Opinion of the Scientific Panel on Dietetic products, nutrition and allergies [NDA] on a request from the Commission related to the Tolerable Upper Intake Level of Chloride
Wulf Becker, Francesco Branca, Daniel Brasseur, Jean-Louis Bresson, Albert Flynn, Alan A.
Jackson, Pagona Lagiou, Martinus Løvik, Geltrude Mingrone, Bevan Moseley, Andreu Palou,
Hildegard Przyrembel, Seppo Salminen, Stephan Strobel, Henk van den Berg, and Hendrik
van Loveren.
Acknowledgment
The Scientific Panel on Dietetic Products, Nutrition and Allergies wishes to thank Jan
Alexander, Angelo Carere, Werner Grunow, Andrew Renwick and Gerrit Speijers for their
contributions to the draft opinion.
.
No abstract available
Chloride is an essential nutrient involved in fluid and electrolyte balance and is required for normal cellular function. Dietary deficiency of chloride is very uncommon due to the widespread occurrence of chloride in foods.
Chloride is present in foods as a normal constituent at a low level. It is also added to foods, mainly as sodium chloride (commonly known as salt) or as mixtures of sodium chloride and potassium chloride (sometimes referred to as salt substitutes) during processing, cooking and immediately prior to consumption. The main reasons for the addition of salt during the processing of foods are for flavour, texture and preservation.
Mean daily chloride intakes of populations in Europe range from about 5-7 g (about 8-11g salt) and are well in excess of dietary needs (about 2 - 2.5 g chloride/day in adults). The main source of chloride in the diet is from processed foods (about 70-75% of the total intake), with about 10-15% from naturally occurring chloride in unprocessed foods and about 10-15% from discretionary chloride added during cooking and at the table.
The major adverse effect of increased intake of chloride, as sodium chloride, is elevated blood pressure. Higher blood pressure is an acknowledged risk factor for ischaemic heart disease, stroke and renal disease which are major causes of morbidity and mortality in Europe. For groups of individuals there is strong evidence of a dose dependent rise in blood pressure with increased consumption of chloride as sodium chloride. This is a continuous relationship which embraces the levels of chloride habitually consumed and it is not possible to determine a threshold level of habitual chloride consumption below which there is unlikely to be any adverse effect on blood pressure.
Gastrointestinal symptoms (discomfort, mucosal lesions and sometimes ulceration) have been seen in healthy subjects taking some forms of potassium chloride supplements (e.g. slow-release, wax matrix formulations) with doses ranging from about 1 to 4 g chloride per day, or more, but incidence and severity seem to be more dependent on the formulation than on dose.
Chloride is not carcinogenic but high intakes of sodium chloride can increase the susceptibility to the carcinogenic effects of carcinogens, such as nitrosamines, and gastric infection with H. pylori.
The panel concludes that the available data are not sufficient to establish an UL for chloride from dietary sources.
There is strong evidence that the current levels of chloride consumption (as sodium chloride) in European countries contribute to increased blood pressure in the population, which in turn has been directly related to the development of cardiovascular disease and renal disease. For this reason, a number of national and international bodies have set targets for a reduction in the chloride as sodium chloride consumed in the diet.
Opinion of the Scientific Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to the Tolerable Upper Intake Level of Chloride
