 140 mg of sodium chloride
• in 30 ml of milk - about 180 mg
• in 200g low-fat natural yoghurt - 76 mg of sodium
• in 50g of celery - 140 mg
• in 60g spinach - 120 g of sodium

Availability of information on salt content per 100g of product packaging or color code.

	Green (low)	Yellow (average content)	Red (high)
salt	0g-0.3g	0.3g - 1.5g	More than 1.5g
sodium	0g -0.1g	0.1g - 0.6g	More than 0.6g

Maximum daily quantity of sodium chloride is dependent on age:

Age	Maximum daily the amount of salt	Maximum daily the amount of sodium
Up to 1 year	Less than 1 gram per day
1-3 years	2 g	0,8 g
4-6 years	3 g	1.2 g
7-10 years	5 g	2 g
11 and older	6 g	2.3 g
Adults	6 g	2.3 g

Mashura G.Y., assistant of the department of faculty therapy of medical faculty SHEE "Uzhhorod National University", Uzhgorod, Ukraine