Salt Advice with a Grain of Salt

There have been numerous articles over the last few years on salt restriction and the US National Academy of Sciences has recommended a limit of 2300 milligrams per day of sodium. 2300 mg of sodium amounts to one teaspoon or 6 grams of salt per day. Most people today are eating much more than that. Worldwide, sodium intake is estimated to average about 3.95 g/day, though there are wide geographical and cultural variations. The authors of a recent paper recommended that sodium be reduced to under 5 g/day, since “there is consistent evidence that high sodium intake (> 5 g/day) is associated with increased CV risk.” However, they freely acknowledged that there is not enough clinical trial evidence to support this target. The paper also emphasized the potential dangers of lowering sodium too much especially the 1500 mg of sodium per day recommended for individuals with high blood pressure, as in the WHO and AHA guidelines. This paper reflects a debate within the international hypertension, nutrition and public health establishment The paper was labelled as a “technical report” from the “joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association” in order to not create confusion among the public following the more strict guidelines. A technical report does not require endorsements or approval from the hundreds of individual organizations represented by the working group. Endorsements from many of the groups would be nearly impossible to obtain, given that many have already endorsed one form or another of the current sodium restrictions. The paper is entitled “The technical report on sodium intake and cardiovascular disease in low- and middle-income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association.” Among the authors of the report are well-known hypertension experts like Giuseppe Mancia, Suzanne Oparil, and Paul Whelton.

Since most excess sodium comes from processed foods, it is important to read sodium content on nutrition labels and to eat more fresh fruits and vegetables which are naturally low in sodium and rich in potassium.