‘Our children are eating far too much salt’, said pediatric nephrologist Michiel Schreuder of the Radboud university medical center in 2009 in the Dutch television program Jeugdjournaal. In the meantime, unfortunately, little has improved. His message in 2022? ‘The government should intervene now and reduce salt in products step by step. That will save an estimated 5,000 deaths a year in the Netherlands.’ Schreuder answers five questions about salt.
Why is eating too much salt bad?
'Salt in itself is not bad, but too much salt is. The guideline for adults in the Netherlands is a maximum of 6 grams of salt per day, but unfortunately we eat well over that. We don't have a guideline for children, but it should be much lower. Our earlier research showed that children were eating almost 6 grams of salt per day, compared to less than 4 grams per day ten years earlier. Recent research by RIVM shows that children eat a lot of processed foods, which we know are high in salt. So children are still eating too much salt. Too much salt leads to higher blood pressure, even in children, with adverse effects on the heart and vessels. In addition, too much salt causes osteoporosis and kidney damage. We calculated that we could prevent 5,000 deaths annually in the Netherlands if we reduced the intake of salt to below the guideline.'
Which products contain a lot of salt?
'Everyone immediately thinks of the salt pot in the kitchen, that we use to sprinkle while cooking or on the table. But in the Netherlands that is at most twenty percent of our salt intake. The rest is hidden in processed foods. Spice mixes sometimes consist of as much as two-thirds salt. Many sweet products, too, contain more salt than people think. For example, speculoos cookies contain almost as much salt as potato chips. In general, the more processed, the saltier. A tomato contains no salt. A can of tomatoes contains a little salt. And a bottle of ketchup and jar of ready-made tomato sauce are packed with salt.
What can the government do?
'For too long the government has put the responsibility on companies and consumers, but that doesn't work. Manufacturers and supermarkets do want to reduce salt, but they don’t actually do it. After all, salt is a cheap and easy flavoring, even in sweet products. For a manufacturer, adding less salt is a risk: consumers are likely to switch to the same competitor's product, which still contains a lot of salt. So reducing salt only works if the government forces all manufacturers at the same time.'
What is a good strategy for the government?
'Eating salt is a matter of habituation. People judge food with less salt than they are used to as bland and not tasty. But fortunately, we can modify that habituation. If you reduce the amount of salt, it takes two to four weeks before your taste has adapted and the food tastes good again with less salt. Therein lies the trick for the government: force all manufacturers at the same time to reduce salt slowly and gradually. For example, by ten percent every six months. Then people can slowly get used to it.
What can you do yourself?
‘Use as much fresh and unprocessed produce as possible, such as fruits and vegetables. Buy loose herbs and spices and make your own spice mixes. And if you buy processed food, check the labels and choose the product with the least salt. Because manufacturers are required by the government to be very clear about this on their packaging. Finally, it is also best to gradually reduce the amount of salt in your food yourself, then your taste can slowly adjust.’
On Friday, Oct. 7, 2022 at 3:45 p.m., Michiel Schreuder held his inaugural lecture, titled Pediatric Nephrology: more than a numbers game.
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