In Sodium Skeptics Try to Shake Up the Salt Debate, he discusses the unequivocal evidence that increased sodium intake is associated with increased blood pressure, which we know leads to increased risk of vascular diseases, like strokes, aneurysms, and atherosclerosis…he quotes the long-time editor-in-chief of the American Journal of Cardiology, “We all must decrease our salt intake!,” a sentiment echoed by many other authorities. So, how is the food industry going to keep the salt controversy alive?!…Big Salt!
Greger points out that campaigns in England were able to successfully bring down salt consumption. There, blood pressures dropped, as did rates of heart disease and stroke. They also successfully brought down cholesterol levels and smoking prevalence, though, and improved fruit and vegetable consumption. In Japan, however, they dropped salt intake while eating a worse diet and smoking more, yet still saw a large reduction in stroke mortality. He points out that Based on what they were able to achieve in Finland, one daily teaspoon of salt may mean between 25 to 50 percent more deaths from heart attacks and strokes. Care with Salt Valid?
We may never get a decade-long randomized trial, but, in 2007, we got something close. There have been randomized trials of sodium reduction, but they didn’t last long enough to provide enough data on clinical outcomes. However with follow up…kind of… indeed, they found that when people cut sodium intake by 25 to 35 percent, they may end up with 25 percent lower risk of heart attacks, strokes, and other cardiovascular events.
What about the new study published in the American Journal of Hypertension that found the amount of salt we are eating is just fine, suggesting a kind of u-shaped curve where too much sodium is bad, but too little could be bad, too? Those biased less towards Big Salt and more towards Big Heart have noted that these studies have been widely misinterpreted, stirring unnecessary controversy and confusion.
If you instead look only at the trials in which they did the gold-standard, 24-hour urine collections in healthy people to avoid the reverse causation and controlled the curve instead there is a continuous decrease of cardiovascular disease (CVD) events like heart attacks and strokes as sodium levels get lower and lower. There was a 17 percent increase in risk of CVD for every gram of sodium a day. And, this is for people without high blood pressure.