An inconspicuous cooking habit can cause osteoporosis in the whole family

When it comes to osteoporosis, the first thing many people think of is calcium supplementation. Many people also pay attention to calcium supplementation to prevent osteoporosis.

Calcium is indeed beneficial for preventing osteoporosis. However, many people overlook a cooking habit at home that can cause osteoporosis for the whole family - they like to add more salt when cooking!

The salt intake of Chinese residents is about twice the recommended amount for health. High salt intake will increase calcium loss and increase the risk of osteoporosis.

How harmful is osteoporosis?

Osteoporosis, to put it bluntly, means "loosening of bones".

Our bones are covered with a hard shell that encloses the trabeculae (a spongy bone tissue) inside. The internal structure of healthy bones is similar to that of a sponge. In addition to supporting the body and protecting important organs, bones also store minerals such as calcium. During bone metabolism, a certain amount of bone tissue is dissolved and absorbed every day, and a considerable amount of bone tissue is generated. The balance between the two maintains bone stability. Once the bone generation is less than its dissolution and absorption, the bone tissue will gradually become thinner, thinner, or even broken, causing osteoporosis.

Normal people vs osteoporosis patients. Copyrighted images from the gallery, reprinting and using may cause copyright disputes

"Osteoporosis" is a common disease that seriously threatens the health of the elderly, and the problem of osteoporosis is particularly serious in middle-aged and elderly women.

The results of the China Osteoporosis Epidemiological Survey show that the prevalence of osteoporosis in people aged 50 and over is 19.2%; the prevalence of osteoporosis in people aged 65 and over is 32.0%, including 10.7% for men and 51.6% for women[1]. More seriously, the bone health level of the Chinese people is also worrying, and there is a trend of younger people suffering from low bone mass. The survey found that there are a large number of people with low bone mass in my country, who are a high-risk group for osteoporosis. The low bone mass rate in the population aged 40 to 49 in my country reached 32.9%, including 34.4% for men and 31.4% for women.

Bone loss usually occurs quietly, without obvious symptoms; however, as osteoporosis worsens, symptoms such as back pain, hunchback, and shortening may occur. It is also easy to fall and fracture. Falls and fractures caused by osteoporosis are a very fatal problem for the elderly [2]. Among them, femoral fractures are particularly dangerous, and about 20% of patients die within a year of diagnosis. The death of Mr. Yuan Longping, the father of rice, was also related to an accidental fall. Therefore, osteoporosis is often called the "silent killer" (you can review the previous article "Why do old people who are in good health die soon after a fall?").

High salt intake increases the risk of osteoporosis!

In addition to providing saltiness, salt is also the best player in blending flavors. It can eliminate bitterness, weaken sourness, and enhance sweetness. It can enrich the aroma of food and boost the overall flavor of food. Therefore, salt is always indispensable in food, and many people are accustomed to adding two spoons of salt when cooking.

However, if you eat too much salt, it will be excreted from the body through urine, and some calcium will be taken out at the same time, which increases the risk of bone loss.

For every 2,300 mg of sodium (equivalent to 6 grams of salt) excreted by the kidneys, 40 to 60 mg of calcium is lost at the same time. Excessive intake of salt means more calcium will be taken away. If there is too much sodium to be excreted and there is not enough calcium, it can only be "grabbed" from the bones. Over time, it will cause calcium loss, which will increase the risk of osteoporosis. Many studies have shown that sodium salt intake is associated with reduced bone density in the hip or vertebrae.

The reality is that the calcium intake of Chinese residents is greatly insufficient (about 330 mg/day per person, and more than 90% of the people get insufficient intake). If they eat more salt, it will only make osteoporosis worse.

For this reason, current health recommendations for osteoporosis in my country suggest that osteoporosis patients should follow a low-salt diet, with adults consuming no more than 6g of salt per day and the elderly no more than 5g.

How much salt do we eat?

It is said that China is a country of great food, with many kinds of delicious "dishes to go with rice", and salt plays an indispensable role in these delicacies.

Copyright images in the gallery. Reprinting and using them may lead to copyright disputes.

Over the past 40 years, salt intake among people of all ages in China has remained at a high level, about twice the amount recommended by the World Health Organization (5 grams).

The results of the 2012 Chinese Residents’ Nutrition and Health Status Monitoring showed that the average daily salt intake per person in my country was 10.5g.

Evaluation data from 2016 showed that the average daily salt intake per capita in China was 9.2 grams, with Henan having the highest intake, followed by Beijing, Liaoning and Shaanxi.

In 2019, The Lancet published an analysis of mortality and disease burden caused by the dietary structure in 195 countries and regions around the world. The results showed that China's mortality rate caused by dietary problems ranked second in the world, and one of the reasons was eating too much salt.

With the advancement of the National Nutrition Plan and the Healthy China Action, we have started the "Three Reductions" campaign, and reducing salt is one of them. By 2020, there have been some results. The "Report on the Nutrition and Chronic Disease Status of Chinese Residents (2020)" shows that the average salt intake of Chinese residents is 9.3 grams per day.

However, the Healthy China Action and the Dietary Guidelines for Chinese Residents (2022) recommend that our daily salt intake should not exceed 5 grams per person. We are still far from this goal!

Overall, the amount of salt we consume is indeed high, about twice the recommended amount for health, and there is still a long way to go to reduce our salt intake.

How to eat less salt?

About 80% of Chinese people's sodium intake comes from the home kitchen, including salt, condiments and pickles added during cooking. How can we reduce salt intake in daily life? It is recommended to start from the following aspects:

1. Use a salt limiter or salt limit spoon. When cooking, you can use a salt limiter and a salt limit spoon to remind yourself how much salt you use. The salt limit spoon has 2g and 3g, so you can control the amount of salt you use more accurately.

2. Use cooking techniques to reduce the use of salt. When cooking food, do not use or use less salt, soy sauce, fish sauce or other salty seasonings. Add salt when the food is almost out of the pot, so that it will taste salty.

3. Use the natural flavor of food to enrich the taste. The natural flavor of some foods can also make the dishes taste better. When cooking certain dishes, you can add vinegar, lemon juice, or chili to replace the saltiness of salt, which can not only meet the taste needs but also reduce salt intake.

4. Limit salty snacks and fast food, beware of hidden salt. Many snacks for children/adults and fast food are high in sodium, such as potato chips, some hamburgers and pizza. In addition, the hidden salt in foods such as bean paste, hot sauce, mustard, pickled vegetables, pickled cucumbers, yellow sauce, soybean paste, fermented bean curd, salted duck eggs, etc. should not be ignored, try to avoid eating less or not eating them.

5. Read the nutrition label and choose foods with lower sodium content. When buying packaged foods, pay attention to the nutrition label, mainly look at the sodium content, and give priority to foods with lower sodium content.

6. When buying table salt, you can choose low-sodium salt. The main component of ordinary table salt is sodium chloride, and low-sodium salt contains about 70% sodium chloride and about 30% potassium chloride. If you choose to consume the same weight of low-sodium salt, you will virtually reduce your sodium ion intake by about 30%. As for some high-end salts on the market, such as bamboo salt and snowflake salt, they are all salt, and there is no benefit in eating more.

7. Not salty does not mean no salt. For example, foods such as plums, ketchup, bread, and sandwich biscuits may not taste salty, but they contain a lot of "hidden sodium", which is equivalent to excessive intake of "salt". You should also be careful to eat less.

References

[1]https://www.chinacdc.cn/gsywlswxx_9498/crbs/201812/t20181217_198289.html

[2] Working Group of "Guidelines for the diagnosis and treatment of osteoporosis in the elderly in China (2023)", Osteoporosis Branch of the Chinese Society of Gerontology and Geriatrics, Osteoporosis Branch of the China Association for the Promotion of International Exchange of Medical and Health Care, etc. Guidelines for the diagnosis and treatment of osteoporosis in the elderly in China (2023) [J]. Chinese Journal of Bone and Joint Surgery, 2023, 16(10): 865-885.

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[7] Bi Xiaoyi, Yang Titi, Xu Peipei, et al. Dietary calcium intake of children aged 6 to 17 years in China from 2010 to 2012[J]. Journal of Health Research, 2021, 50(03): 431-434. DOI: 10.19813/j.cnki.weishengyanjiu.2021.03.014.

[8]HuangF,WangZ,ZhangJ,DuW,SuC,JiangH,JiaX,OuyangY,WangY,LiL,ZhangB,WangH. DietarycalciumintakeandfoodsourcesamongCh ineseadultsinCNTCS.PLoSOne.2018Oct1;13(10):e0205045.doi:10.1371/journal.pone.0205045.PMID:30273413;PMCID:PMC6166981.

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[10] Chinese Medical Association Osteoporosis and Bone Mineral Disease Branch. Guidelines for the diagnosis and treatment of primary osteoporosis (2022)[J]. Chinese General Practice, 2023, 26(14): 1671-1691. DOI: 10.12114/j.issn.1007-9572.2023.0121.

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[13]Health effects of dietary risks in 195 countries, 1990–2017: systematic analysis for the Global Burden of Disease Study 2017. DOI: https://doi.org/10.1016/S0140-6736(19)30041-8.

This article is a work of Science Popularization China-Starry Sky Project

Produced by: Science Popularization Department of China Association for Science and Technology

Producer｜China Science and Technology Press Co., Ltd., Beijing Zhongke Xinghe Culture Media Co., Ltd.

Author: Ruan Guangfeng, Deputy Director of Kexin Food and Health Information Exchange Center

Review | Zhong Kai, Researcher at the National Food Safety Risk Assessment Center