Conflicting Evidence on Health Effects Associated with Salt Reduction Calls for a Redesign of the Salt Dietary Guidelines

TY - JOUR

T1 - Conflicting Evidence on Health Effects Associated with Salt Reduction Calls for a Redesign of the Salt Dietary Guidelines

AU - Graudal, Niels

AU - Jürgens, Gesche

N1 - Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Ninety-five percent of the World's populations have a mean salt intake between 6 and 12 g, which is much lower than the tolerated daily level of up to 55 g/d. In spite of this, the recommended upper level by many health institutions is as low as 5.8 g/day. When reviewing the evidence for an upper level of 5.8 g/day, it becomes apparent that neither the supporting studies selected by the health institutions, nor randomized controlled trials and prospective observational studies disregarded by the health institutions, document that a salt intake below this 5.8 g, has beneficial health effects. Although there is an association between salt intake and blood pressure, both in randomized controlled trials and in observational studies, this association is weak, especially in non-obese individuals with normal blood pressure. Furthermore a salt intake below 5.8 g is associated with the activation of the renin-angiotensin-aldosteron system, an increase in plasma lipids and increased mortality. A redesign of the salt dietary guidelines, therefore, seems to be needed.

AB - Ninety-five percent of the World's populations have a mean salt intake between 6 and 12 g, which is much lower than the tolerated daily level of up to 55 g/d. In spite of this, the recommended upper level by many health institutions is as low as 5.8 g/day. When reviewing the evidence for an upper level of 5.8 g/day, it becomes apparent that neither the supporting studies selected by the health institutions, nor randomized controlled trials and prospective observational studies disregarded by the health institutions, document that a salt intake below this 5.8 g, has beneficial health effects. Although there is an association between salt intake and blood pressure, both in randomized controlled trials and in observational studies, this association is weak, especially in non-obese individuals with normal blood pressure. Furthermore a salt intake below 5.8 g is associated with the activation of the renin-angiotensin-aldosteron system, an increase in plasma lipids and increased mortality. A redesign of the salt dietary guidelines, therefore, seems to be needed.

KW - Blood Pressure

KW - Diet, Sodium-Restricted/adverse effects

KW - Dietary Approaches To Stop Hypertension/adverse effects

KW - Evidence-Based Medicine

KW - Hormones/blood

KW - Humans

KW - Hypertension/diet therapy

KW - Lipids/blood

KW - Recommended Dietary Allowances

KW - Renin-Angiotensin System

KW - Risk Factors

KW - Sodium Chloride, Dietary/adverse effects

U2 - 10.1016/j.pcad.2018.04.008

DO - 10.1016/j.pcad.2018.04.008

M3 - Journal article

C2 - 29727609

SN - 0033-0620

VL - 61

SP - 20

EP - 26

JO - Progress in Cardiovascular Diseases

JF - Progress in Cardiovascular Diseases

IS - 1

ER -