Sodium

Dietary sources

In western countries and in Italy, an adult consumes an average 6-15 g di sale (NaCl) every day, corresponding to about 2.3-6 g of sodium (1g NaCl = 0.4 g NA).

About 36% of the sodium in our diet comes from salt “added to food during cooking or at the table” (discretional sodium), while 64% comes from sodium used in the artisan or industrial processing of food (sodium chloride or sodium glutamate) and from that contained naturally in food (non-discretional sodium).
Sodium from cereals and cereal-based products (such as bread) accounts for 42% of non-discretional sodium (1.5-4g), followed by meat/eggs/fish (31%) and milk and dairy products (21%), due to the salt added during the packing processes (information obtained from the Italian Society of Human Nutrition).

Notes on physiology

The average bodily content of Na in an adult man is about 92 g, 46 g of which are found in extra-cellular fluids, with 11.5 g in intercellular fluids and 34.5 g trapped in bone.
Sodium is absorbed in the small bowel and the colon. Its concentration in extra-cellular fluids is regulated by the renal tubules (through aldosterone). Sodium is expelled in faeces and perspiration (7%).
Sodium carries out the important tasks of regulating the volume of extra-cellular fluids and the acid-base balance

Sodium requirements

Healthy adults: the EC recommends an intake of 1.5-8.8 g of salt a day.
During pregnancy: the daily recommendation during pregnancy and while breastfeeding is the same as for an average adult.
Children: the American RDA propose separate levels of consumption for babies, children and teenagers.

The low-salt diet

The rationale

An adult actually requires much less sodium than is commonly introduced via diet.

This dietary habit (well compensated for in a healthy person by correct expulsion of Na in urine) may be damaging in patients with pathologies related to sodium retention. Sodium retention determines an increase in the volume of extra-cellular fluids: water is drawn outside the cells to keep the concentration of sodium constant, causing fluid retention, oedema and high blood pressures. There is a direct relationship between the introduction of Na and increased systolic and diastolic blood pressure levels.
This relationship is continuous, meaning that there is no level of sodium introduction below which the effect does not occur. According to certain studies, a reduction in the amount of sodium results in an appreciable drop in deaths due to acute cardiovascular events (Law et al, 1991).
Low-salt diets vary according to the patient’s requirements and oscillate between 1 g and 3 g of sodium a day.

Indication of a low-salt diet:

A low-salt diet is indicated in all cases of sodium retention and therefore in the following pathological conditions:

• Treatment and prevention of fluid retention (oedema)

• High blood pressure

• Obesity/Excess weight

• 

  High blood pressure associated with obesity

• Cardiopathy with chronic heart failure

• Acute/chronic nephropathy, nephritic syndromes

• Advanced hepatic cirrhosis with ascites

• Patients taking cortisone treatment

Useful advice in clinical practice

The restriction of sodium in diets is usually hard for the patient to accept due to the lack of taste in food.
The doctor must:

• recommend the elimination of certain foods with high quantities of Na

• suggest alternative foods and condiments which are enjoyable and tasty, but with a low Na content.

It is important to remind the patient that numerous medicines and pre-packed drinks contain variable amounts of sodium and that numerous low-salt recipe books are available from bookstores. In obese or overweight patients, as well as those affected by high blood pressure, the association of a low-salt diet with a low-calorie diet is fundamental.

Useful advice in clinical practice

Low-salt breadsticks – Low-salt rusks – Low salt tea biscuits with fructose

Panmonviso low-salt products present 3 fundamental dietary properties:

1. Very low Na content (0.02%)
2. Less calories with equal volume
3. Great taste

Our low-salt breadsticks, rusks and tea biscuits have been formulated especially to make a low-salt, low-calorie diet more pleasant and acceptable.

Low-salt, vitamin-enriched Breadsticks and Rusks

Low-salt breadsticks and rusks are excellent bread substitutes to accompany meals, for breakfast or for a snack.
The products are well-risen, which means “large volume in proportion to weight”, producing a quick sense of “fullness” from a psychological viewpoint (optical volume).
Consequently, the feeling of hunger is eliminated with 30% less calories than with a common oven-baked product of the same weight.

Both breadsticks and rusks are vitamin-enhanced, containing Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), Vitamin PP (Niacinamide), Vitamin B9 (Folic Acid) and Iron.

As shown in the photo, with the same weight (50 grams), the volume of Monviso low-salt breadsticks is clearly greater than that of bread.

Low-salt vitamin-enriched fructose tea biscuits

Fructose tea biscuits contain no added salt or sucrose and have a low fat and low cholesterol content.
Excellent for breakfast, as a snack, a low-calorie end to a meal or between meals.

Dry biscuits and shortbread have a high sodium content due to the use of raising agents (bicarbonate of sodium, sodium pyrophosphate). The Monviso Tea Biscuit is made with sodium-free raising agents (ammonium bicarbonate).

Fructose has a higher sweetening power than sucrose meaning that you can get the same sweetness you enjoy with less carbohydrate. It requires no insulin during the initial stages of digestion and thanks to its low GI (glycaemic index), it causes a slighter rise in glycaemia after meals. Diabetics with a healthy weight and a good glucid, cholesterol and triglyceride balance can use fructose as a sweetener.

Vitamins: Vitamin B1 (Thiamine), Vitamin B2 (Riboflavin), Vitamin PP (Niacinamide), Vitamin B9 (Folic Acid) and Iron. These are ideal for patients who have to follow a low-calorie, low-salt and low GI diet. The nutritional characteristics of Monviso low-salt rusks have been compared with those of a dry tea biscuit and are summarised in the table.