Boynton Beach, Fla Dr. G photo. (When I was in practice, everybody called me “Dr. G.” except the overhead pager at the hospital. Then half the visitors would think of a proctology joke.)
The Los Angeles Times (2/12, Healy, 692K) “Booster Shots” blog reports that a new study published Tuesday in the American Heart Association’s journal Hypertension found that “steadily reducing sodium in the foods we buy and eat could save a half-million Americans from dying premature deaths over a decade.” An immediate 40% reduction in salt intake could also increase the amount of lives saved this decade to 850,000. The estimates come from three separate teams from the University of California-San Francisco, Harvard University’s School of Public Health, and Canada’s Simon Fraser University “crunching the numbers” and reaching “estimates independently.” Americans consume over 3,600 milligrams of sodium daily, and the teams agreed if this were to be reduced to 1,500, “as many as 1.2 million premature deaths could be averted over the course of a decade.”
Blogfinger Medical Commentary by Paul Goldfinger, MD, FACC
On Feb 5, we ran a post about the definition of controlled hypertension: click here
And here is a link to our prior article on how much salt to eat: click here
The AMA article above focuses on therapy and prevention through reducing dietary salt. The mortality statistics are astonishing.
A brief introduction to salt chemistry may be helpful. Salt is composed of sodium and chloride, i.e. salt is sodium chloride (NaCl). Each molecule contains one part sodium and one part chloride. The sodium is the important component in terms of salt/health issues.
If your doctor speaks of a low salt diet, then he is referring to sodium chloride (i.e. table salt and salt from foods.) One gram of salt contains 1,000 mg (milligrams) of sodium chloride (salt). About half of that is sodium. So if you are on a low salt diet, and your doctor suggests 4 grams of salt per day, it means that you would consume 2 grams (ie 2,000 mg) of sodium each day. If your doctor suggests a low sodium diet and he stipulates that you consume 2,000 mg of sodium per day, then your salt intake would be a total of 4 grams of salt (i.e. 2 grams of sodium). 1 teaspoon of salt contains 2,300 mg. of sodium. It doesn’t take much to reach the desired daily intake goal.
You need to understand this in order to read food labels. ( see our link about salt above) It’s best to avoid confusion by focusing on sodium, since that is how most labels are written. You must be careful, because one can of soup might contain up to 1000 mg. of sodium. Most of our dietary sodium comes from packaged processed foods.
You would do well to read the LA Times article above (just click the link above in the AMA section).
I also promised an article about various non-drug ways to reduce high blood pressure, and that will happen, but this one is particularly important because of the latest mortality stats. If you have hypertension in your family, you should reduce salt intake to at least 2,000 mg. per day. If you have hypertension, your sodium intake should be even lower. Discuss the details with your physician.
Avoid processed foods with high salt intake and learn not to add salt at the table. You can adjust to that, even if you were raised with a lot of salt in your food. Both my parents had high blood pressure, and I always thought that I would too (there is a genetic element), but my BP has remained normal, which I partially attribute to a careful low salt diet.
In the article cited, it is recommended that we all reduce our sodium intake. If you do not have hypertension, there is a substantial risk that you will develop the problem as you get older; it is very prevalent. Salt intake is correlated with risk of developing hypertension, and hypertension is correlated with the development of life-threatening cardiovascular diseases and their complications. This has been repeatedly shown in studies from all over the world. The usual figure is that 45% of cardiovascular disease is related to high blood pressure. (source: American Heart Assoc.)
In the JNC-7 national guidelines paper on preventing cardiovascular disease, they place sodium restriction under the heading “Lifestyle modifications to prevent and manage high blood pressure.”
Certainly, if you have hypertension or a family history, you should reduce your intake of sodium down to 1,500 to 2,000 mg. per day. In this American Heart Association paper they recommend salt reduction “population wide” to achieve a “direct effect on cardiovascular mortality.” They use computer modeling to predict the effects over the next 10 years. Note that cardiovascular risk is multifactorial, and many of the relationships are not definitively proven,but the body of evidence tells us to reduce salt intake even in young people.
You should discuss your individual risk profile with your physician. Guidelines are general recommendations, and we all have individual variations in our prevention and treatment requirements.
Paul, in your linked post you write “We all should try to keep our sodium intake under 2,000 mg.” I wonder why. Does salt intake have any deleterious effect on people who don’t have high blood pressure or a history of it? It strikes me that salt is often lumped together with sugar and fat as things that are just per se bad for you, when I never hear an explanation of why a healthy person who is not at risk on the blood pressure front should care how much salt they consume.
But of course, I am far from a doctor. I’m curious if I’m totally off-base.
Cheers.
Al