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Jul 24, 2016

Too Much and Too Little Salt is Associated with Increased Heart Risks

Study links a low-sodium diet to increased risk in healthy adults, though most Americans consume excess sodium.

Moderation is key when it comes to sodium intake, based on study findings that link low sodium diets to increased cardiovascular risk in healthy adults.

Published in The Lancet, this study looked at the effects of sodium in adults with and without high blood pressure. It’s well established that high sodium intake increases risk for high blood pressure, heart events and death. That’s why guidelines suggest that all Americans consume less than 2,300 mg of sodium each day—the equivalent to 1 teaspoon of salt.  However, too little salt can be just as harmful, since our bodies need sodium to function properly. Experts wonder if sodium restriction is beneficial in all adults or just those with high blood pressure.

To learn more, researchers analyzed data from four large studies that included more than 133,000 adults from 49 different countries. All studies used 24-hour urine samples to assess sodium consumption and followed participants for over four years, tracking key outcomes like heart events and death.

Overall, roughly half of study participants had high blood pressure. After analysis, researchers found that sodium intake affected adults with and without hypertension differently.

In both groups, low sodium intake (less than 3,000 mg/day) was associated with 26–34% greater risk for heart events and death compared to moderate sodium intake (4,000–5,000 mg/day). However, high sodium intake (more than 7,000 mg/day) only increased risk for heart events and death in adults with hypertension.

Findings suggest that a low-sodium diet may not be for everyone. As other studies have shown, too little salt can be harmful in adults with and without hypertension. Authors believe current guidelines may be too low for the general population.

However, that doesn’t mean that sodium guidelines should be thrown out the window. There’s no question that a low-sodium diet is important for patients with high blood pressure. In this study, high sodium intake increased blood pressure much more in patients with hypertension than those without. High sodium diets significantly increased risk for heart attack, stroke and death in patients with hypertension. Therefore, authors suggest that lowering sodium intake should mainly be targeted at adults with hypertension and high sodium diets. The average American consumes excess sodium, so the 2,300 mg/day guidelines still hold true without further research. As they learn more, experts hope to refine sodium guidelines for patients with and without high blood pressure.

Questions for You to Consider

  • What foods should I avoid when trying to limit sodium intake?

  • While many foods naturally contain small amounts of sodium, it is estimated that 75 percent of dietary sodium comes from processed foods. When limiting salt intake, try to avoid prepared meals and limit consumption of condiments, canned and frozen foods, and packaged snacks, which contain some of the highest concentrations of sodium. Always read food labels when possible to help accurately measure your salt intake each day.
  • What can I do to reduce my sodium intake?
  • Most of the sodium you get each day comes from processed foods rather than salt you use in cooking and at the table. Here are some tips to help you shake the sodium out of your diet: 

    • Avoid prepared foods. High sodium foods include:

      • Salty snacks such as chips and pretzels
      • Canned soups and sauces
      • Cured meats such as bacon and ham
      • Foods packed in salt water such as pickles, olives, and canned tuna
      • Frozen pizzas and dinners
      • Fast food

    • Use fresh foods whenever possible. Good choices include:

      • Fresh, frozen, or canned vegetables without added salt
      • Fresh meats, fish, and poultry rather than cooked or prepared items
      • Herbs and spices as seasoning instead than salt

    • Learn to read food labels.  Look at the “Nutrition Facts” panel on the label of packaged foods. This will tell you how much sodium is in the food.  When figuring out your sodium intake from the food label, keep in mind:

      • The milligrams (mg) listed is per serving. It is not for the whole package.  If you eat more or less than what they consider one serving, you’ll have to do the math to figure out how much sodium you are getting.

      • The percent of daily value (% DV) is based on 2400 mg a day, not the recommended 1500 mg. That means the sodium in a serving is a higher percent of your daily limit than what is listed on the label.

    • Choose carefully in restaurants. Restaurant food is high in sodium. Some ways to eat out and still keep your sodium level under control include:

      • Having your meal prepared without added salt
      • Asking that sauces, gravies, and salad dressings be served on the side
      • Selecting fresh vegetables, fruits, and salads and plain meats or fish from the menu

Featured Video

Processed foods are responsible for 75% of the excessive sodium consumed by Americans.


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