Overconsumption of Salt and Calories in the General Population

Salt and calorie intake are excessive in the general population and requires control to diminish the prevalence and impact of heart disease.

Background

Heart disease is a condition that has an impact on the heart and can come in many different forms. The most common form is a myocardial infarction, a type of cardiovascular disease that can be caused by hypertension. Hypertension is defined as abnormally high blood pressure. Although hypertension can be passed on by genetics, especially in men (Williams, D.R., 2008.), it is very commonly caused by a person’s diet. A diet in high salt, saturated fat and excessive calories has been shown to directly cause hypertension (Frisoli, T.M., Schmieder, R.E., Grodzicki, T. and Messerli, F.H., 2012.) It’s also shown that a reduction in intake of these, can improve a person’s blood pressure and is therefore reversible up to a certain point (Blumenthal, J.A., Sherwood, A., Smith, P.J. and Hinderliter, A., 2018). Over the past years, due to the population’s lifestyle change, cardiovascular disease has increased drastically. This is life threatening and can easily be reduced by a reduction, however it has just continued to grow over time. Figure 1 (Blumenthal, J.A., Sherwood, A., Smith, P.J. and Hinderliter, A., 2018.) is showing an increase in the obesity prevalence in children from 1978 to 2014, which is directly cause by an overconsumption in calories. The change is from 5% to 18.5%, however began to slow down at 2004. The increase is drastic and extremely dangerous in terms of one’s health and the cause of heart disease, meaning to reduction of calorie intake needs to be controlled to reduce heart disease.

Figure 1 (Blumenthal, J.A., Sherwood, A., Smith, P.J. and Hinderliter, A., 2018.)

Many studies as well as the NHS recommended no more than 2400mg of sodium per day, however the world food organisation states to prevent disease in later life, it’s recommended the general population to consume no more than 5g of salt/ 2000mg of sodium per day, and 3g to 4g of salt would be more effective in reducing disease (Who.int, 2019). In terms of calories the NHS recommended men eat no more than 2500kcal and women to eat no more than 2000kcal (nhs.uk, 2019), to prevent obesity. Salt is also very excessive in the population, adults in the UK eat on average 8g of salt per day/3200mg of sodium, which is 1200mg more salt per day that the recommended amount for a person to prevent the occurrence of heart disease (Shankar, B., et al., 2013).

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A high salt intake and overeating can both directly causes the increase in blood pressure separately; however, it is likely that someone overeating will be eating more salt because of the extra food they are consuming, making it more dangerous for someone overeating to develop heart disease. Salt can be deceiving as its not always known exactly how much is added to foods such as a meal in a restaurant. The balance of salt in the body is essential for kidney function. Sodium (from salt) and potassium help the kidney get water from the blood to the bladder. A change in sodium will alter the balance, reducing the kidneys ability to do remove the water, leaving more in the blood and therefore cause a higher blood pressure (Blaustein, M.P. and Hamlyn, J.M., 1984.) As well as the dangers of the body’s sodium level, overeating can also cause hypertension by block the arteries. Overeating causes the body to store fat and atherosclerosis to occur. Atherosclerosis is the hardening of the walls of blood vessels such as the arteries. Fat deposits build up over time making the arteries narrower/ less room for blood to flow increasing the pressure. If an artery is blocked completely leading to the heart, a myocardial infarction will occur (Sowers, J.R., 2003). Lack of exercise and high saturated fat consumption will also contribute to the cause of heart disease

Hypothesis

Hypothesis: Salt and calorie intake in the general population are excessive.

The study investigates whether the sodium and calorie intakes are too high to evaluate the danger of heart disease in the population, and if it should be controlled to prevent this. Results are analysed to see if the data from sodium intake is correlated with other factors such as level of activity and calorie consumption and gain a better understanding of why this may be occurring and if it should be focused on by the population, to diminish the disease.

Method

Twenty-five university students were asked to fill out a 24 hour and four-day food diary, as accurately as possible. This included drinks and portion sizes as well as brands where possible. The software ‘Nutritics’ was then used to analyse the information into different components such as vitamins and sodium intake. There were also further questions such as gender, whether they take supplements, whether follow a restricted diet, if they are vegetarian and amount of exercise they participate in. This was to gain a better understanding of their lifestyle. In the results, only the four-day average was used, to get the most reliable result that represent participants actual everyday diets.

Results

 Figure 2

 

Figure 2 shows a scatter graph presenting the average sodium intake per day, over a four-day average. This includes 25 different participants. The black line at 2000mg of sodium shows the line at which sodium intake should stop, to prevent heart disease. This is according to the world health organisation (Who.int, 2019). 40% of students are shown to have an intake higher than this recommended amount, and three participants specifically have an extremely high intake at 8233.968mg, 5147.451mg and 5262.229mg. The overall average intake is 2392.466, which is also over the recommend intake.

Figure 3 

Figure 3 is showing a comparison of sodium intake and calorie intake of 1 participant, compared to the recommended amount discussed above. This is to represent how an individual may be undereating and may be at a healthy weight, however their sodium consumption is at such an extreme and would be likely to develop heart disease extremely quickly if they consumed this much every day. Sodium consumption is at 8233.968mg, which is 311.7% higher than recommended consumption.

 

     Figure 4

Figure 4 is showing the calorie consumption of all participants, over a four-day average. The plots in yellow represent male, blue represents females and red represents unknown. Results show that five females were overeating by a small amount, and one male was largely overeating, however, calorie intake required will vary depending on the activity level carried out in that day. This means 24% of people in the study were overeating, but only by a small amount and does not count for calories lost by exercise. Results for calorie intake show an inconsistent result with other studies such as figure 1, where calorie consumption is found to be much higher.

Figure 5

SODUIM INTAKE MG

CALORIE INTAKE KCAL

 CALORIE INTAKE (KCAL)

Figure 5 compares salt consumption with calorie consumption, to conclude if there is a correlation between them. There is a very weak positive correlation between the two sets of data. There is a much stronger correlation between exercise and sodium consumption as shown in figure 6. The R value of 0.009 shows that the relationship is weak, however it is not 0 so there is still a slight correlation.

Figure 6 

Pearson’s statistical analysis MET score and sodium intake

Results

COEFFICENT (R)

-0.36072

N (NUMBER)

19

T STATISTIC

-1.59467

DEGREES OF FREEDOM

17

P VALUE

0.130035

Figure 6 is showing sodium intake against MET scores (a score of the level of exercise the participant undergoes). The graph shows that most participants with high sodium intakes have a MET score of 1, therefore don’t usually participate in much high intensity exercise. Most participants with a MET score of 2 had low sodium intakes, however as MET score goes up to 3, some individuals intakes increased slightly, but remain low overall. The coefficient -0.36072 represents that an increase in sodium means there’s decrease in MET score intake, also shown in the trendline. The P value of these results show that it is not significant at 0.5.

Discussion

Although correlations and conclusions were found in the data, food diaries can be extremely inaccurate, and results don’t necessarily represent the whole population. Individuals may have forgot about something they consumed, been dishonest about what they consumed or simply underestimated their portion size because of lack of knowledge. If this is the case, sodium consumption could have been underestimated and levels may be even higher than recorded by each participant, making the danger of the populations diet even more dangerous. Calorie intake is also likely to have been underestimated, as averages do not correspond with national levels. The study size of 25 participants is also extremely small so is not likely to represent the whole population. Most of the individuals were also at a similar age and attend the same university, meaning the sample isn’t random, therefore the results are not reliable. For more reliable results, a larger sample size should have been used and a more diverse selection of participants should have been selected. The software ‘Nutritics’ does not contain all brands of food, which may have affected the accuracy of information inputted into the software.

The results show that overall, sodium intake is excessive, however in this group of individuals, calorie intake is not as an extreme problem as most of the group are consuming close to their recommended intakes. In contrast, there are still participants over eating, which is also shown in the increase in obesity levels in Figure 1. Furthermore, the data does not show any difference in consumption in males and females. A weak correlation was found between calories and sodium, as well as a correlation between sodium intake and exercise intensity. This is displaying people who carry out a ‘healthy’ lifestyle, such as participating in exercise and not overeating, are less likely to have a high sodium intake, and therefore are less likely to develop heart disease. This may be because eating less food gives the individual less chance to consume sodium in a meal, however is might be due to the participants knowledge. Studies show a person’s knowledge or upbringing is correlated with high body fat and an unhealthy lifestyle (Ventura, A.K. and Birch, L.L., 2008.). Figure 6 shows that the individuals with a MET score of 1, were the only participants overconsuming salt at a high level. This shows that those that don’t exercise often have an unhealthier diet compared to those that do, suggesting a lack of interest in looking after their health or what they eat. This is dangerous in terms of risk of heart disease, because they are likely to have more than one contributing factor to high blood pressure. Exercising can lower blood pressure (Chin, A., Xin, X. and He, J., 2002), also meaning those that have a higher sodium intake, but have a MET score of 3, are under less risk at developing heart disease. Participants that have sodium intakes more than double the recommended amount, such as the individual shown in figure 3 with an average intake of 8233.968mg of sodium, are at extremely high risk if they were to eat this amount every day. Because of the participants low calorie intake, it represents how salt in food may be very deceiving if this individual wasn’t overeating. Consuming foods in high salt is highly accessible in a variety of places and the problem is only going to increase unless control is put in place. In the UK McDonalds chicken nuggets and fries contains on average 1.72g of salt, which is extremely high for just one meal (Dunford, E, et al, 2012). This would eventually lead to a further increase in heart disease, putting the population at major risk. The population should be encouraged to watch their salt and calorie intake, as well as take part in regular activity, that will all contribute to the prevention of cardiovascular disease.

Bibliography

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Dunford, E., Webster, J., Woodward, M., Czernichow, S., Yuan, W.L., Jenner, K., Mhurchu, C.N., Jacobson, M., Campbell, N. and Neal, B., 2012. The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction. Canadian Medical Association Journal, 184(9), pp.1023-1028.

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