Dietary Sodium Restriction: Take It With a Grain of Salt

Am J Med. 2013 Nov;126(11):951-5. doi: 10.1016/j.amjmed.2013.05.020. Epub 2013 Sep 18.

Abstract

The American Heart Association recently strongly recommended a dietary sodium intake of <1500 mg/d for all Americans to achieve "Ideal Cardiovascular Health" by 2020. However, low sodium diets have not been shown to reduce cardiovascular events in normotensive individuals or in individuals with pre-hypertension or hypertension. Moreover, there is evidence that a low sodium diet may lead to a worse cardiovascular prognosis in patients with cardiometabolic risk and established cardiovascular disease. Low sodium diets may adversely affect insulin resistance, serum lipids, and neurohormonal pathways, leading to increases in the incidence of new cardiometabolic disease, the severity of existing cardiometabolic disease, and greater cardiovascular and all-cause mortality. Although a high sodium intake also may be deleterious, there is good reason to believe that sodium intake is regulated within such a tight physiologic range that there is little risk to leaving sodium intake to inherent biology as opposed to likely futile attempts at conscious control.

Keywords: Cardiology; Cardiovascular health; Public health; Salt; Sodium.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / diet therapy
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diet therapy
  • Diet, Sodium-Restricted / adverse effects*
  • Humans
  • Hypertension / diet therapy
  • Hypertension / etiology
  • Hypertension / prevention & control
  • Recommended Dietary Allowances
  • Risk Factors
  • Sodium, Dietary / adverse effects
  • United States

Substances

  • Sodium, Dietary