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Is That Right? "Decreasing salt intake is advisable"

The federal government's Dietary Guidelines for Americans, issued in 2005, tell us that "Decreasing salt intake is advisable" for reducing the risk of hypertension and, by extension, cardiovascular disease. But new research questions the wisdom of counseling Americans to consume no more than 2,300 milligrams--about a teaspoon--of salt daily, as those guidelines advise. (The guidelines suggest those at high risk of hypertension cut back to 1,500 mg or less per day.)


Researchers in the department of nutrition at the University of California, Davis analyzed existing studies regarding people's salt intake and found that people appear to innately regulate the amount of salt in their diet. "Normal" salt intake, which they found consistent among all the studies they surveyed (involving more than 19,000 people from several countries), ranged between 2,700 and 4,900 mg a day. It's likely, the authors say, that people's central nervous systems have evolved to carefully control the amount of salt we seek. Sodium helps maintain your body's balance of fluids, transmit nerve impulses and regulate muscles' activities; getting too little, the authors suggest, could be as dangerous as getting too much. And outside attempts to govern salt intake might be destined to fail if our bodies are telling us we need more sodium.

Whether future studies bear out their findings, these researchers, whose work was published Thursday in the Clinical Journal of the American Society of Nephrology, say the folks involved in updating sodium-intake standards and devising the new Dietary Guidelines, due out in 2010, should consider whether it's wise public policy to recommend across-the-board sodium restriction if that restriction runs counter to our physiological needs:

If a "normal" range of sodium intake exists that is consistent with the optimal function of established peripheral and central nervous system (CNS) mechanisms, that fact should be the sole basis of national nutrition guidelines for dietary sodium intake. To attempt to use public policy to abrogate human physiology would be futile and possibly harmful to human health.

The Dietary Guidelines note that we get about 77 percent of our sodium from processed foods, which tend not to be very healthful, salt or no salt. Whether your aim is to reduce sodium consumption or not, steering clear of heavily processed foods may be "advisable" indeed.

By Jennifer LaRue Huget  |  October 16, 2009; 7:00 AM ET
Categories:  Nutrition and Fitness  
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Comments

I'm glad to hear about this latest research report.

I reviewed the high-salt/disease connection 20 years ago, and was not convinced salt restriction was important for the general population. Perhaps 20-25% of the population's blood pressure is salt-sensitive.

Here are two more links to well-written articles, evidence-based, skeptical about salt restriction:

http://www.cochrane.org/reviews/en/ab004022.html

http://tierneylab.blogs.nytimes.com/2009/04/06/hold-the-salt/?emc=eta1

I reviewed them for my my Heart Health Blog at NutritionData.

-Steve Parker, M.D.

Posted by: SteveParkerMD | October 16, 2009 12:20 PM | Report abuse

I generally don't eat processed foods with added sodium, so adding healthful salt is important. My body lets me know I need it. I carry a small jar of unprocessed sea salt in my purse. Some find it comical, but after discussing it with our local TSA security checkpoint folks at the airport, it's not all that uncommon of a practice.

Posted by: MzFitz | October 16, 2009 12:48 PM | Report abuse

Processed foods contain a lot of non-salt additives and preservatives that contain sodium. It's sodium in general that is the problem, not sodium chloride (table salt) specifically. It is easy enough to cut down on sodium just by cooking from scratch.

Posted by: ZF-MD | October 16, 2009 2:41 PM | Report abuse

If a normal range is just what we eat in today's societies does that mean normal=healthy? If that holds true in societies where most people cook from scratch that would be more meaningful - this article does not clarify that.

If what we eat is 'normal' then heavy fat laden diets would also be considered 'healthy' as people seem to naturally crave saturated fat (but don't appear to self regulate).

While most people are not particularly salt sensitive, some are and have high blood pressure that correlates with high sodium intake.

Posted by: mgferrebee | October 17, 2009 7:19 AM | Report abuse

Your last paragraph is NOT helpful. How do you define a "processed food?" the fact is, some "highly processed" foods are very healthful, for example canned tomato products. The more a tomato is processed, the higher levels of Lycopene it expressed (many studies suggest that Lycopene helps prostrate health in men). If you really want to be helpful here, cite the real top sources of sodium in the diet, not just branish all processed foods as avoidable. It is misleading and ignores the convenience that consumers look for. They are many, many very healthful processed foods -- cereals, granolas, low sodium soups, whole grain breads, etc.

Posted by: Exile_in_Philly | October 17, 2009 9:52 AM | Report abuse

Response to mgferrebee:

The point of the research is not whether the amount of sodium intake is healthy or not -- a good question, but a different question.

The question here is: is the amount of sodium we ingest a behavior we control or an appetite that the body determines automatically? This research and Dr. Geerling's paper last year in the journal Experimenal Physiology point to the latter -- an appetite determined on our need, not a product of conscious choice. If confirmed, no matter what official recommendations may be, the body's physiology will be controlling so we should "move on" to other known strategies such as increasing the mineral content of our diets by eating more fruits, vegetables and dairy products -- proven to eliminate "salt sensitivity."

So, put aside very legitimate questions about healthfulness and you can more easily see the practical significance of this study of 19,000 separate individuals in 33 countries over 25 years. Impressive and worth considering its implications.

Dick Hanneman
President
Salt Institute

P.S. As the salt industry association, we had no connection with this study.

Posted by: rhanneman | October 17, 2009 11:04 AM | Report abuse

If a person is retaining water, then he/she must cut down on salt intake. Pressing a finger on the ankle will tell you if water is retained. A sedentary person will need less salt than a physically active one. Living in hot places will require more salt intake. The delicate flavors of certain food are lost when too much salt is added. Will please someone come up with a software program to tell me how much salt I need or may it's better by using common sense ?

Posted by: ThishowIseeit | October 17, 2009 7:16 PM | Report abuse

My mom, who was thin, religiously avoided salt to try to lower her blood pressure. The avoidance of salt lowered her sodium to a level where she had to be hospitalized and almost died.

Posted by: foxtrot1 | October 19, 2009 10:56 AM | Report abuse

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