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Chinese morality rate ranked the highest due to “excessive salt intake”?

The Chinese have a famous saying, "I've eaten more salt than you've eaten rice," which is supposed to be an exaggerative expression, yet a 2019 study published in the Journal of the American Heart Association revealed that China has one of the highest average salt intakes worldwide, with an average daily salt intake that almost doubles the World Health Organization's recommended one. An article in the Journal of the American Medical Association looked at daily salt intake across 20 provinces in China and found that the 12 investigated provinces in northern China exhibited leading salt consumption compared to the south, seemingly confirming the proverb that described the southern meal as sweet and the northern meal as salty.

However, a diet of high salt intake is related to many health risks, including easily causing high blood pressure: after meals, salt is absorbed by the small intestine into the blood, prompting the formation of a hypertonic environment,  and causing more absorption of water into the blood vessels, then aggravating the burden on the heart, blood vessel walls and kidneys, ultimately impairing the kidney’s ability to reabsorb of calcium ions. In the long run, this process may lead to cardio-cerebral vascular disease and kidney disease. Other hazards include getting ugly, worsening intelligence level, and having a stroke.

On January 4, 2024, according to CCTV, Professor Ma Guansheng, the director of the Department of Nutrition and Hygiene at the School of Public Health at Peking University, claimed that the "Chinese morality rate ranked the highest globally due to ‘excessive salt intake’, and eating too much salt has become an important concern that jeopardizes the health of Chinese residents". However, according to the study, the relevant statements are only “High intake of sodium was the leading dietary risk for deaths and DALYs in China, Japan, and Thailand” and ”China had the highest age-standardized rates of diet-related cardiovascular disease deaths.” The reported statements may have been a distortion by the media.

It is obvious that China's per capita daily salt intake is high and the harm of a high-salt diet is worth attention. The cumulative impact of subtle everyday habits should not be underestimated, and we should be seeking self-reflection and moderation properly, but there is no need to panic.



References

Afshin, Ashkan, et al. “Health Effects of Dietary Risks in 195 Countries, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017.” The Lancet, vol. 393, no. 10184, May 2019, pp. 1958–72. www.thelancet.com, https://doi.org/10.1016/S0140-6736(19)30041-8.

El Darouti, M. A., et al. “Salty and Spicy Food; Are They Involved in the Pathogenesis of Acne Vulgaris? A Case Controlled Study.” Journal of Cosmetic Dermatology, vol. 15, no. 2, 2016, pp. 145–49. Wiley Online Library, https://doi.org/10.1111/jocd.12200.

Piñar-Morales, Raquel, et al. “Human Prion Diseases: An Overview.” Medicina Clinica, vol. 160, no. 12, June 2023, pp. 554–60. PubMed, https://doi.org/10.1016/j.medcli.2023.03.001.

Robinson, Austin T., et al. “The Influence of Dietary Salt Beyond Blood Pressure.” Current Hypertension Reports, vol. 21, no. 6, Apr. 2019, p. 42. PubMed, https://doi.org/10.1007/s11906-019-0948-5.

Salt and Sodium Intake in China | Lifestyle Behaviors | JAMA | JAMA Network. https://jamanetwork.com/journals/jama/article-abstract/2491630. Accessed 12 Jan. 2024.

Salty and Spicy Food; Are They Involved in the Pathogenesis of Acne Vulgaris? A Case Controlled Study - El Darouti - 2016 - Journal of Cosmetic Dermatology - Wiley Online Library. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocd.12200. Accessed 12 Jan. 2024.

Tan, Monique, et al. “Twenty‐Four‐Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta‐Analysis.” Journal of the American Heart Association, vol. 8, no. 14, July 2019, p. e012923. ahajournals.org (Atypon), https://doi.org/10.1161/JAHA.119.012923.


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