A Unique Child: Nutrition - A guide to ... salt

It is well known that a diet high in salt increases an adult's risk of developing high blood pressure and, in turn, suffering a stroke or heart failure. But there is growing evidence that too much salt may also influence children's blood pressure and predispose them to developing diseases such as osteoporosis and stomach cancer. There is a link too to childhood obesity. Salty food increases children's thirst and, research shows, their intake of soft drinks.

We are not born liking salt; we develop a preference for it the more we eat it. So with habits formed in childhood often continuing through to adulthood, limiting children's salt intake in the first place is vital. There is much, though, that early years settings can do to reduce salt levels in children's diets.

WHAT IS SALT?

Salt is a combination of sodium and chloride. Sodium chloride is the chemical term for salt. It's the sodium in salt that can be bad for your health.

There are different kinds of salt, such as rock and sea salts, but a survey by Consensus Action on Salt and Health (CASH) has shown that these are as high in sodium chloride as table salt so are just as bad for our health, regardless of their healthy image. See the CASH gourmet salt survey - www.actiononsalt.org.uk/less/surveys/2011/ Gourmet%20salts/59361.html.

DO WE NEED TO HAVE SALT IN OUR DIET?

We all need some salt in our diets to maintain our fluid balance, and for nerve and muscle function. Adults need less than 6g per day for our bodies to function, while babies under a year old need less than 1g per day.

For children aged one to three, it is recommended that they do not exceed 2g of salt per day - that is 0.8g of sodium. For fourto six-year-olds, that rises to 3g of salt per day - 1.2g of sodium (see table).

ARE SALT INTAKES GENERALLY HIGH?

Both adults and children are generally eating more than the recommended limits. Even if you don't add salt to children's food, it is still likely they will get enough - usually too much - from their diet anyway. Salt is contained in many everyday foods and drinks, and it is also to be found in unlikely foods such as breakfast cereals and bread.

Salt is added to some foods as a preservative or to enhance flavour, which is why many processed foods such as bacon, ham, ready meals, stocks, prepared sauces and cheese are high in salt.

This is why it is recommended that we limit processed foods in young children's diets, cook from scratch as much as possible and use herbs and spices in recipes instead of salt, as they develop flavour just as well (see recipe column).

HOW DO YOU CHECK FOR SALT IN PREPARED FOOD?

Many prepared foods now have nutritional labelling including salt labelling. National advice is that foods containing:

• 0.3g salt or less per 100g are low in salt

• 0.3g-1.5g of salt per 100g have medium levels, and

• more than 1.5g per 100g are high.

For sodium, foods are:

• low if they contain 0.1g or less per 100g

• medium if they contain 0.1g-0.6g per 100g, and

• high if they contain more than 0.6g per 100g.

Some companies choose to label sodium instead of salt, others label just salt and some label both. If a label provides sodium then you need to multiple it by 2.5 to find out the salt content. So sodium x 2.5 = salt.

If a company labels both, it is just showing the salt equivalent of the sodium and there is no need to combine the figures.

Traffic light labelling makes it easier to see at a glance if a product is high (red), medium (amber) or low (green) in nutrients. The amount of salt in grams per serving is also stated.

With some popular foods and staples high in salt - such as baked beans, condiments, cheese, cereal and bread - it is important to look for low-salt alternatives or eat fresh food with no added salt (see table).

You will find lots more information on reading food labels for young children in the Eat Better, Start Better guidelines at www.childrensfoodtrust.org.uk/eatbetterstartbetter.

HOW TO REDUCE SALT WHILE RETAINING THE FLAVOUR

• Don't add salt when cooking for young children. Instead, flavour savoury dishes with plenty of vegetables, herbs, spices, lemon, pepper, vinegar, chilli and garlic.

• Don't give children salt to add to their food.

• Limit your use of soups, stocks, gravy granules and ready-made sauces, whether they are dried or in liquid form. Instead, cook sauces for young children from raw ingredients, and thicken them with cornflour instead of gravy granules.

• Limit bought and home-made meat products for young children, things like sausage rolls and meat pies, to no more than once a week.

• Think about how often you are using ingredients like bacon, cheese, soy sauce and ham as these can be high in salt. For example, swap ham and cheese sandwiches for chicken or tuna.

• Don't give children condiments like ketchup very often, as these again can be high in salt.

• Give children healthy snacks such as fruit and yoghurt, rather than salty ones, like crisps.

• Cook from scratch with raw ingredients. Meat, poultry, fish, eggs, pulses, fruits, vegetables and many starchy foods are naturally low in salt.

• Check food labels and choose varieties that are lower in salt.

• Watch out for flavour enhancers like monosodium glutamate (E621, also known as MSG) in the ingredients of things like soups, sauces and sausages, as these can be high in sodium.

HOW DO THE DIFFERENT FOOD OPTIONS MEASURE UP?

FOODS THAT ARE OFTEN HIGH IN SALT - cut down on these foods
Anchovies
Bacon
Cheese
Chips (if salt added)
Coated chicken (eg nuggets)
Corn snacks (eg Wotsits)
Gravy granules
Ham
Noodle snack pots
Olives
Pickles
Potato snacks (eg Hula Hoops)
Prawns
Salami
Salted and dry roasted nuts
Salt fish
Sausages
Smoked meat and fish
Soy sauce
Stock cubes and bouillon
Yeast extract (eg Marmite)


FOODS WHERE SOME BRANDS ARE HIGH IN SALT - check the label
Baked beans
Biscuits
Burgers
Breakfast cereals
Bread and bread products*
Cakes and pastries
Cooking sauces
Crisps
Filled pasta
Ppasta sauces
Pizza
Potato croquettes
Ready meals
Soup
Sandwiches
Sausages
Tinned pasta
Tomato ketchup
* bread provides a fifth of our salt intake


FOODS THAT ARE LOWER IN SALT - eat more of these
- Breakfast cereals** (eg Shredded Wheat)
- couscous
- eggs
- Emmental
- fresh fish
- fresh meat and poultry
- fromage frais
- fruit and vegetables (dried, fresh, frozen and tinned)***
- home-made bread**
- home-made sauces**
- home-made soup**
- mozzarella
- pasta and rice
- plain cheese spreads
- plain cottage cheese
- plain popcorn
- porridge oats
- pulses (peas, beans, lentils)***
- ricotta
- seeds
- unsalted nuts yoghurt
** with no added salt *** choose tinned products with no added salt
www.actiononsalt.org.uk/Docs/resources/leaflets/33300.pdf


RECOMMENDED MAXIMUM SALT INTAKES
Age Maximum salt intake
0-6 months <1g/day
7-12 months 1g/day
1-3 years 2g/day
4-6 years 3g/day
7-10 years 5g/day
11 years and above 6g/day
Source: SACN recommended maximum salt intakes in the SACN salt and
health report: www.sacn.gov.uk/pdfs/sacn_salt_final.pdf, page 50

MORE INFORMATION

• Children's Food Trust - for recipes, guidelines and practical tools, try Eat Better, Start Better at www.childrensfoodtrust.org.uk/eatbetterstartbetter

• Consensus Action on Salt and Health, www.actiononsalt.org.uk/salthealth/children/index.html

Prepared with the help of Laura Sharp, nutritionist at the Children's Food Trust, and Kawther Hashem, nutrition assistant at Consensus Action on Salt and Health