Doctor's Review: Medicine on the Move

October 27, 2021

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Less salt doesn't lower blood pressure?

A new study in the May 2011 issue of the Journal of the American Medical Association has challenged the long-held belief that consuming more sodium is linked to a higher incidence of high blood pressure and a greater risk of dying from a stroke.(1)

The study, which evaluated urinary sodium excretion in 3681 middle-aged Europeans without CVD, showed that the individuals who excreted less sodium were more likely to die of CVD. The study also indicated that systolic blood pressure was more likely to change with the change in sodium excretion. The publication of this study has added fuel to the already heated debate regarding the role that sodium plays.

What’s being said?

Many experts are saying that the results of this study cannot be extrapolated to a North American population which has a more diverse genetic background.(2) Others are applauding, saying that the study confirms one published in 2008 that used data collected in the Third National Health and Nutrition Examination Survey (NHANES III) that looked at sodium consumption and the incidence of CVD mortality.(3)

The findings suggested that there was a small but not statistically significant relationship between low sodium consumption and an increase in CVD deaths. Although this study was US-based with more participants, the sodium consumption was calculated using information obtained during a 24-hour diet recall. Though far from conclusive, it does question whether decreasing sodium intake is necessary.

What’s happening in Canada?

The more recent study on food consumption in Canada showed that all Canadians routinely consume more sodium than recommended, although we eat slightly less than Americans. Most is consumed as sodium chloride, and almost 77 percent of the daily intake is found in processed foods.(4)

To reduce the sodium in our food, Health Canada established the Sodium Working Group, which submitted a plan to reduce sodium levels by 2016.(5) However, the group has been disbanded and it’s unclear whether its recommendations will be implemented.(6) In the meantime, the Health Check Program, which is an independent third-party program, has developed criteria to help companies offer healthier, lower-sodium choices.

What should we tell patients?

Based on the DASH diet study, we know that consuming moderate amounts of sodium is one part of a diet to lower blood pressure. It’s also important to maintain a healthy weight, consume adequate potassium, magnesium and other nutrients. The same study that claims Canadians consume too much sodium also tells us that we’re not eating enough other essential nutrients. Instead of eliminating sodium, maybe it’s time to focus on great tasting foods that provide the nutrients patients need.

This article was accurate when it was published. Please confirm rates and details directly with the companies in question.


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