Salt has been used as seasoning and food preservative for thousands of years, but having too much of it can lead to various diseases, including high blood pressure, cardiovascular diseases, and kidney disease. Salt overconsumption is also known to accelerate cognitive decline. To avoid increased likelihood of developing such diseases due to salt overconsumption, the WHO recommends adults consume no more than five grams of salt per day.
Salt added to food after preparation accounts for 6-20% of total salt intake. It is known that the behavior varies among socio-demographic groups, but in different cultural and social settings it is not always clear who is most likely to reach for the saltshaker. In a new Frontiers in Public Health study, scientists in Brazil set out to find who among older adults is most likely to do so.
"Adding salt to food at the table remains a relatively common habit among Brazilian older adults and occurs more frequently among men than among women," said first author Dr Flávia Brito, an associate professor at Rio de Janeiro State University.
"Women's salt-adding behavior, however, was associated with a wider range of social and dietary characteristics than men's," added co-author Dr Débora Santos, a titular professor at Rio de Janeiro State University.
Who likes it extra salty?
The study used survey data from 2016 and 2017 from more than 8,300 Brazilian adults aged 60 years or over. Participants recalled their dietary choices over the previous 24 hours and were asked if they do or don't have the habit of adding extra salt at the table. Independent variables the researchers included in their analysis were sex, age groups over 60, years of education, whether people lived alone or with others, household income, area of residence, and whether participants included ultra-processed foods, fruits, and vegetables in their diets.
The findings showed that 12.7% of men and 9.4% of women added salt to their foods. Between sexes, different socio-demographic factors were identified to influence salt use at the table.
"Among men, few variables were associated with the habit of adding salt, suggesting that their behavior may be less directly related to specific dietary patterns," Brito pointed out.
"On the other hand, women's salt-adding behavior appeared to be more closely linked to broader dietary patterns and contextual characteristics," added Santos.
Among men, only two factors were significantly associated with adding extra salt. Those on a special diet for high blood pressure were less than half as likely to do so than their counterparts following no such diet. Men who lived alone were 62% more likely to add salt than those living with others. Women's odds were 68% higher if they did not follow a diet to manage high blood pressure. If they lived in urban areas or often ate ultra-processed foods, the odds doubled. For women who regularly consumed fruits or vegetables, however, the likeliness was 81% or 40% lower, respectively. This could be due to this group paying more attention to diet quality, including reduced salt intake.
Salty habits
The team pointed out that the study doesn't uncover causal relationships. In addition, salt-adding behavior was self-reported by participants and therefore the data may be biased. It is also possible that salt use has changed since the time of surveying.
Adding extra salt may be due to both taste and habit, the team said. Repeatedly eating high-sodium foods can reduce sensitivity to salty flavors, which may lead to individuals preferring stronger saltiness. Yet, adding extra salt can be more about habit than about improving taste. To reduce overall salt consumption, measures to lower sodium contents in industrialized and ultra-processed foods are needed.
In addition to measures relating to food production, particularly processed foods, there also are measures everyone can take individually. Given the differences between men's and women's salt-adding behavior, the researchers said that campaigns aiming to decrease the additional use of salt should be tailored to different population groups, including gender and lifestyle characteristics
"The use of herbs and natural seasonings as alternatives to salt or culinary techniques such as using the acidity of citrus fruits may help reduce discretionary salt use while maintaining food palatability," concluded Santos. "Practical strategies, such as avoiding the routine placement of saltshakers on the table, may also help reduce habitual salt use."
