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Is sodium unhealthy?
jc3737 posted:
Curr Opin Cardiol. 2007 Jul;22(4):306-10. Sodium, blood pressure, and cardiovascular disease. Cohen HW , Alderman MH . SourceDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Abstract PURPOSE OF REVIEW: Persistent recommendations for universal restriction of dietary sodium intake are based on associations of sodium intake with blood pressure. No clinical trial data support an association of sodium intake with mortality and morbidity outcomes, however, while results of observational studies appear heterogeneous. Can these contradictory data be reconciled to inform health policy regarding sodium intake recommendations?
RECENT FINDINGS: We reported (2006) a statistically significant (P = 0.03) association of sodium intake less than 2.3 g/day with increased cardiovascular disease mortality (hazard ratio 1.37) in a representative sample of the US adult population with an observed baseline mean sodium intake of 2.7 g/day. Others reported (2004) a significant (P < 0.01) higher stroke death among males and borderline significant (P = 0.07) for females, for highest compared with lowest sodium tertile in a community in Japan with mean intake of 5.4 g/day.
SUMMARY: These results are consistent with earlier studies suggesting that the association of sodium with morbidity and mortality in industrial societies follows a 'J shape' with a direct association at high levels of average intake (over 4 g), an inverse association at lower levels (less than 2 g) and no measurable effect for the widely prevalent intakes in between.
PMID: 17556882 [PubMed - indexed for MEDLINE>
jc3737 responded:
very mixed data

Am J Med. 2006 Mar;119(3):275.e7-14. Sodium intake and mortality in the NHANES II follow-up study. Cohen HW , Hailpern SM , Fang J , Alderman MH . SourceDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Abstract PURPOSE: US Dietary Guidelines recommend a daily sodium intake <2300 mg, but evidence linking sodium intake to mortality outcomes is scant and inconsistent. To assess the association of sodium intake with cardiovascular disease (CVD) and all-cause mortality and the potential impact of dietary sodium intake <2300 mg, we examined data from the Second National Health and Nutrition Examination Survey (NHANES II).
METHODS: Observational cohort study linking sodium, estimated by single 24-hour dietary recall and adjusted for calorie intake, in a community sample (n = 7154) representing 78.9 million non-institutionalized US adults (ages 30-74). Hazard ratios (HR) for CVD and all-cause mortality were calculated from multivariable adjusted Cox models accounting for the sampling design.
RESULTS: Over mean 13.7 (range: 0.5-16. years follow-up, there were 1343 deaths (541 CVD). Sodium (adjusted for calories) and sodium/calorie ratio as continuous variables had independent inverse associations with CVD mortality (P = .03 and P = .008, respectively). Adjusted HR of CVD mortality for sodium <2300 mg was 1.37 (95% confidence interval [CI>: 1.03-1.81, P = .033), and 1.28 (95% CI: 1.10-1.50, P = .003) for all-cause mortality. Alternate sodium thresholds from 1900-2700 mg gave similar results. Results were consistent in the majority of subgroups examined, but no such associations were observed for those <55 years old, non-whites, or the obese.
CONCLUSION: The inverse association of sodium to CVD mortality seen here raises questions regarding the likelihood of a survival advantage accompanying a lower sodium diet. These findings highlight the need for further study of the relation of dietary sodium to mortality outcomes.
jc3737 replied to jc3737's response:
In findings involving 2,564 people in the large, multi-ethnic Northern Manhattan Study (NOMAS), scientists said people who drank diet soda every day had a 61 percent higher risk of vascular events than those who reported no soda drinking.
"If our results are confirmed with future studies, then it would suggest that diet soda may not be the optimal substitute for sugar-sweetened beverages for protection against vascular outcomes," said Hannah Gardener, Sc.D., lead author and epidemiologist at the University of Miami Miller School of Medicine in Miami, Fla.
In separate research using 2,657 participants also in the Manhattan study, scientists found that high salt intake, independent of the hypertension it causes, was linked to a dramatically increased risk of ischemic strokes (when a blood vessel blockage cuts off blood flow to the brain).
In the study, people who consumed more than 4,000 milligrams (mg) per day of sodium had more than double the risk of stroke compared to those consuming less than 1,500 mg per day.
At the start of both studies, researchers assessed diet by a food frequency questionnaire.
NOMAS is a collaboration of investigators at Columbia University in New York and Miami's Miller School of Medicine, launched in 1993 to examine stroke incidence and risk factors in a multi-ethnic urban population. A total of 3,298 participants over 40 years old (average age 69) were enrolled through 2001 and continue to be followed. Sixty-three percent were women, 21 percent were white, 24 percent black and 53 percent Hispanic.
In the soda study, researchers asked subjects at the outset to report how much and what kind of soda they drank. Based on the data, they grouped participants into seven consumption categories: no soda (meaning less than one soda of any kind per month); moderate regular soda only (between one per month and six per week), daily regular soda (at least one per day); moderate diet soda only; daily diet soda only; and two groups of people who drink both types: moderate diet and any regular, and daily diet with any regular.
During an average follow-up of 9.3 years, 559 vascular events occurred (including ischemic and hemorrhagic stroke, which is caused by rupture of a weakened blood vessel). Researchers accounted for participants' age, sex, race or ethnicity, smoking status, exercise, alcohol consumption and daily caloric intake. And even after researchers also accounted for patients' metabolic syndrome, peripheral vascular disease and heart disease history, the increased risk persisted at a rate 48 percent higher.
In the sodium research, 187 ischemic strokes were reported during 9.7 years of follow-up. Stroke risk, independent of hypertension, increased 16 percent for every 500 mg of sodium consumed a day, the scientists calculated. Those figures included adjustment for age, sex, race/ethnicity, education, alcohol use, exercise, daily caloric intake, smoking status, diabetes, high cholesterol, high blood pressure and previous heart disease.
Only a third of participants met the current U.S. Dietary Guidelines for Americans that recommend daily sodium intake fall below 2,300 mg, or
DoloresTeresa responded:
oops. I didn't see this and posted something similar.

jc3737 replied to DoloresTeresa's response:
from the study

"the study, people who consumed more than 4,000 milligrams (mg) per day of sodium had more than double the risk of stroke compared to those consuming less than 1,500 mg per day".

I have no idea who is right on this issue but I know that personally I am not able to tolerate any salt at all....not even a pinch and I probably get less than 500mg per day....only that found in vegetables.

I see studies that reach oppopsite conclusions,but aren't there societies that don't consume any salt?

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Long-time fan of the Diet Debate-though infrequent contributor to the discussion.

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