The Journal of the American Medical Association released a study last month with findings that may shock the nutrition world. This is quite an interesting follow up to my latest DASH diet review. This study finds a low sodium diet could increase cardiovascular risk.
The Journal of the American Medical Association study included 3,681 middle aged Europeans with no prior heart disease or complications. The participants reported salt intake and had sodium excretion measured in their urine. According to the study this was the most precise way to measure sodium usage in the body.
This study found, surprisingly, that those with lower salt intake were more likely to die of heart disease. The participants were divided into three groups: low consumption (2.5 g per day), moderate consumption (3.9 g per day) and high consumption (6.0 g per day). The low consumption group experienced 50 deaths (4.1%). The moderate consumption group had 24 deaths (1.9%). The high consumption only had 10 deaths (0.8%).
Physicians who have reviewed this study find it rather flawed. Those who consumed the least amount of sodium provided less urine (meaning the participants may not have collected urine for the full 24 hours.) This study also only surveyed a small population of healthy people with no previous cardiac events. The Center for Disease Control found this study extremely flawed and actually criticized the study overall. They state since it goes against all other current evidence it should be “taken with a grain of salt.” According to the physician I work for right now (Dr. Jorge Prada), healthy individuals who undergo a low sodium diet tend to have higher health risk. When the body lacks a nutrient it tries to save as much as it can. A low sodium diet in unnecessary conditions could cause and increase in sodium retention.
I personally stand by my previous recommendation to monitor sodium intake. This seems to be the only modern published study of its kind and I am not willing to change my nutrition recommendations based on it. From personal experience in my nutrition practice, I have seen blood pressure drop to normal levels within a month of a low sodium diet (1.5-1.8 g per day). We have patients who end up removing their blood pressure medication simply by changing the food they eat. Our biggest diet recommendations are to avoid processed foods and restaurant foods (those typically highest in sodium.)
Image credit to creative commons user dixieroadrash