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Sodium Reduction May Save Hundreds of Thousands of Lives

Less sodium in Americans’ diets could save as many as 500,000 lives over 10 years, according to new research in the American Heart Association journal Hypertension.

Using computer simulations and models, researchers projected the effects of small, steady annual reductions of sodium consumption in the US diet (about 5% of 1 tsp of salt per person per day), reducing sodium consumption by 40% to about 2,200 mg/day over 10 years.

Among the key study findings are the following:

  • A gradual reduction in sodium consumption by 40% to about 2,200 mg/day over 10 years is projected to save hundreds of thousands of lives—between 280,000 and 500,000 depending on the modeled assumptions.
  • About 60% more deaths could be averted over this time period if the same reductions could be achieved more quickly (500,000 to 850,000 lives).

Three research groups contributed to the study, with each using a different approach for their simulation. One approach used observational cardiovascular outcome follow-up data, while the other two based their projections on established evidence that salt reduction lowers blood pressure. These two groups inferred the cardiovascular effects of reducing sodium from data about the relationship of blood pressure to cardiovascular disease.

“The research groups used the same target populations and baseline death rates for each projection, and our study found that the different sources of evidence for the cardiovascular effects of sodium led to similar projected outcomes,” says Pamela Coxson, PhD, lead study author and a mathematics specialist in the department of medicine at the University of California, San Francisco (UCSF).

“It is helpful when three research groups use different approaches and come up with similar results,” says Kirsten Bibbins-Domingo, PhD, MD, senior study author, and an associate professor of medicine at UCSF and the director of the UCSF Center for Vulnerable Populations.

The three approaches included a gradual reduction of sodium by 40%, instant reduction of sodium by 40%, or instant reduction to no more than 1,500 mg/day. According to the researchers, only the first scenario is a potentially achievable public health goal.

Currently the US food supply makes it difficult for Americans to choose lower-sodium foods and achieve recommended daily levels. Americans consume an average of 3,600 mg of sodium per day, with about 80% coming from commercially prepared and processed foods, according to the researchers.

Excessive sodium intake contributes to high blood pressure, which increases the risk of heart attacks, strokes, and other cardiovascular diseases. In the United States, cardiovascular disease is the leading cause of death, and nearly one-half of these deaths are related to high blood pressure.

“These findings strengthen our understanding that sodium reduction is beneficial to people at all ages,” Coxson says. “Even small, gradual reductions in sodium intake would result in substantial mortality benefits across the population.”

“Such gradual reductions could be achieved through a combination of consumer education and food labeling but should likely also include regulation to assure that lower sodium options are available for US consumers,” Bibbins-Domingo says.

— Source: American Heart Association