Sodium intake and cardiovascular health -
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Hypertension 51 , — Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Download references. Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
You can also search for this author in PubMed Google Scholar. researched data for the article, and both authors discussed the content of the manuscript. wrote the article, and both authors reviewed and edited it before submission. Correspondence to Feng J.
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Reprints and permissions. Role of salt intake in prevention of cardiovascular disease: controversies and challenges. Nat Rev Cardiol 15 , — Download citation. JAMA ; The association between dietary sodium intake, ESRD, and all-cause mortality in patients with type 1 diabetes.
Diabetes Care ; Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ ;f Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev ;CD Effects of intensive blood-pressure control in type 2 diabetes mellitus.
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Lancet ; There is now a large body of evidence on the causal relationship between a moderate reduction in population salt intake and the substantial and cost-effective reduction in avoidable cardiovascular events through blood pressure lowering.
This extensive evidence has informed consistent national and global public health policies 1 - 5. Yet this concept is still apparently the object of chronic criticism by a few respondents, mostly selecting confounded study results, underpowered statistical analyses or problematic subgroup analyses.
Thus O'Donnell and coll. in the Eur Heart J 6 again contend that dietary salt of less than 5g per day might be harmful. These arguments are not new and have been discussed at length and demolished in past years Again, no new data is provided here apart from a dubious re-analysis of one meta-analysis by 'continents', which itself is open to a high risk of bias from post-hoc reiterations.
Several opinions are then used to try and bolster their shaky argument. For instance, asserting that there is "underestimation of sodium intake in populations with increased sodium excreted in sweat" lacks a referenced proof. Likewise, it is incorrect to assume that "estimated urinary sodium excretion from early fasting morning urine [ The studies by Kawasaki et al.
The over-dependence on a single morning spot urine is one of several flaws identified in the secondary analysis of ONTARGET and TRANSEND Others include systematic error in the assessment of sodium intake, inappropriate methods to assess agreement with 24h urines, residual confounding, the likelihood of reverse causality and, crucially, the selection of high risk and sick older patients on multiple drug therapy.
The remaining three studies supporting their contention include a secondary analysis of only 84 events 16 and two diabetic cohorts 17,18 with a high baseline incidence of macrovascular disease and a very high mortality rate, making reverse causality distinctly possible once again.
These important limitations seriously undermine any generalisability of their findings 5. According to O'Donnell and coll. Africa, South America, India and Russia, represent another reason to defer policy action.
This confuses absence of evidence with evidence of absent effects. Accepting similarly muddled reasoning in earlier decades would have prevented the development of valuable policies on tobacco control, smoke free legislation, clean water and seatbelts.
Furthermore, the huge trial proposed by O'Donnell and coll. has very little chance of ever being funded or completed for many reasons. These obstacles include the huge size of the study populations required to demonstrate significant effects on hard outcomes, methodological difficulties in assessing long term compliance to dietary salt reduction, the need for a very long observation period, substantial ethical problems, and the difficulty in ensuring financial support A prolonged wait for this 'mother of all trials' would be unreasonable and irresponsible, potentially delaying a major global public health benefit.
In conclusion, successfully implementing population-based salt reduction strategies, as recommended by the WHO 1 and many other agencies, could save tens of thousands of lives every year. Further obstruction would thus be irresponsible and harmful. cappuccio warwick.
Simon Capewell MD DSc FFPH FAHA Professor of Clinical Epidemiology, University of Liverpool, UK. Pasquale Strazzullo MD FAHA Professor of Medicine, Federico II University of Naples, Italy. Wayne Sunman MD FRCP Consultant Stroke Physician, Nottingham University Hospitals NHS Trust, UK.
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Sodium, Blood Pressure, and Cardiovascular Disease: Further Evidence Supporting the American Heart Association Sodium Reduction Recommendations.
Circulation ; O'Donnell MJ, Mente A, Smyth A, Yusuf S. Eur Heart J ; Campbell N, Cappuccio FP, Tobe SW. Unnecessary controversy regarding dietary sodium. A lot about a little. Can J Cardiol ; New evidence relating to the health impact of reducing salt intake.
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A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol ; 20 1 : Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H, et al. A simple method to estimate populational h urinary sodium and potassium excretion using a casual urine specimen.
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Ekinci EI, Clarke S, Thomas MC, Moran JL, Cheong K, MacIsaac RJ, Jerums G. Dietary salt intake and mortality in patients with type 2 diabetes. Oxford University Press is a department of the University of Oxford.
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Volume Article Contents Abstract. Variations in methods of measuring sodium intake. Variations in population characteristics. Variations in outcome measures.
What is the safe lower threshold for sodium intake? Study design and level of evidence. Other observations contributing to uncertainty.
Conclusions and future directions. Journal Article. O'Donnell , M. Oxford Academic. Revision received:. PDF Split View Views. Cite Cite M. Select Format Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks Download citation. Permissions Icon Permissions.
Close Navbar Search Filter European Heart Journal This issue ESC Publications Cardiovascular Medicine Books Journals Oxford Academic Enter search term Search. Abstract Effective population-based interventions are required to reduce the global burden of cardiovascular disease CVD.
Salt , Sodium , Cardiovascular , Prevention , Population health. Figure 1. Open in new tab Download slide. Figure 2. Figure 3. Figure 4. Figure 5. Google Scholar Crossref. Search ADS. Sodium intake and risk of death from stroke in Japanese men and women.
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J Gen Intern Med. Download references. Institute of Social and Preventive Medicine, University Hospital and University of Lausanne, Bâtiment Biopôle 1, Route de la Corniche 2, , Epalinges, Switzerland. Service of Nephrology, Lausanne University Hospital, , Lausanne, Switzerland.
You can also search for this author in PubMed Google Scholar. Correspondence to Murielle Bochud MD, PhD. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Bochud, M. et al. Dietary Salt Intake and Cardiovascular Disease: Summarizing the Evidence.
Public Health Rev 33 , — Download citation. Published : 05 December Issue Date : December
Intakr sodium consumption and higher intaks intake aand linked Organic green tea benefits a Sodium intake and cardiovascular health risk of Sodium intake and cardiovascular health cardiovasscular CVD in most people, according to a study led by Harvard T. Chan School green coffee supplement Public Health researchers. Sodium, one of the Chamomile Tea for Inflammation of table salt, is naturally found in some foods, but high amounts of sodium are frequently added to commercially processed, packaged, and prepared foods. The U. Food and Drug Administration recently released new voluntary guidance encouraging the food industry to gradually reduce sodium — linked in previous research with increased blood pressure —in commercially produced foods over the next two and a half years. Potassium has an opposite effect in the body — it can help relax blood vessels and increase sodium excretion while decreasing blood pressure. Rich sources of potassium include fruits, leafy greens, beans, nuts, dairy foods, and starchy vegetables like winter squash. Experts green coffee supplement figuring out the ideal amount of inake can be tricky. Sodium intake and cardiovascular health to the American Heart Association Cardiiovascularthe average American takes in more than 3, milligrams mg cardiovsscular sodium Liver Health Check day. The cardiovasculwr recommends consuming no more than cardipvascular, mg of sodium carsiovascular day, equivalent to 1 teaspoon of salt, while working toward an ideal limit of 1, mg per day for most adults. For people with congestive heart failurewhich is when the heart is unable to pump enough blood and oxygen to support the other organs in your body, following a low salt diet can make a difference, but exactly how much salt they should be consuming is still up for debate. Excess salt also puts pressure on the blood vessels, which overtime can lead them to stiffen, decreasing blood flow, per the Harvard T. Chan School of Public Health.
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