Salt Restrictions for Some May Be Better Than for All

Restricting sodium intake seems best suited to communities with the highest consumption levels, according to an 18-country study in The Lancet.

Researchers used urine samples from nearly 100,000 adults to estimate sodium and potassium intakes. Blood pressure was also measured, and cardiovascular events were tracked.

Mean sodium intake was 4.8 g per day, with Chinese communities having higher intakes (5.6 g). During a median follow-up of 8 years, a mean increase of 2.86 mm Hg in systolic pressure was noted for every 1-g increase in sodium intake above the overall average. There was a positive association between sodium intake and stroke, but only in communities with the highest sodium intake. Of note, the frequency of cardiovascular events showed an inverse association with sodium intakes in communities with the lowest intakes.

Higher potassium intakes were associated with lower rates of all cardiovascular events.

The authors suggest that targeting restrictions to communities with sodium intakes above 5 g/day would bring the most benefit. Commentators call the findings "exceedingly provocative."

My Take:
WHO recommends that populations consume less than 2 g/day sodium as a preventive measure against cardiovascular disease, but this target has not been achieved in any country. This recommendation is primarily based on individual-level data from short-term trials of blood pressure (BP) without data relating low sodium intake to reduced cardiovascular events from randomized trials or observational studies. Now a new well-designed study questions the wisdoms of this recommendation.



I am more concerned with the form of sodium in the diet rather than the amount. Science looks at sodium as an inorganic element (Na)with an atomic number of 11. As a nutrient, medicine looks at sodium chloride (NaCl), its most common form, table salt.

However, organically bound sodium in food is the best source for the human body. Meats and seafood are naturally high in sodium but processed meats add large amounts of salt. Beets, carrots and celery are vegetables that contain large amounts of organically bound sodium. Spinach and chard are also excellent sources.

Sodium is essential for all animal life. It is needed for the ionic exchange across the cell membrane moving in opposition to potassium. The sodium-potassium pump is moves chemical compounds in and out of every cell in your body.

Bottom Line:
Unless your salt intake is quite high, it’s probably not a health issue, even if you have hypertension. However, rather than adding salt to food or eating salted foods, try eating foods that are naturally high in organically bound sodium

Source: August 10, 2018, New England Journal of Medicine