To Salt or Not to Salt?

Salt is getting a lot of press these days.  The 2010 Dietary Guidelines urged Americans to limit salt consumption to a teaspoon per day, and recommended lower intakes for those who have hypertension, are older than 50 or are African American.  However, recent publications in the American Journal of Hypertension and Scientific American questioned the notion that lower sodium diets help prevent deaths from cardiovascular disease.  So, is it time to pour on the salt?  Maybe not.  Although salt is a necessary nutrient, and in moderation has an important place in a healthy diet, there is much that is not known about how individuals respond to sodium.  First, many of the studies examining salt and blood pressure risk are just a few months long (high blood pressure and heart disease can take years to develop) or are based on patients’ recollection of foods they ate, which can be inaccurate.  Second, the small decreases in blood pressure reported with lower sodium diets, though seemingly insignificant on their own, can be augmented by an overall healthy lifestyle that includes physical activity and weight management and can serve as one of many factors that reduce heart disease risk, as seen in patients who combined the lower sodium DASH diet with exercise.  Finally, not all individuals respond to sodium in the same way, and for those who are sodium sensitive, a low sodium diet may make a difference.

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