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February is the federally declared "American Heart Month." With that comes a barrage of advice about how to prevent heart disease, including putting down the salt shaker. But where is the science supporting that recommendation?
A study published in the Journal of the American Medical Association argues that, contrary to all the advice you've heard, lower sodium is actually associated with an INCREASED risk of cardiovascular death. In addition, the study concludes higher sodium levels do not correspond with increased hypertension or cardiovascular disease complications.
Researchers at the University of Leuven, Belgium examined the incidence of death, illness and hypertension in relation to the amounts of sodium excreted in urine. Participants included 3,681 people without cardiovascular disease at the beginning of the study.
According to the article, the risk of death from heart disease was significantly higher in those with the lowest sodium (a death rate of 4.1%) compared to those with the highest sodium levels (less than 1%). The authors found baseline sodium levels did not predict total mortality or either fatal or nonfatal cardiovascular events.
And with respect to high blood pressure, there was no association between urinary sodium levels and hypertension.
What they found is the opposite of the American Heart Association advice. The AHA claims 1 of every 10 Americans dies from eating too much salt. That's based on a Harvard study using computer modeling to also estimate that 2.3 million people worldwide died of too much salt in 2010. The study recommended that dietary sodium be cut to 1,000 milligrams per day.
According to the authors of the JAMA study their findings "refute the estimates of computer models of lives saved and health care costs reduced with lower salt intake. They do also not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level."
The Belgian results are consistent with a meta analysis by the Cochrane Collaboration finding that reductions in the amount of salt people eat doesn't reduce their likelihood of dying or experiencing cardiovascular disease.
The Salt Institute, an industry trade association, pointed out that the Belgian study results indicate there is an increased rate of death for sodium intakes at the levels recommended by the U.S. government's Dietary Guidelines. They called on government agencies like the FDA to stop "their population-wide sodium reduction agenda and amend the Dietary Guidelines on sodium."
The Belgian study confirms previous research indicating that reductions in sodium lead to an increased risk of disease and death. Other studies have shown:
- Low-salt diets lead to higher rates of cardiac events and death
- Low-salt diets are linked to an increase in insulin resistance, a precursor to Type 2 diabetes
- Elderly patients with low sodium levels have more falls and broken hips and a decrease in cognitive abilities.
- Low birth weight babies are also born with low blood sodium levels because their mothers were on low-salt diets, and infants with low sodium levels may be predisposed to poor brain function between the ages of 10 and 13.
Heart disease researchers and public policy advocates have long labeled sodium as the primary dietary factor in the development of high blood pressure and subsequent cardiovascular disease despite the lack of valid scientific data.
Healthy sources of sodium in your diet include eggs, seafood, meats, kelp, seaweed, beets, turnips, Swiss chard, spinach and parsley. Eat these while avoiding processed foods high in added sodium.
Also, replace refined white table salt with high quality unbleached natural sea salt. Unrefined sea salt will have some color to it – grey, pink, yellow, brown, etc. – depending on its source and its mineral content. Good choices to try are Celtic Sea Salt or Himalayan Pink Sea Salt.
To read about the health benefits of salt, check out Dr. David Brownstein's book "Salt – Your Way to Health."