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. 2006 Mar;119(3):275.e7-14.
doi: 10.1016/j.amjmed.2005.10.042.

Sodium Intake and Mortality in the NHANES II Follow-Up Study


Sodium Intake and Mortality in the NHANES II Follow-Up Study

Hillel W Cohen et al. Am J Med. .


Purpose: US Dietary Guidelines recommend a daily sodium intake <2300 mg, but evidence linking sodium intake to mortality outcomes is scant and inconsistent. To assess the association of sodium intake with cardiovascular disease (CVD) and all-cause mortality and the potential impact of dietary sodium intake <2300 mg, we examined data from the Second National Health and Nutrition Examination Survey (NHANES II).

Methods: Observational cohort study linking sodium, estimated by single 24-hour dietary recall and adjusted for calorie intake, in a community sample (n = 7154) representing 78.9 million non-institutionalized US adults (ages 30-74). Hazard ratios (HR) for CVD and all-cause mortality were calculated from multivariable adjusted Cox models accounting for the sampling design.

Results: Over mean 13.7 (range: 0.5-16.8) years follow-up, there were 1343 deaths (541 CVD). Sodium (adjusted for calories) and sodium/calorie ratio as continuous variables had independent inverse associations with CVD mortality (P = .03 and P = .008, respectively). Adjusted HR of CVD mortality for sodium <2300 mg was 1.37 (95% confidence interval [CI]: 1.03-1.81, P = .033), and 1.28 (95% CI: 1.10-1.50, P = .003) for all-cause mortality. Alternate sodium thresholds from 1900-2700 mg gave similar results. Results were consistent in the majority of subgroups examined, but no such associations were observed for those <55 years old, non-whites, or the obese.

Conclusion: The inverse association of sodium to CVD mortality seen here raises questions regarding the likelihood of a survival advantage accompanying a lower sodium diet. These findings highlight the need for further study of the relation of dietary sodium to mortality outcomes.

Comment in

  • Salt intake and cardiovascular mortality.
    He FJ, de Wardener HE, MacGregor GA. He FJ, et al. Am J Med. 2007 Jan;120(1):e5; author reply e7. doi: 10.1016/j.amjmed.2006.03.019. Am J Med. 2007. PMID: 17208066 No abstract available.
  • [Does salt prolong your life?].
    Resch KL. Resch KL. Forsch Komplementmed. 2007 Jun;14(3):184-5. Forsch Komplementmed. 2007. PMID: 17717902 German. No abstract available.

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