There Doesn’t Really Seem to Be a Consensus About Salt
The growing conflict surrounding health consequence of dietary salt (sodium; table salt) intake continues to get more interesting. It reminds me of the emotional/quasi-scientific rhetoric that still surrounds “low-fat” dietary recommendations.
A recent medical review by the Cochrane Collaboration has determined that a reduction in dietary salt (sodium) may not be as health promoting as suggested by USDA’s 2010 “Dietary Guidelines for Americans”.
The Cochrane Collaboration is a large and highly regarded organization of scientists and physicians who work to provide the most unbiased assessment of the scientific evidence available. They use scientifically advanced statistical techniques to combine information from many different studies. There are very critical as to the scientific validity of the studies they include.
Believe it or not, not all “studies” are created equal. Many published studies contain errors and bias that render their conclusions less meaningful than their authors might wish
To Salt or Not To Salt
This review found a minimal effect of dietary salt restriction on blood pressure in patients with normal blood pressure (an average decrease of only 1.27/0.05 to 1.29/0.45 mm Hg ). Surprisingly, a reduced salt diet had no effect on blood pressure in patients with high blood pressure .
Furthermore, salt reduction resulted in a significant increase in plasma cholesterol (2.5%) and plasma triglyceride (7%), which expressed in percentage, was numerically larger than the decrease in BP (<1%).
Elevations of cholesterol and triglycerides are known risk factors for increased heart disease.
Other Surprising Salt Studies
A separate Cochrane Library review published in July found no evidence that small reductions in sodium intake lowered the risk of heart disease or premature death. Another study by Belgian scientists published in May of this year found that people who consumed lots of salt were no more likely to develop hypertension, and were statistically less likely to die of heart disease, than those with low salt intake.
Furthermore, reduced sodium intake seems to harm patients with heart failure and diabetes type 1 and 2. (see references 3-6 in present study). In all three patient groups reduced salt intake is associated with increased rate of death.
What To Do
Now that I’ve put this post up, many patients will ask me, “What should I do, reduce my salt intake or not?” My approach is a practical one.
The way I see it, if there really is some health benefit, it’s hard to prove so any benefit is probably small at best. And remember, some studies have shown your health may actually worsen with dietary salt reduction.
I tell my patients with heart failure and kidney problems they should be careful to not consume too much salt as it can quickly worsen these conditions.
For everyone else, I think it is best to focus your efforts on health improvement elsewhere.
I believe regular exercise, stress reduction, smoking cessation, wearing seat belts and limiting the carbohydrates and trans fats in your diet are all much more likely to improve your health that limiting the salt in your diet.