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少吃盐有益身体健康

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    多年来,美国人已经习惯吃盐了。多数人不知道他们吃了多少盐---根据美国心脏协会研究,平均每人每天大约9到12 g (或3,600到4,800毫克)。而那是政府推荐量的两倍。

    在过去四十年,美国人的盐消耗量上升了50%,主要是因为吃了更多的处理过的以及餐馆里的食物。“久而久之,我们适应了我们的味觉以及我们的身体喜好,吃的盐比我们身体机能需求水平高出很多”,科尔斯顿.比宾斯.多明戈博士说,她是旧金山加州大学的一位流行病学家。

    当然,适量的盐对身体健康非常重要---调节血压,协调肌肉和神经功能---然而太多的盐(即我们当前消耗的水平)可能导致高血压、心脏病、中风等。根据美国医疗协会研究,如果美国人把他们的食盐量减半,每年可以防止多达15万的夭折事件。比宾斯.多明戈在3月11日的美国心脏协会年会上提出最新研究表明:甚至稍微减少---即使每天1克---就能有激动人心的效果,能在十年中拯救20万生命。

    使用一台尖端计算机模型分析美国成年人心脏病患者随着时间推移的动态,比宾斯.多明戈和她的同事发现越来越多的人普遍减少摄盐量能彻底改善公共健康状况。每人每天减少1克盐(或者40毫克的钠),在2019年前美国总人口中就能防止3万例冠状动脉心脏病。减少一半的食盐量---相当于6克---在2019年能防止140万心脏病。

    研究人员发现少吃盐能全面的改善人们的健康状况,尤其对美国黑人和妇女来说更有益。美国黑人这一群体比一般人口的血压要高,并且“很多研究表明他们对盐更敏感,”比宾斯.多明戈说。她的研究发现食用盐每天减少3克平均能减少8%的心脏病发作,而对美国黑人来说会减少10%。一个相似的研究发现减少3克使用盐量对妇女来说能减少8%的中风风险,而对男人则下跌了5%。

    这些数字肯定能给大家减少食用盐量带来了强烈的刺激,然而这并不简单。你能够放下盐瓶,少吃盐多的小吃,然而在处理过的食物中仍然有很多的钠,而设法从饮食中提取它是非常棘手的。“它在平常美国人中是如此普遍存在,因此告诉人们‘你必须得避开盐’是很困难的。”比宾斯.多明戈说。

    并且有些盐掩藏在你根本想不到看不到的地方。根据美国农业部的钠图,一片商业制造的全麦面包含有148毫克的钠,白面包有170毫克,一杯麦片含有213毫克钠,全然的葡萄干小麦片含239毫克钠。然后还有罪魁祸首呢:处理过的汤和酱汁。比如鸡汤面,即使在准备期间已经用水稀释过,一杯里还是有高达1106毫克的钠。“我认为人们没有提示,”比宾斯.多明戈说。“推荐日食盐量是大约一茶匙,”她说。“仅仅是加盐就很容易超过这个量很多,”更不用说在我们打开盐瓶前食物中所有的盐了。

    如果您出外用餐,那所有的方法都无效。根据英国公众舆论行动组织盐对健康的研究,餐馆三餐包含了15克盐,几乎是日推荐量的三倍。

    比宾斯.多明戈说,对于收入有限的家庭来说减少食盐更为困难,这些家庭更多的依赖处理过的或袋装的食物,罐头水果蔬菜等,而非新鲜蔬菜。病人告诉她说他们已经减少食用腌制果实,炸土豆条以及椒盐饼干,开始食用更多的汤。“你发现了,他们在选择健康饮食的时候实际上却食用了更多的盐,”她说。

    公众健康专家说,任何减少摄盐量的大规模的成功都必须有政府决策人员和食品工业介入。“如果你能仅靠几点就减低了血压,那你就能减少成千上万的死亡,”纽约市身心健康保健部委员托马斯.弗雷登博士说。他最近宣布一项在未来五年内减少摄盐量20%,未来十年内减少40%的全民运动。弗雷登在过去曾把转化脂肪作为目标,指责连锁餐厅,要求在菜单上列出含有热量,他减少盐分的努力比他早先的倡议少了食品餐馆工业对他的仇恨。#p#分页标题#e#

    “弗雷登在寻找义务指南。这是全国运动,为了开发这些再教育指南,他正和工业产业紧密合作,”纽约州餐馆协会律师罗宾.布克曼说,但是他挖苦的补充说,“我不知道这是否是一件快乐的事情。”

    弗雷登指出英国一次成功的减盐运动作为证据和原则。英国政府展开了包括食品制造商志愿减少含盐量的进取性全民运动的几年后,英国市民大概减少了10%的年钠消耗量。“如果您注意了在英国发生了什么事,你会发现首先工业产业是很关心的,”弗雷登说。“但是几年以后,他们发现在不失去顾客的情况下原来是可以减少20%到30%的含盐量的。”

    对于比宾斯.多明戈来说,比起授权或禁止食品生产商,更大的问题是能使人们做出更好的选择。“这实际上是我们用很少的费用可以达到个人自由的事。”

    但是弗雷登坚持强硬路线。当被问道是否应该允许政府影响我们应该怎么吃以及吃什么时,他用了一个针对性的反问来回答:“应该允许工业给我们提供让我们病残,杀害我们的食物吗?

译文:Eating a Bit Less Salt Can Be a Big Health Boon


Over the years, Americans have become inured to salt. Most people haveno idea how much salt they consume — on average, about 9 to 12 g (or3,600 to 4,800 mg of sodium) per person per day, according to theAmerican Heart Association (AHA). That's twice the amount recommendedby the government.
In the past four decades, Americans' salt consumption has risen 50%,mostly as a result of eating more processed foods and more foodprepared in restaurants. "Over time, we have adapted our taste buds andadapted our bodies to crave much, much higher levels of salt than werequire to function," says Dr. Kirsten Bibbins-Domingo, anepidemiologist at the University of California, San Francisco.

Some salt is crucial for good health, of course — to regulate bloodpressure and assist with muscle and nerve function — but too much (thatis, at the levels we currently consume) can lead to hypertension, heartdisease and stroke. If Americans halved their salt intake, as many as150,000 premature deaths could be prevented each year, according to theAmerican Medical Association. And new research presented March 11 byBibbins-Domingo at the AHA's annual conference shows that even smallreductions — as little as 1 g of salt per day — could have dramaticeffects, saving 200,000 lives over the course of a decade.

Using a sophisticated computer model to analyze trends in heart diseaseover time among U.S. adults, Bibbins-Domingo and colleagues discoveredthat incremental population-wide reductions could drastically improvepublic health. Cutting out just 1 g of salt (or 40 mg of sodium) perperson per day could prevent 30,000 cases of coronary heart diseaseacross the U.S. population by 2019. Reducing consumption by half — amore sizable 6 grams — could prevent 1.4 million cases of heart diseaseduring that same period.

While eating less salt would improve the health of the populationacross the board, researchers found that the benefits would be greatestfor African Americans and women. As a group, African Americans tend tohave higher blood pressure than the general population, and "manystudies suggest that they may be more sensitive to salt,"Bibbins-Domingo says. Her analysis found that a reduction of 3 g ofsalt per day would reduce heart attacks 8% on average; among AfricanAmericans, that rate would drop 10%. A similar result was found inwomen, whose stroke risk dropped 8% with a 3-g reduction in saltintake; in men, the risk fell 5%.

The numbers certainly offer compelling incentives to cut saltconsumption, but that's no easy task. You can put down the salt shakerand cut back on obviously salty snacks, but there's still so muchsodium packed into processed foods that trying to extract it from yourdiet is a tricky business. "It's so pervasive in an average U.S. dietthat it's really hard to tell people, 'You have to avoid salt,' " saysBibbins-Domingo.

And there is salt hiding in places you wouldn't think to look. According to a ,a single slice of commercially made whole-wheat bread has 148 mg ofsodium; white bread has 170 mg. Cheerios contains 213 mg of sodium percup; Total Raisin Bran, 239 mg. And then there are the big offenders:processed soups and sauces. Chicken noodle soup, for example, evenafter it has been diluted with water during preparation, has a whopping1,106 mg of sodium per cup. "I think people don't have a clue," saysBibbins-Domingo. "The recommended daily amount of salt is about ateaspoon," she says. "It's easy to add that much if you're just addingsalt," let alone all of the salt that's in food before we break out theshaker.

If you're dining out, all bets are off. According to the British organization , a three-course meal in a restaurant can contain more than 15 g of salt, almost three times the recommended daily amount.

Bibbins-Domingo says it's especially tough for families with limitedincome, who tend to rely more on processed or packaged foods and cannedfruits and vegetables rather than fresh foods. Patients tell herthey've cut salted nuts, potato chips and pretzels from their diet andstarted eating more soup instead. "You realize that they're actuallyconsuming more salt in their attempt to make healthy choices," shesays.

Any large-scale success in salt-intake reduction would have toinvolve policymakers and the food industry, say public-health experts."If you could reduce blood pressure by just a few points, you couldreduce hundreds of thousands of deaths," says Dr. Thomas Frieden,commissioner of New York City's Department of Health and MentalHygiene, who recently announced a national campaign to diminish saltintake 20% in the next five years and 40% in the next decade. Frieden,who has in the past targeted trans fats and led the charge to requirechain restaurants to list calorie content on menus, has evoked lessanimosity from the food and restaurant industries with hisdesalinization efforts than with his previous initiatives.

"[Frieden] is looking for voluntary guidelines. It's a nationalmovement, and he's working closely with the industry on developingthese re-education guidelines," says Rob Bookman, an attorney for theNew York State Restaurant Association, but he adds wryly, "I don't knowif it's one big happy family."

Frieden points to a successful salt-reduction campaign in the U.K. as akind of proof of principle. Several years after the British governmentlaunched an aggressive national campaign, which included voluntaryreductions in salt content by food manufacturers, British citizens hadreduced their annual sodium consumption roughly 10%. "If you look atwhat happened in the U.K., at first the industry was very concerned,"Frieden says. "But after a few years, they saw that they could droptheir salt content 20% to 30% [without losing customers]."

For Bibbins-Domingo, the issue is less about mandating foodproduction or proscribing salt consumption than enabling people to makebetter choices. "This is actually something that we can achieve withvery little cost to our personal liberties," she says.

But Frieden adheres to a harder line. When asked whether thegovernment should be allowed to influence how or what we eat, heresponded with a pointed rhetorical question: "Should industry beallowed to serve us food that makes us sick and kills us?"


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