The majority of Bahamians eat more sodium (salt) than is recommended for a healthy diet, and too much sodium increases a person's risk for high blood pressure which often leads to heart disease and stroke according to Family Medicine practitioner Dr. Patrick Whitfield.

According to Dr. Whitfield, most people eat an average of 3,300 milligrams of sodium a day. The United States dietary guidelines recommend limiting sodium to less than 2,300 milligrams a day. Six in 10 adults (people who are 51 years or older, people with high blood pressure in all age groups, people with diabetes and people with chronic kidney disease) he said should further limit sodium to 1,500 milligrams (about two-thirds of a teaspoon) a day.

The doctor' advice comes as the Pan American Health Organization (PAHO) and the World Health Organization (WHO) recognize World Salt Awareness Week, March 10-16 and encourage consumers to "Stop, look, choose... the lower salt option" during this week. The campaign highlights the importance of nutrition labeling to inform consumers about the salt contents in processed foods, a growing source of dietary salt in developing countries and the main source in developed ones.

"Most people do not even realize how much salt they are consuming," said Dr. Branka Legetic, coordinator of PAHO/WHO's salt reduction initiative. "It's critical to be aware of the salt that it is already in the foods we eat and when possible to choose the lower-salt option. For that we need nutrition labels that clearly show salt content. This is a key regulatory measure that countries with salt-reduction goals have been adopting."

Dr. Whifield, who practices out of the Oxford Medical Center, says there is a direct correlation between salt intake and the development of high blood pressure.

"People in The Bahamas, the Caribbean and North America consume far more salt than is recommended for a healthy diet, which obviously would increase the risk for heart attack. Heart attacks frequently would lead to heart disease, heart failure, stroke and increasingly kidney failure... obviously disabling, and a debilitating type of disease."

Collectively, heart failure, heart attack and stroke, have an enormous impact on premature death rate and disability in The Bahamas, said the family medicine practitioner.

"We have noted that our life expectancy in The Bahamas seems to be decreasing a little -- probably because of the increase of chronic diseases such as high blood pressure, cancer, heart attacks and stroke."

Dr. Whitfield said that one of the common myths is that people assume that it's the sodium in their pot than can be over the top, but he said that in actuality, most of the salt people take in does not come from the home, but rather from places like convenience stores and restaurants, and more specifically fast food joints.

"The portion of salt that you put in the pot to cook with for your family is really not enough to cause you any major issues. Because of our diets, most of the salt comes from processed foods, which manufacturers will put in to maintain a longer shelf life."

Dr. Whitfield said more than 40 percent of sodium in the diet comes from breads and rolls, cold cuts and cured meats such as deli or packaged ham and turkey, pizza, and processed poultry. He said soups and sandwiches such as cheeseburgers are also big culprits. "One of the leading foods that will increase your salt intake is the cheeseburger because the bread contains a little more salt than we would suggest, cheese is fairly high in salt, then you add in the processed burger which is also high in salt."

Cheese, pasta dishes, meat-mixed dishes such as meatloaf with tomato sauce, and snacks such as chips, pretzels and popcorn are also huge offenders according to the doctor.

Foods to enjoy

He recommends people eating more fruits, vegetables and low-fat dairy foods. Cutting back on foods that are high in saturated fat, cholesterol and total fat; eating more whole gain products, fish, poultry and nuts; eating less red meats and sweets; eating foods that are rich in magnesium, potassium (fruits and vegetables) and calcium (low-fat dairy products and green leafy vegetables).

Foods to limit or avoid

Fast foods such as cheeseburgers, barbecued ribs and chicken, dairy products such as cottage cheese, canned soup, sauces (soy sauce, teriyaki, spaghetti sauce), nuts and vegetables, and snacks such as pretzel chips should be avoided. Flour-based products such as bread, bagels, pies and cookies he said should also be on the list along with pizza and deli meats, frozen dinners and vegetable juices.

Ways to reduce salt intake

Dr. Whitfield says to always choose fresh, frozen or canned vegetables without added salt most often. Fresh or frozen fish, shellfish, poultry and meat he said is best. And to always read the nutrition fact label to compare the amount of sodium in processed food such as frozen dinners, packaged mixes, cereals, cheese, breads, soups, salad dressing and sauces as the amount in different types and brands vary widely. He urges consumer to look for labels with the words low sodium printed on the label.

When cooking at home he said to be cognizant about how much salt you use and to learn to use spices and herbs rather than salt to enhance flavor. And to go easy on condiments such as soy sauce, ketchup, mustard, pickles and olives which can add a lot of salt to food.

When eating out he said to opt for plain foods like grilled or roasted entrees, baked potatoes and salad with oil and vinegar, as batter-fried foods and combination dishes like stews or pasta with sauce tend to be high in salt.

As PAHO and the WHO recognize World Salt Awareness Week, Dr. Whitfield said the awareness is something that should be sustained.

"It's a good start and we must continue our efforts to try to get people to decrease their salt intake. But this is a fairly recent phenomenon in the last 25 to 30 years where increasingly people generally speaking are eating more processed foods because of time limitations. It's convenient, it's easier," he said.

The issue of too much salt intake is one he said people should take seriously.

"People can't see around the curve and can't see the outcome and the risk of a stroke and its potential effects -- not only on their health, but also on their ability to provide for their family which obviously would be debilitating.

"The risk of having to go on dialysis because of high blood pressure and then you have to look at it from the collective point of view in terms of it costing the country significant amounts of funding, not only for hospitals, but also insurance premiums, and the lack of productivity in people who either become disabled or people who die, and it's resulting effect on the family.

"So whereas it is correct that everybody can, and should eat as they please, we can only advise, and try to encourage people to just remember that they do have dependents and that in the event that something disabling happens, not only are they impacting themselves, but they're also impacting their family. So whereas it may seem a small thing to cut the amount of salt in your diet, you really have to look beyond the disease high blood pressure and consider its potential impact on the quality of your life, the length of your life as well as your ability to provide for your family."

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