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03/07/2006

Elderly at risk from government heatwave advice

Older people could die as temperatures soar this week because the Department of Health is failing to provide vital advice on salt intake.

The warning from the Salt Manufacturers’ Association echoes growing independent concern from bodies such as Help the Aged that the elderly are being urged to drink water but not to maintain the sodium without which they can be vulnerable to heart attacks and strokes.

A new Department of Health “Heatwave Guide” to looking after yourself in hot weather makes no mention of the importance of maintaining sodium and other electrolyte levels. And NHS Direct similarly offers no advice on salt intake in a heatwave.

“This is an issue where urgent, authoritative advice is needed,” says SMA general secretary Peter Sherratt. “Many older people have cut back on salt as a result of the Government’s blanket advice and they could now be highly at risk.”

Amongst the experts who have raised the issue is leading physiologist Professor Bill Keatinge. He recommends that elderly people maintain their intake of both water and salt during heatwaves, when heat-related deaths typically increase by 50 per cent. In just one week of the hot summer of 2003, over 2,000 deaths in Britain were linked to the weather.

“Heat stress causes loss of salt and water in sweat, which thickens the blood and can lead to an increased risk of heart attack and stroke,” says Professor Keatinge. Older people – especially those who are not acclimatised to the heat – are far more vulnerable, particularly during the early summer when temperatures begin to rise. Hot weather may lessen appetite, but not eating regularly can lead to a salt deficiency. The sodium in salt is important for muscle function and helps to maintain the fluid balance within the body.

Professor Keatinge advises that older people should maintain their salt levels by continuing to eat the balanced diet that they normally would. To avoid dehydration, they should drink plenty of water when thirsty.

Meanwhile, Help the Aged has mounted a campaign urging the public to look out for older relatives and neighbours in the hot weather. A key recommendation is to maintain salt intake and drink lots of water.

Also at risk from government blanket advice to cut salt are those who exercise. Any energetic activity that causes us to sweat also depletes the vital sodium levels in our body. Poor performance and cramps can follow, but a greater threat comes from hyponatraemia – abnormally low concentration of sodium in the blood – which can result in coma or even death.

Research by Professor Ron Maughan of Loughborough University has undertaken research which that professional footballers can lose up to 20 grammes of salt in a typical day’s training. His warning to maintain salt levels applies to anyone who exercises, especially during heatwaves. This comes at a time when the Food Standards Agency is saying our daily intake should not exceed six grammes.

At Wimbledon last week, the American player Robert Kendrick called for salt during his match with Rafael Nadal. He added it to his water bottle and drank from it as he fought to stave off the effects of sodium lost through sweating.

ends

Notes to editors

1. The Salt Manufacturers' Association is the trade association representing UK manufacturers of salt, including domestic salt, catering salt, water-softening salt, industrial salt and de-icing salt.
2. Interviews can be arranged with Professor Bill Keatinge on request. We can also provide contact details for a spokesperson at Help the Aged.
3. A string of experts across the world have questioned the UK government’s blanket advice, including:
• Immediate past president of the European Hypertension Society, Professor Tony Heagerty
• Nutrition expert, Dr David McCarron, whose research suggests that mineral deficiency, rather than salt consumption, is one of the most important influences upon high blood pressure
• Professor Ron Maughan, sports scientist, Loughborough University. Researched sweating tendencies of footballers at premierclubs and found that some could lose upto 20g of sodium in a day's training.
• Leading British physiologist, Professor Bill Keatinge, has found that, in unacclimatized elderly subjects, the risk of heart attack or stroke is increased by salt depletion during a heatwave. He suggests that they should be strongly advised not to reduce their salt intake in summer or when holidaying in warmer climates.
• Professor Ingo Fusgen, University of Witten-Herdecke in Germany. Studies show that up to 10 per cent of older people suffer from sodium deficiency.
• Professor Deiderick Grobbee, cardiovascular specialist from the Netherlands and author of the Rotterdam. Tested 8,000 people in their 50s+ and found that as long as their salt intake wasno more than 16g a day, there was an insignificant effect on blood pressure.
• Six Canadian medical groups rejected a recommendation for universal salt restriction, instead making lifestyle recommendations for reducing blood pressure such as exercising, eating a balanced diet, and stress management.