Doctor, doctor: Excess salt and tonsil trouble

When I try to do without salt in my food, I find that it doesn't taste anywhere near as good. I admit I use a lot, both in cooking and at the table. I'm in my 30s and have no health problems as far as I know, so do I really have to cut down? What is the evidence against salt?
It's pretty clear, particularly in the light of the latest analysis, printed in last month's British Medical Journal, of studies following 177,025 people with varying salt intake. The figures make the results hard to argue against. The more salt you swallow, the higher your risk of heart attack and stroke, as salt drives up blood pressure – so if everyone reduced their daily intake of salt to below the WHO recommended 5g a day, it would save 850,000 lives a year around the world. Give a low-salt diet a trial for a month – that is, no salt on the table and far less in your cooking: replace it with tasty spices that don't raise your blood pressure. The reason you need to stick to it for that long is it takes a month for your tastebuds to get used to the tastes that your salt dependence has smothered. After that, you won't want to drown your food in salt again. Best of luck.

Our six-year-old daughter has had four bouts of tonsillitis in the last year. Our doctor has suggested taking out her tonsils, but a friend suggests we would be better to wait to see if the throat infections die down naturally. In the meantime, she has missed a lot of school. What do you think?
Around 15 years ago, Dutch doctors allocated 300 children with similar histories of sore throats to surgery or to "watchful waiting", and compared their subsequent annual episodes. Watchful waiting was as effective as surgery for the children who had one or two bouts of tonsillitis each year. Above that number, however, especially if the children had such large tonsils and adenoids that they interfered with breathing during sleep, operations were the better option. With four bouts of tonsillitis a year, your child does fall into the "operate" category. Let your GP and ENT surgeon guide you on your decision: their experience and knowledge of your daughter's throat is all-important.

• Got a question for Dr Tom Smith?

• This article was amended on 20 January 1020 to clarify that the potential loss cited of 850,000 lives a year was out of the global population.

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