12 January - 20 June 2016

Challenging ideas about salt

11 Sept 13

A study published in the American Journal of Hypertension challenges several 'facts' about salt intake and the desirability of reducing intake. It was written by a team of researchers representing several different academic institutions.  The team analysed peer-reviewed publications reporting 24-hour urinary sodium excretion (UNaV) in a defined population, as identified from the medical literature. These datasets were combined with data from a previous report of worldwide dietary sodium consumption, which, the authors note, suggests that there is a narrow range of salt consumption driven by physiological requirements rather than by dietary factors. In other words, the brain 'tells' the body how much salt to consume, rather than consumption being dictated by diet.  The authors quote an estimated healthy range for human sodium intake as 120–220 mmol/d (2,800–5,000 mg/d). Therefore, the lower level is higher than the current US sodium guidelines for healthy individuals of no more than 2,300 mg per day, and much higher than the recommended level of no more than 1,500 mg per day for those at risk of heart disease. The authors therefore conclude that a low salt diet may be damaging to health, perhaps because it leads to impairment of certain organs, and this is consistent with some recent reports that have characterised an increase in CVD and all-cause mortality associated with reduced sodium intake.  Essentially, this study argues that there is a physiologically determined 'optimum' range for salt intake, which dietary recommendations cannot override and should not ignore. Future guidelines should be based on this biologically determined range, the authors argue.

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