Literature DB >> 27488354

Con: Reducing salt intake at the population level: is it really a public health priority?

Niels Graudal1.   

Abstract

Scientific evidence to support the recommended salt intake of < 5.8 g/day is virtually non-existingent. There are no randomized controlled trials (RCTs) to investigate the effect of salt reduction (SR) below 5.8 g on health outcomes. The effect of SR on blood pressure (BP) reaches maximal efficacy at 1 week. RCTs in healthy individuals lasting at least 1 week show that the effect of SR on BP is <1 mmHg, but that SR has significant side effects, including increases in renin, aldosterone, noradrenalin, adrenalin, cholesterol and triglyceride. Still, disregarding confounders and side effects, health authorities use BP effects obtained in studies of pre-hypertensive and hypertensive patients to recommend SR in the healthy population and use these biased BP effects in statistical models indirectly to project millions of saved lives. These fantasy projections are in contrast to real data from prospective observational population studies directly associating salt intake with mortality, which show that salt intake <5.8 g/day is associated with an increased mortality of ∼15%. The population studies also show that a very high salt intake >12.2 g is associated with increased mortality. However, since <5% of populations consume such high amounts of salt, SR at the population level should not be a public health priority. Consequently, this policy should be abolished, not because any attempt to implement it has failed, and not because it costs taxpayers and food consumers unnecessary billions of dollars, but because-if implemented-it might kill people instead of saving them.
© The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Entities:  

Keywords:  blood pressure; cardiovascular; clinical trial; epidemiology; meta-analysis

Mesh:

Substances:

Year:  2016        PMID: 27488354     DOI: 10.1093/ndt/gfw280

Source DB:  PubMed          Journal:  Nephrol Dial Transplant        ISSN: 0931-0509            Impact factor:   5.992


  4 in total

Review 1.  Biochemical interaction of salt sensitivity: a key player for the development of essential hypertension.

Authors:  Imran Kazmi; Waleed Hassan Al-Maliki; Haider Ali; Fahad A Al-Abbasi
Journal:  Mol Cell Biochem       Date:  2020-10-18       Impact factor: 3.396

Review 2.  Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

Authors:  Niels Albert Graudal; Thorbjorn Hubeck-Graudal; Gesche Jurgens
Journal:  Cochrane Database Syst Rev       Date:  2017-04-09

3.  Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

Authors:  Niels Albert Graudal; Thorbjørn Hubeck-Graudal; Gesche Jurgens
Journal:  Cochrane Database Syst Rev       Date:  2020-12-12

Review 4.  Sodium and Health: Old Myths and a Controversy Based on Denial.

Authors:  Francesco P Cappuccio; Norm R C Campbell; Feng J He; Michael F Jacobson; Graham A MacGregor; Elliott Antman; Lawrence J Appel; JoAnne Arcand; Adriana Blanco-Metzler; Nancy R Cook; Juliet R Guichon; Mary R L'Abbè; Daniel T Lackland; Tim Lang; Rachael M McLean; Marius Miglinas; Ian Mitchell; Frank M Sacks; Peter S Sever; Meir Stampfer; Pasquale Strazzullo; Wayne Sunman; Jacqui Webster; Paul K Whelton; Walter Willett
Journal:  Curr Nutr Rep       Date:  2022-02-14
  4 in total

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