Franz H Messerli1,2,3, Louis Hofstetter1, Lamprini Syrogiannouli4, Emrush Rexhaj1, George C M Siontis1, Christian Seiler1, Sripal Bangalore5. 1. Swiss Cardiovascular Center, Bern University Hospital, University of Bern, Freiburgstr. 18, Bern 3010, Switzerland. 2. Jagiellonian University, Krakow, Poland. 3. Division of Cardiology, Mount Sinai Health Medical Center, Icahn School of Medicine, New York, NY, USA. 4. Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. 5. The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, USA.
Abstract
AIMS: Since dietary sodium intake has been identified as a risk factor for cardiovascular disease and premature death, a high sodium intake can be expected to curtail life span. We tested this hypothesis by analysing the relationship between sodium intake and life expectancy as well as survival in 181 countries worldwide. METHODS AND RESULTS: We correlated age-standardized estimates of country-specific average sodium consumption with healthy life expectancy at birth and at age of 60 years, death due to non-communicable diseases and all-cause mortality for the year of 2010, after adjusting for potential confounders such as gross domestic product per capita and body mass index. We considered global health estimates as provided by World Health Organization. Among the 181 countries included in this analysis, we found a positive correlation between sodium intake and healthy life expectancy at birth (β = 2.6 years/g of daily sodium intake, R2 = 0.66, P < 0.001), as well as healthy life expectancy at age 60 (β = 0.3 years/g of daily sodium intake, R2 = 0.60, P = 0.048) but not for death due to non-communicable diseases (β = 17 events/g of daily sodium intake, R2 = 0.43, P = 0.100). Conversely, all-cause mortality correlated inversely with sodium intake (β = -131 events/g of daily sodium intake, R2 = 0.60, P < 0.001). In a sensitivity analysis restricted to 46 countries in the highest income class, sodium intake continued to correlate positively with healthy life expectancy at birth (β = 3.4 years/g of daily sodium intake, R2 = 0.53, P < 0.001) and inversely with all-cause mortality (β = -168 events/g of daily sodium intake, R2 = 0.50, P < 0.001). CONCLUSION: Our observation of sodium intake correlating positively with life expectancy and inversely with all-cause mortality worldwide and in high-income countries argues against dietary sodium intake being a culprit of curtailing life span or a risk factor for premature death. These data are observational and should not be used as a base for nutritional interventions. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Since dietary sodium intake has been identified as a risk factor for cardiovascular disease and premature death, a high sodium intake can be expected to curtail life span. We tested this hypothesis by analysing the relationship between sodium intake and life expectancy as well as survival in 181 countries worldwide. METHODS AND RESULTS: We correlated age-standardized estimates of country-specific average sodium consumption with healthy life expectancy at birth and at age of 60 years, death due to non-communicable diseases and all-cause mortality for the year of 2010, after adjusting for potential confounders such as gross domestic product per capita and body mass index. We considered global health estimates as provided by World Health Organization. Among the 181 countries included in this analysis, we found a positive correlation between sodium intake and healthy life expectancy at birth (β = 2.6 years/g of daily sodium intake, R2 = 0.66, P < 0.001), as well as healthy life expectancy at age 60 (β = 0.3 years/g of daily sodium intake, R2 = 0.60, P = 0.048) but not for death due to non-communicable diseases (β = 17 events/g of daily sodium intake, R2 = 0.43, P = 0.100). Conversely, all-cause mortality correlated inversely with sodium intake (β = -131 events/g of daily sodium intake, R2 = 0.60, P < 0.001). In a sensitivity analysis restricted to 46 countries in the highest income class, sodium intake continued to correlate positively with healthy life expectancy at birth (β = 3.4 years/g of daily sodium intake, R2 = 0.53, P < 0.001) and inversely with all-cause mortality (β = -168 events/g of daily sodium intake, R2 = 0.50, P < 0.001). CONCLUSION: Our observation of sodium intake correlating positively with life expectancy and inversely with all-cause mortality worldwide and in high-income countries argues against dietary sodium intake being a culprit of curtailing life span or a risk factor for premature death. These data are observational and should not be used as a base for nutritional interventions. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Bryan Williams; Giuseppe Mancia; Wilko Spiering; Enrico Agabiti Rosei; Michel Azizi; Michel Burnier; Denis L Clement; Antonio Coca; Giovanni de Simone; Anna Dominiczak; Thomas Kahan; Felix Mahfoud; Josep Redon; Luis Ruilope; Alberto Zanchetti; Mary Kerins; Sverre E Kjeldsen; Reinhold Kreutz; Stephane Laurent; Gregory Y H Lip; Richard McManus; Krzysztof Narkiewicz; Frank Ruschitzka; Roland E Schmieder; Evgeny Shlyakhto; Costas Tsioufis; Victor Aboyans; Ileana Desormais Journal: Eur Heart J Date: 2018-09-01 Impact factor: 29.983
Authors: Joshua A Salomon; Haidong Wang; Michael K Freeman; Theo Vos; Abraham D Flaxman; Alan D Lopez; Christopher J L Murray Journal: Lancet Date: 2012-12-15 Impact factor: 79.321
Authors: Safi U Khan; Muhammad U Khan; Haris Riaz; Shahul Valavoor; Di Zhao; Lauren Vaughan; Victor Okunrintemi; Irbaz Bin Riaz; Muhammad Shahzeb Khan; Edo Kaluski; M Hassan Murad; Michael J Blaha; Eliseo Guallar; Erin D Michos Journal: Ann Intern Med Date: 2019-07-09 Impact factor: 25.391
Authors: Kirsten Bibbins-Domingo; Glenn M Chertow; Pamela G Coxson; Andrew Moran; James M Lightwood; Mark J Pletcher; Lee Goldman Journal: N Engl J Med Date: 2010-01-20 Impact factor: 91.245
Authors: Katie A Meyer; Lisa J Harnack; Russell V Luepker; Xia Zhou; David R Jacobs; Lyn M Steffen Journal: J Am Heart Assoc Date: 2013-10-02 Impact factor: 5.501
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