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16/06/2008

Older people at risk from Government heatwave advice

As temperatures rise this summer, older people could die because the Government is failing to provide vital advice on salt intake.

The warning from the Salt Association comes as forecasters predict above average temperatures and older people become more at risk from low salt levels. The alert 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.

The latest Department of Health “Heatwave Guide” to looking after yourself in hot weather (2007) simply mentions heat exhaustion as a result of water or sodium depletion, but gives no advice on the importance of maintaining sodium and other electrolyte levels. And NHS Direct similarly offers no advice on keeping up your salt intake in a heatwave.

“This is an issue where urgent, authoritative advice is needed,” says Salt Association 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 seriously at risk.”

This view is echoed by EuSalt, the European Salt Producers’ Association. Wouter Lox, managing director of EuSalt (European Salt Producers’ Association), said: “There are a number of physiological changes that occur as part of the ageing process. Together with an increased risk of general illness and the resulting medication, they all have the affect of making older people more susceptible to an electrolyte and water imbalance.

"A recent paper¹ suggests that polypathia (a multiplicity of illnesses) in older people is frequently associated with an inadequate supply of sodium. It highlights the importance of improving fluid intake and not restricting salt intake."

Amongst the experts who have raised the issue is leading physiologist Professor Bill Keatinge, who has recommended 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 and almost 15,000 in France were linked to the weather. Many were elderly. The World Meteorological Organization estimates that the number of heat-related deaths could double in less than 20 years.

“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 advises 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.

Ends

Notes to editors

• The Salt Association (previously 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. More detail on its stance on the health issue can be found at www.saltsense.co.uk.
• A string of experts across the world have questioned the UK government’s blanket advice on salt intake, including:
  • ¹Professor Ingo Fusgen, University of Witten-Herdecke in Germany. Studies show that up to 10 per cent of older people suffer from sodium deficiency. http://www.saltsense.co.uk/documents/IFusgen-Disordersofwaterandsodiummetabolisminolderpatients.PDF
  • 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 at Loughborough University. He researched sweating tendencies of footballers at premier clubs and found that some could lose up to 10g of salt in a single training session.  He has said: “Sweating is a highly individual issue. If people are salty sweaters, this may make them more vulnerable to muscle cramps. It is absolutely clear that the government’s blanket advice is not appropriate and could indeed be harmful to some people. Whilst my research concentrated on high performance athletes, it could well have relevance for anyone who exercises hard or sweats heavily during the course of their work or on holiday in a hot climate.”
  • 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 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 was no more than 16g a day, there was an insignificant effect on blood pressure. 
• For further information on the Salt Association's stance on salt and health, please visit the press office at www.saltsense.co.uk The media resources available there also include downloadable photographs.