Salty diet in hospital the last thing these patients need
SOME
months ago, I wrote to the Tasmanian Health Minister observing that meals supplied to hospital and rehabilitation patients were routinely putting people at risk, especially given the state’s higher-than-average proportion of old people (like me).
My observation is based principally on experience as an inpatient at the Royal Hobart Hospital and the Peacock 3 ward in 2016.
As expected — after working at Sydney’s Royal North Shore Hospital in 1950, and after later hospital sojourns as inpatient and outpatient in public and/or private wards, and/or an emergency patient in NSW, South Australia and Tasmania — most medical and paramedical staff were competent, but sometimes limited by available resources.
The public health system is putting at risk the health of inpatients with Meniere’s disease. Failure to solve the problem could lead to an increased risk of falls with potentially life-changing injuries or premature death.
Statistically, the disease would affect 150 to 1000 people in Tasmania; but as it is a disease of ageing and the Tasmanian population is relatively old, the number will be nearer the top of the range.
I mention this disease first, because dealing with it every day looms large in my life: relatively expensive medication three times a day; a wheeled walking frame; a system of ramps around my house; and severe restrictions on places I can go and events I can attend.
Falls since 2013 have led to several broken ribs, concussion, a permanently splintered kneecap; and in 2016, a fractured pelvic ramus (a broken bum in Strine terms) and hospitalisation.
One of the first pieces of advice given to sufferers is to adopt a low-salt diet. I had not used salt in cooking or as an additive for 40 years, but I used to enjoy the occasional slice of ham, and it seems this brought on my first hours-long vertiginous episode, with vomiting, five years ago (think chronic seasickness).
Of more epidemiological consequence is the historically high incidence of diseases like high blood pressure, high cholesterol levels, angina and heart attack. More than 100,000 Tasmanians are at risk of cardiovascular catastrophe. About 12,000 Tasmanians have had a stroke. I’ve suffered one micro-stroke, manifested as a retinal bleed leading to restricted sight and double vision. Excess salt is a potential risk factor.
Chronic kidney disease can affect one-third of the population, the number of people and its severity increasing with age. Again, a low-salt diet is indicated. It seems up to 200,000 Tasmanians could be affected.
Recent research suggests that excess salt can adversely affect the brain health.
During my stay in RHH and Peacock 3 in 2016, I consistently asked for no-salt or low-salt food: but many meals then offered included
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salty corned beef, ham, processed meat or cheese, sometimes gravy, pickles or olives, or potato salad or some other salty component. Some bread was labelled low-salt.
Very few of the professional or ancillary hospital staff I spoke to seemed well informed on dietary matters, and none managed to improve things.
Often the only items I could eat were salad, fruit salad and ice cream. Despite my precautions, I had several episodes of Meniere’s, with vertigo and vomiting. In five weeks I lost 5kg.
The sad fact is that far too many people are habituated to excess salt in daily diets. There is a widespread fantasy throughout the catering industry and society at large, that salt brings out the flavour. It does nothing of the sort, salt being itself one of the five (or arguably six) basic flavours. When you ingest salt, it hits only salt receptors on the tongue and, inevitably, the only flavour you “bring out” is salt.
This dietary information has been readily available since the 1950s, but on the available evidence it is still not widely understood by workers in commercial-scale kitchens; and self-regulation across the food industry manifestly doesn’t work.
In the interests of all Tasmanians, particularly those at risk of these diet-linked diseases, I suggested to Health Minister, Mr Michael Ferguson, that he take immediate action to audit the use of salt in his hospital and other catering services.
I also suggested that in consultation with other State and Federal Governments, he should begin the slow process of developing a widespread education program aimed ultimately at lowering average sodium intake.
I sent copies of my letter to shadow health minister Rebecca White, Health Service Tasmania head Dr David Alcorn and AMA Tasmanian branch president Dr Stuart Day.
I have had no substantive replies, but I am most grateful to Ms White for her ongoing interest.