DAILY SALT INTAKE: new research on salt in our diets adds to confusion

AUGUST 18, 2014

Three new research papers published in the New England Journal of Medicine which sought to look at the cardiovascular risks of salt consumption have only added more confusion when it comes to salt intake. One of the studies, titled Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events, had a particularly interesting finding.

It suggested that people who consumed more than 6,000mg a day and those who consumed less than 3,000mg a day had a greater risk of cardiovascular events and mortality. Those consuming a moderate amount in the 3,000-6,000mg range had the lowest number of heart-related events.

“An estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than either a higher or lower estimated level of sodium intake. As compared with an estimated potassium excretion of less than 1.50 g per day, higher potassium excretion was associated with a reduction in the risk of the composite outcome,” the paper concludes.

The American Heart Association (AHA) limit - 1,500mg of sodium per day, is therefore half the lower-limit of what the moderate group consumed in that study which included 101,945 participants, 42% of whom were from China.

Here is what your salt intake looks like;

1/4 teaspoon salt = 575mg sodium
1/2 teaspoon salt = 1,150mg sodium
3/4 teaspoon salt = 1,725mg sodium
1 teaspoon salt = 2,300mg sodium

No end in debate

These new findings will not stem the debate around salt intake. In an editorial in the same issue of the journal, Dr. Suzanne Oparil of University of Alabama at Birmingham writes: “Taken together, these three articles highlight the need to collect high-quality evidence on both the risks and benefits of low-sodium diets.”

The AHA stands by its guidelines. “The bulk of the available evidence to date shows reduced sodium intake is associated with reduced blood pressure, which itself is associated with a reduction in cardiovascular event,” AHA president Dr. Elliott Antman said in a statement.

“Along with improving overall diet, controlling weight, and increasing physical activity, lowering sodium intake is key to lowering blood pressure in the general population and improving blood pressure control in those with hypertension.”

Some scientists have also argued that public-health messaging encouraging people to significantly cut their sodium and salt consumption is overblown or missing the point – arguing that we should focus less on salt and instead encourage people to eat more whole and non-processed food.

Most processed food is full of sodium and most whole foods contain negligible amounts of naturally occurring sodium.

What to make of it all?

It is true our bodies need salt - but if it is consumed in excess, you increase your risk for hypertension, which can ultimately lead to heart disease. The debate is ongoing, but lightening up your sodium intake - particularly from processed and restaurant food - can’t hurt.