• Salt intake in China among highest in the world for the past four decades. (Getty Images)
A new study highlights how the Chinese could reduce their salt intake and lower high blood pressure. How do Australians compare and could potassium-rich foods help reverse the damage?
By
Yasmin Noone

16 Jul 2019 - 2:17 PM  UPDATED 16 Jul 2019 - 2:17 PM

Chinese cuisine is among the most diverse, popular and delicious food styles across the globe. But according to a new study, the Chinese diet could be costing millions of people their heart health.

Research published in the Journal of the American Heart Association this month has found that salt intake in China has been among the highest in the world for 40 years.

The study, led by Queen Mary University of London, showed that average sodium intake in all age groups (children, teens and adults) across China is approximately double the recommended maximum limit.

The World Health Organization recommends that adults have less than five grams of salt a day to help reduce blood pressure and risk of stroke, coronary heart attack and cardiovascular disease – a major cause of death and disability in China.

Meanwhile, Chinese adults have been consistently consuming around 11.2 grams of salt a day (on average), over the past four decades. 

"On average, one tablespoon of soy sauce contains 61 percent of the maximum recommended daily salt intake."

How does Australia's love of salt compare to China's? 

In Australia, it’s estimated that most adults have around nine grams of salt a day.

The study’s authors reason that a rapid increase in the consumption of processed foods and foods eaten out of the home may be to blame for China’s high salt intake. They also pinpoint that reliance on pickled foods, rich in salt, could also be a culprit.

“Nevertheless, discretionary salt use still constitutes the vast majority of the sodium consumed in China,” the study reads.

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Heart Foundation dietitian, Sian Armstrong, explains that many Asian style sauces are extremely high in salt and should be avoided or replaced with a low-salt alternative.

Last year, a report from The George Institute for Global HealthVicHealth and the Heart Foundation, showed that sauces like soy sauce and fish sauce may push our salt intakes to high levels.

“We had a look at Asian style sauces and found that that they are particularly salty," Armstrong tells SBS. "On average, one tablespoon of soy sauce contains 61 percent of the maximum recommended daily salt intake.

“Similarly, fish sauce contains about 96 per cent of the maximum recommended daily salt intake.”

The power of potassium

The good news is that the study identifies a possible solution to China’s salt intake problem, beyond reducing the amount of salt-rich foods consumed.

While high levels of salt in your diet may increase you blood pressure, eating foods that are rich in potassium, like bananas and oranges, may work to reduce it.

It’s believed that potassium creates the opposite effect on blood pressure to salt. While high levels of salt in your diet may increase your blood pressure, eating foods that are rich in potassium, like bananas and oranges, may work to reduce it.

The study’s results also note that the potassium intakes in China are very low: “urgent action is needed to simultaneously reduce sodium and increase potassium intake across China,” the paper reads.

The authors advise replacing regular salt with low-sodium, high-potassium salt substitutes, which have been shown to lower blood pressure and reduce cardiovascular mortality in randomised trials.

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Armstrong suggests that Australians struggling with blood pressure issues could also increase the amount of potassium-rich foods in their diet.

“Our recommendation is to reduce the amount of sodium, particularly table salt, which can be damaging to your health,” says Armstrong. 

“But potassium will have the opposite effect. So we also recommend people eat foods like fruits, vegetables, nuts and dairy every day [to reduce blood pressure]. These are the foods everyone should be basing their diet around anyway.”

According to Queensland Health, fruits that are very rich in potassium include custard apples, bananas, jackfruits, nectarines and grapefruits. Potassium-rich vegetables are spinach, potatoes, tomatoes, sweet potatoes and artichokes.  

...fruits that are very rich in potassium include custard apples, bananas, jackfruits, nectarines and grapefruits.

Salt intake and Chinese geography

The study’s authors reviewed all data published on salt intake in China, which involved 900 children and 26,000 adults across the country.

They found that Chinese children aged three-to-six years old are eating five grams of salt every day – the maximum amount of salt recommended by the World Health Organization for adults.

The results also showed a clear North-South China divide with salt intake. A geographic pattern in the 24-hour urinary excretion of sodium found the highest sodium excretions found in northern China, the Tibet Autonomous Region, the Ningxia Hui Autonomous Region, and Henan Province.

The lowest sodium excretions were found in southern China, Guangdong Province, Hubei Province, and Guizhou Province.

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