We partnered with Harvey Norman and AWASH for a cooking demonstration in Hobart for World Stroke Awareness Week 2012.  Here is a recipe that was cooked on the day.

Description:

Serves 2

An easy lamb recipe with two slow-release low GI carbs - lentils and yoghurt. You feel fuller for longer!

Ingredients:

1 tablespoon olive oil
1 clove garlic, crushed
few sprigs of fresh oregano
zest of 1 lemon
300g (10oz) lamb fillet or back strap

Dressing:

juice of 1 lemon
½ cup low fat natural yoghurt
freshly ground pepper, to taste

Salad:

1 tablespoon olive oil
1 x 400g can brown lentils, drained
2 medium tomatoes, diced
35g (1oz) baby spinach leaves, shredded (leave out spinach of on blood thinning medication such as Warfarin)

Method

1. Combine the olive oil, garlic, oregano and lemon zest in a bowl. Add the lamb fillets or backstrap and marinate for at least 30 minutes. Brown the marinated lamb in a fry pan over medium-high heat or on the barbecue until just cooked. Remove, cover and set aside.
2. Meanwhile, combine the lemon juice with the yoghurt in a small jar, leaving aside a squeeze of the lemon juice. Add pepper. Put on the lid and shake to combine.
3. To make the salad, heat the olive oil in a fry pan over a medium heat and add the lentils, stirring till warm through. Add the tomatoes and spinach and a squeeze of lemon juice and stir to combine. Remove from the heat.
4. Slice the lamb across the grain about 1.5cm (3/4″) thick.
5. Spoon the lentil salad onto serving plates. Top with the sliced meat and pour over the dressing.

Additional Tips

Preparation time: 10 mins plus marinating time Cooking time: 15 mins

Nutrition per serve:

2452 kJ (584 calories), 31g fat (including 8g saturated fat), 16g carbohydrate (including 9g sugars), 7g fibre and 466mg sodium

Image via: brambleberry.com

The National Stroke Foundation, The George Institute, AWASH and C-PAN are working together in partnership to deliver important messages about reducing salt and the prevention of stroke.

AWASH Key Findings Report March 2012

Processed foods available in Australian supermarkets supply 75% of dietary salt. Although some manufacturers have reduced salt levels in foods there are wide variations in the salt content of comparable foods. Interpreting the food label to understand salt content is difficult for many consumers which makes identifying healthier choices hard.

We examined the effect on a typical daily diet of switching from higher to lower salt products in six categories of processed foods: breads, cereals, sauces and spreads, meat products, convenience foods and dairy. We used the recently launched FoodSwitch app to identify the lower salt alternates.

Key findings

Switching to healthier, lower salt equivalent products can save 5g of salt each day A diet with 5g less salt would reduce the risk of stroke by almost a quarter.

Savings start with breakfast where almost one half of a gram of salt could be saved by switching to a healthier option:

Kellogg’s Just Right Barley & Berry Flavour was 94% less salty than Kellogg’s Special K Forest Berries.

For a morning snack of crisp-bread and peanut butter failing to make the smart choice will result in four times more salt Coles Crunchy Peanut Butter No Added Salt had 96% less salt per serve than Kraft Crunchy Peanut Butter.

Switching to the healthier option of Ryvita Multigrain Wholegrain Rye Crispbread from an Arnott’s Sao Biscuit, meant 67% less salt.

Healthier ingredients for a homemade lunch comprising one sandwich wrap with a ham, cheese and pickle filling could save 1.4g of salt. Most of this was achieved by choosing the right ham and bread product Switching to Don Shaved Light Leg Ham from Primo Premium Shaved Leg Ham saved 0.6g of salt. Wattle Valley Soft Wraps Wholegrain was over half a gram saltier compared to Freedom Foods Norganic Multigrain Wraps

There was a three-fold difference in the salt content of the fruit filled bars for an afternoon snack Weight Watchers Raspberry Pie Bar had 0.1g salt/serve compared to Coles Fruit Filled Bar (Apple & Cinnamon) (0.3g salt/serve).

The biggest saving of the day was the pasta dinner where 2.4g of salt was saved by switching to a lower salt dish Lean Cuisine Steam Beef and Mushrooms with Pasta Steams in Minutes (1.4g salt/serve) has hugely less salt than Pastabilities Ravioli Beef with Caramelised Onion and Red Wine in Cracked Black Pepper (3.8g salt/serve).

See Video of findings here thanks to ninemsn.

BACKGROUND

Reducing salt intake, with the aim of lowering blood pressure and preventing heart disease and stroke, has been identified as one of the most cost effective options for improving public health. Following the recent United Nations High Level Meeting on preventing chronic disease, salt reduction, alongside tobacco control, was highlighted as a global health priority.

Each year World Action on Salt and Health coordinates World Salt Awareness Week to increase understanding of the harmful effects of salt on health. The theme for this year’s Salt Awareness Week(26th March – 1st April 2012) is Reducing salt: preventing stroke. A stroke occurs when part of the blood supply to the brain is cut off, reducing the amount of oxygen that can get to the brain and its effect is to suddenly and seriously reduce brain function causing a stroke.

There are two main types of stroke - ischaemic stroke caused by a blocked blood vessel which stops blood getting to the brain, and haemorrhagic stroke caused by a blood vessel burst and leakage of blood into the brain. Stroke is the second biggest cause of death after coronary heart disease and a leading cause of disability. In Australia there are an estimated 60,000 strokes per year with 30% of those affected dying within the first twelve months and only 10% making a full recovery.1 Stroke is estimated to cost Australia $2.14 billion / year.

The risk of stroke increases with age, and with an ageing population it is almost certain the incidence rate will increase unless action is taken.1 There are risk factors that can be targeted to reduce stroke, but the most important one is reducing blood pressure. Excess dietary salt consumption is one of the main causes of high blood pressure.

The Suggested Dietary Target (SDT)2 for salt intake is 4 grams / day and the maximum recommended intake is 6 grams /day. Most Australians eat between 8 and 10 grams / day with major adverse consequences for their health. Reducing salt intake by 5 grams / day (taking a level teaspoon of salt out of your diet) will reduce the risk of stroke by about a quarter. This would translate into thousands of strokes prevented in Australia every year.

The Australian Division of World Action on Salt and Health (AWASH) Drop the Salt! campaign was launched in May 2007 with three objectives - to reduce the salt content in foods, to change consumer behavior and to improve labelling of salt on products. Engagement with Federal and State Governments and the food industry is ongoing.

Most recently AWASH has launched the FoodSwitch app to help consumers make healthier food choices. Developed in partnership with Bupa Australia, FoodSwitch combines nutritional profiling from Food Standards Australia New Zealand (FSANZ) and traffic light labelling criteria developed by the UK Food Standards Agency. The aim of FoodSwitch is to make choosing healthy foods easy to identify at a glance by presenting nutritional information in an interpretive traffic light format. Using FoodSwitch this report highlights how dietary salt can be reduced by 5 grams a day through switching to healthier foods of the same type.

Salt consumption in adults and children and a food industry perspective on salt targets are just some of the topics on the agenda at a seminar in Melbourne to mark the start of World Salt Awareness Week on 26 March.

Deakin University’s Centre for Physical Activity and Nutrition Research (C-PAN) with the Australian Division of World Action on Salt and Health (AWASH), and the National Stroke Foundation is holding a free public seminar.

Salt reduction and stroke prevention is the theme for this year’s World Salt Awareness Week because salt is the major factor that raises blood pressure and high blood pressure is the single biggest modifiable risk factor for stroke. Evidence also suggests that a high salt intake has a direct, independent effect on stroke, indicating that salt is responsible for many incidences of stroke.

Professor Caryl Nowson from Deakin University is an expert in the role of dietary minerals and electrolytes in the control of blood pressure. She holds the chair of professor of Nutrition and Ageing at Deakin University and was the founding chairperson of AWASH.

Professor Nowson, who will be speaking at the seminar, said excessive salt consumption was a critically important public health issue.

“The maximum daily amount of salt recommended for health by the National Health and Medical Research Council is just four grams of salt each day,” Professor Nowson said.

“Consumption levels in recent studies suggest daily average intake is about nine grams – more than double that amount.”

National Stroke Foundation CEO Dr Erin Lalor said reducing average salt intake by just one gram per day worldwide could prevent thousands of deaths from stroke every year. “Stroke is the second leading cause of death in Australia and a major cause of adult disability,” Dr Lalor said.

“By raising awareness of the dangers of high salt consumption we hope to reduce the incidence of stroke.

“It’s very important that everyone learns how to cut their salt intake and how to read food packaging so you can make healthier food choices.”

Professor Nowson will be joined at the seminar with speakers from the National Stroke Foundation, Deakin University and the Australian Food and Grocery Council.

Image via www.facebook.com

How can implementing a population-wide salt-reduction program be so hard?

For most of human evolution, the average daily diet contained a fraction of a gram of salt and our physiology developed accordingly. A few thousand years ago, with the discovery that salt could preserve food, average intake started to rise. Now, with salt poured into the food supply, average Australian consumption levels are many times our physiological need. Populations eating the level of salt upon which we evolved are now few, but they provide a window into normal physiological processes. One of the most notable findings is that their blood pressure levels do not rise with age.

Despite recent highly publicised reports, there is little debate about the adverse impact of salt on human health. The totality of the evidence is convincing and the unbiased findings from randomised trials of salt reduction particularly so. While a number of non-randomised studies have suggested health benefits of salt consumption, the publicity they receive greatly exceeds their real significance. Observational nutritional epidemiology is incredibly difficult to do well, and the diversity of findings almost certainly reflects methodological challenges, not discrepant science. Although direct evidence from a single adequately powered mortality and morbidity trial of salt reduction is lacking, the circumstantial evidence remains striking and the likelihood that reduction in salt intake will not reduce vascular risk is small.

The strength of the evidence base has persuaded multiple national and international organisations of the need to reduce salt consumption. All hypertension guidelines advocate consuming less salt, and more than 30 countries now have some form of population-based salt-reduction program in place. A series of influential reports has highlighted the large health gains that might be achieved from such national programs and the low costs required to deliver them. The issue is no longer whether salt reduction should be a goal, but how it can be achieved.

The reason salt reduction presents such a great public health opportunity is that almost everyone eats far more than they need. Average consumption in Australia is between 8 and 10 grams per day, with immediate and long-term implications for blood pressure. The early effects occur within weeks and the chronic effects over decades. As shown by Huggins and colleagues in this issue of the Journal, and previously noted by the Intersalt study, a daily intake 6 grams above physiological need will push up systolic blood pressure by a few millimetres of mercury in the short term and thereafter by about half a millimetre each year. This chronic effect translates into 25mmHg over 50 years, with enormous implications for individual and population risks of vascular disease.

Blood pressure is a leading cause of disease burden in Australia, and our strategy for preventing disease attributable to high blood pressure is hypertension control — individuals are diagnosed as hypertensive and treated within the medical system. Hypertension is currently the most frequent reason for a primary care consultation, with annual direct health care costs of more than a billion dollars. For those who need and receive it, antihypertensive therapy is a highly effective intervention.

Unfortunately, the clinical approach also has some limitations. First and foremost among these is that half of all disease caused by high blood pressure occurs among people without hypertension. Risks start to accrue well below the blood pressure level of 140/ 90mmHg that generally defines hypertension, and systolic blood pressure levels of 125–135 mmHg are associated with greater risks than a level of 120mmHg. While more moderate than the risks faced by those with hypertension, these blood pressure levels  cause a very large number of adverse events because these are theblood pressure levels of most of the population.

The limited coverage achieved by the clinical hypertensioncontrol strategy further reduces its effectiveness. Only about half of hypertensive people are identified and treated;14 less than half ofthese get to target blood pressure levels,14 and almost none achieve a systolic pressure of 120 mmHg or below. Accordingly, clinicalmanagement of hypertension in Australia probably prevents only about a 10th of all blood pressure-related disease.

A plausible population-wide salt-reduction program thatremoved salt at the source could within a few years avert a similarproportion of disease burden at an annual cost of just $10–20 million. To achieve this, the Australian Government simply needsto set and enforce salt targets for foods, as has been done in the United Kingdom.7 Average salt consumption would fall, mean population blood pressure would immediately follow, and the long-term rise in blood pressure with age would be attenuated.

The real question is how this can be so hard. For almost no extra cost and at no risk, there is a high likelihood we could double the proportion of blood pressure-related disease averted within just a few years. With a proven overseas model to follow, our failure to take the action required is bordering on negligent. No one is going to lose their parliamentary seat and no one is going to go out of business if they make this happen. There are just going to be a lot of unnecessary strokes and heart attacks while the people pickling us figure this out.

Author Bruce C Neal, MB ChB, PhD, FRCP, Senior Director
The George Institute for Global Health, Sydney, NSW.

Published in the MJA 1 August 2011

Getting across to men just how bad salt is for their health is the focus of a debate being hosted by The George Institute for Global Health in Sydney today as part of World Salt Awareness Week.

Whilst the adverse affects of high blood pressure on men’s sex lives is clear, the direct link between salt and sex is yet to be proven. There is, however, a huge body of evidence showing that salt is the main cause of high blood pressure which kills thousands of Australian men each year - mostly through premature strokes, heart attacks and heart failure. Excess salt is also implicated in a range of other serious illnesses including stomach cancer, kidney disease, osteoporosis and asthma.

Professor Bruce Neal, Senior Director at The George Institute and Chairman of the Australian Division of World Action on Salt and Health (AWASH) will open the event by presenting the findings of new research on salt levels in foods commonly eaten by Australian men. New salt targets for the food industry will also be launched on the day. Said Prof Neal, “Whilst we won’t present definitive new evidence linking salt and sex, we are serious about getting the salt message across to men. Men die younger and need to drastically reduce the amount of salt they eat.  But the food industry needs to play its part too.”

He added, “Our latest work reveals the shockingly high levels of salt that are hidden in the processed foods and meals that men are eating every day. Whilst many companies have been reducing salt levels in foods, and the government’s Food and Health Dialogue has set salt targets for bread and breakfast cereals, a greater effort is needed to ensure salt intakes in Australia can be reduced much more quickly. That’s why we have today announced 85 new salt targets for foods.  This will give industry the direction they have been asking for. We will be working closely with companies to help them reduce salt in line with these interim targets in support of ongoing Food and Health Dialogue discussions.

Around 100 delegates will attend the debate which will be chaired by Dr Stan Goldstein Chief Medical Advisor of Bupa Australia. Panel members will include Andrew Giles from the Garvan Research Foundation, Daniel Williams from Men’s Health Magazine, Sue Radd from the Nutrition and Wellbeing Clinic and Jodie McHenery from the Dietitians Association of Australia.

Said Dr Goldstein, “Bupa Australia communicates crucial health information to the public and to its members every day.  Young men (and women) are eating too much salt, developing habits that can unknowingly hit them hard over time - there is clear evidence that this is resulting in premature death and disease.  Getting the message across, especially to men, that they need to reduce their salt intake should be a priority for government and health organisations.”

World Salt Awareness Week runs from March 21st – 27th this year and the theme is Salt and Men’s Health. Other events being organised by AWASH as part of the week include a low salt cooking class and the launch of a new project to assess salt intake in Lithgow, New South Wales. A range of informative materials are also available.

For more on Drop the Salt campaign and AWASH click here.