Adding Salt & Soy Sauce at the Table, What Risk for Heart Health?
- Alastair Hunt
- Apr 15
- 7 min read
Updated: Apr 16
Salty seasoning is a way of life - whether it’s a dash of light soy sauce on rice, a splash of fish sauce in soup or a shake of salt over eggs. But have you ever wondered if that extra drizzle or pinch at the table could be quietly affecting your heart? A major UK study has shed light on a surprisingly specific habit: adding salt to food after it's cooked. And the findings might make you think twice before reaching for the condiment bottle.
What makes this research particularly useful is its focus on behaviour that’s entirely within our control. Unlike hidden salt in hawker food or packaged snacks, the salt (or soy sauce) we add at the table is a personal choice—and one that's surprisingly common across many cultures. By tracking over 400,000 people for more than a decade, the study reveals that even this seemingly small habit may be linked to a significantly higher risk of heart disease and early death.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
What the Study Explored
The research, led by Fengping Li et al, followed over 413,000 UK adults aged around 56, none of whom had cardiovascular disease (CVD) or cancer at the outset. Participants were asked how often they added salt to their food at the table - excluding salt used during cooking - and then tracked for up to 12 years to monitor their heart health and mortality.
The study aimed to explore a specific aspect of salt consumption that is often overlooked in research: the frequency of adding discretionary salt to food after it's been prepared. This detail is interesting because it focuses on personal behaviour, not just total sodium intake from processed foods or restaurant meals. By singling out this habit, the researchers could assess whether something as simple as reaching for the salt shaker is linked to serious long-term health outcomes.
Key Findings
Roughly 44% of participants reported adding salt at the table, with nearly 5% saying they “always” did so. During the follow-up period, over 37,000 people experienced a cardiovascular event and more than 21,000 died from any cause.
After adjusting for lifestyle and health factors (like diet quality, smoking, physical activity, and underlying conditions), the researchers found that:
People who always added salt at the table were 21% more likely to develop cardiovascular disease compared to those who rarely or never did.
Their risk of dying from heart-related conditions was 19% higher.
And their risk of dying from any cause was increased by 22%.
Interestingly, the study found that the risks weren’t limited to those who always used the salt shaker. Even people who only sometimes or usually added salt at the table showed elevated risks compared to those who rarely or never did. Specifically, occasional users had a 3% higher risk of both cardiovascular disease and early death, while those who usually added salt faced a 4% increase in cardiovascular risk and a 6% rise in all-cause mortality.
Although these figures are smaller than the 21–22% increases seen in the “always” group, they reveal a clear upward trend - the more often people added salt at the table, the greater the health risk. This dose–response pattern suggests that even modest reductions in this habit could yield long-term benefits.
Why This Study Stands Out
While much has been said about sodium and health, few studies have investigated this very specific and modifiable behaviour. That’s what makes this research especially useful. Most dietary advice around salt focuses on reducing processed and restaurant food consumption. But the act of adding salt at the table is a direct, individual choice - and a relatively easy one to adjust.
The study also benefits from its robust design. With a massive cohort of over 400,000 participants and a median follow-up of 12 years, it offers strong statistical power. And by excluding people with pre-existing cardiovascular disease or cancer at the beginning, the researchers could more accurately assess risk among generally healthy adults.
They also conducted thorough sensitivity analyses to test the reliability of their findings, excluding people with kidney disease, those who experienced major dietary changes and even those who died within the first two years of follow-up (in case they were already ill at baseline). Across all these analyses, the association between salt use at the table and cardiovascular risk remained consistent.
Beyond the Numbers: What’s Happening?
Adding salt at the table might seem harmless, but it could be a marker of long-standing taste preferences or higher overall sodium intake. Some people become accustomed to saltier food, which can dull the palate and encourage the addition of more salt over time.
Moreover, those who frequently add salt may also be less conscious of their dietary choices overall, or compensate for reduced salt in cooking by overusing it at the table. While the study controlled for many of these potential confounders - including diet quality and socioeconomic status - it’s possible that salt-adding behaviour serves as a subtle signal of broader dietary habits.
The researchers also noted that people who added salt at the table tended to have higher estimated sodium intake based on urine samples. This strengthens the link between the behaviour and actual physiological exposure to salt.
Practical Implications: Small Change, Big Benefit
This study reinforces the idea that tiny, everyday habits can have outsized effects on long-term health. While we can’t always control what’s in processed or restaurant food, we can choose what goes on our plate at home.
Reducing salt added at the table is a practical first step in lowering sodium intake—especially when done in combination with a diet rich in fruits, vegetables, whole grains, and unprocessed foods. And unlike large dietary overhauls, this is a small, manageable change.
If you’re looking to cut back, consider the following:
Taste before salting: Many people salt their food out of habit, not necessity. A quick taste can help avoid unnecessary salt use.
Enhance flavour in other ways: Use herbs, spices, vinegar, lemon, or garlic to make meals more interesting without relying on salt.
Reconsider salt substitutes: Potassium-based alternatives may be suitable for some, but not all. Always check with your doctor, especially if you have kidney concerns.
Keep the shaker off the table: This simple environmental nudge can help break the cycle of automatic salting.
Addressing a Common Misunderstanding
Some may assume that reducing salt in cooking simply shifts the problem to the table. And indeed, previous studies have shown that people often compensate by adding salt to meals when sodium content is reduced. But this research suggests that how and when you add salt matters - and frequent salting at the table may reflect higher risks regardless of cooking habits.
Public health campaigns may benefit from highlighting this nuance. Instead of just reformulating foods, we might also need to raise awareness of discretionary salt use and encourage long-term taste adaptation.
Final Thoughts
This study doesn’t mean you need to panic over a pinch of salt. But it does highlight the importance of mindful eating and the cumulative effect of small habits over time. With nearly half of participants in this study reporting the habit of adding salt at the table, it’s a reminder that even modest behavioural tweaks can support better heart health.
Whether you’re trying to manage your blood pressure, reduce cardiovascular risk or simply live a bit healthier, cutting back on added salt at the table is a simple, evidence-based step in the right direction. In a world where chronic disease continues to climb, it’s these small, consistent actions that may offer the biggest rewards.
As always, the best health strategy is one you can stick with - one that fits your personal lifestyle profile. For most people, improving sleep and health is about finding motivation and prioritising self-care - with an ultimate goal of taking action. If you want to take effective and targeted steps that fit into your unique lifestyle and circumstances, The Whole Health Practice is here to help.
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Stay Healthy,
Alastair
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Related Studies
Li F, Chen L, Liu B, Zhong VW, Deng Y, Luo D, Gao C, Bao W, Rong S. Frequency of adding salt at the table and risk of incident cardiovascular disease and all-cause mortality: a prospective cohort study. BMC Med. 2022 Dec 15;20(1):486. doi: 10.1186/s12916-022-02691-9. PMID: 36522670; PMCID: PMC9753015.
Yu L, Li S, Zhao J, Zhang J, Wang L, Wang K. Secular trends in salt and soy sauce intake among Chinese adults, 1997-2011. Int J Food Sci Nutr. 2018 Mar;69(2):215-222. doi: 10.1080/09637486.2017.1344203. Epub 2017 Jun 28. PMID: 28659003.
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