Published: May 20, 2013 | Updated: May 20, 2013
By Crystal Phend, Senior Staff Writer, MedPage Today

Action Points

• This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
• A greater taste for salt among older hypertensive adults might be sated by seasoning (oregano) instead.
• Point out that hypertensive individuals consumed more salt than normotensive ones.

SAN FRANCISCO — A greater taste for salt among older hypertensive adults might be sated by seasoning instead, a small experimental study showed.

In a taste test of bread identical except for sodium level, 68% of hypertensive individuals picked the saltier one compared with 31% of normotensive participants, Patricia T.M. Villela, MS, of Brazil’s Sao Paulo University, and colleagues found.

Adding oregano to the bread on a retest 2 weeks later drastically lowered the proportion who preferred the saltier bread, the group reported here at the American Society of Hypertension (ASH) meeting.

Only 14% of the hypertensive individuals picked the saltier, seasoned bread; none of the normotensives did.

Seasoning appears to “assist in choice of food with less salt,” the researchers concluded.

Their 44-patient study didn’t find statistical significance in the difference between groups at either time point (P=0.06 and P=0.35, respectively), and was limited in power to draw conclusions about the influence of herbs and spices on dietary intake outside of an experimental setting.

But it’s a good early step in an area that hasn’t been tackled much in hypertension, commented ASH president-elect Domenic Sica, MD, of Virginia Commonwealth University in Richmond.

“Taste remains the big uncharted domain,” he told MedPage Today in an interview. “It’s an area of potentially significant importance in the long term, but the actual approaches to it are still fairly rudimentary.”

The science of taste has mainly been exploited by industry to make food harder to resist rather than as a way to make healthy choices easier, Sica noted. Most sodium in the Western diet comes from processed foods.

Federal and other guidelines suggest a threshold of 1,500 mg of sodium per day for hypertensive adults and other high-risk groups, and 2,300 mg for the general population, although a controversial report just out from the Institute of Medicine suggested insufficient evidence to drop the recommended daily allowance below 2,300 for any group.

Either way, the average American far exceeds recommendations, consuming a mean of 3,400 mg per day.

So findings like these suggesting routes to change preferences could help reign in the excess, Sica pointed out.

“When you try to get someone who has an enriched sodium intake by several grams, which would not be uncommon in the South, let alone most places, to restrict their intake, it’s problematic,” he said. “One could say it doesn’t matter what the salt intake threshold is if you limit desire for salt.”

He noted that taste for salt is usually informed by chronic exposure and habits that change slowly.

In Britain, a collaboration between government and industry cut salt in processed foods by a steady 3% to 4% per year, which was slow enough that it didn’t noticeably change flavor, sales, or the level of complaints.

The 15 days between the two experimental taste tests in the study likely wasn’t enough to determine where participants’ tastes could have changed.

The study did indicate a preference for higher salt intake among hypertensive adults outside the study too, because 24-hour urinary sodium excretion was greater than in the normotensive group (177 versus 141 mEq, P=0.036).

Body mass index was similar between groups. Average age was 73. Systolic blood pressure tended to be higher in the hypertensive people (P=0.08).

The researchers specified that their taste tests were run with French bread containing 421, 648, and 875 mg sodium per 100 g.